During the holidays, increased social activities and food availability can be stressful for anyone who has body image problems, disordered eating or a full-blown eating disorder. This also presents an opportunity for an astute parent or friend to identify and help prevent a minor problem from snowballing into a major one. Prevention is easier than treating eating disorders.

The natural survival response of humans when food and calories are limited is to become obsessed with finding food until adequate calories have been consumed. Today’s pressures to be lean, however, can override those survival instincts. However, the calorie shortage still causes an obsession with food and can trigger the natural survival response to binge when food is available. This often is followed by attempts to purge the calorie consumption through excessive exercise or even purging attempts like induced vomiting or abuse of laxatives.

QUESTION: What are the signs that someone is teetering toward the edge of an eating disorder?

ANSWER: There are many signs that can signal potential weight and body image problems, as well as an unhealthy relationship with food. Classically we think of an eating disorder being linked to excessive weight loss, as in anorexia nervosa. Well before that stage, however, signs of risk, such as concern with bloating or intense fear of weight gain, can be apparent. This frequently is linked to poor self-esteem and feelings of guilt after eating that may lead to excessive and compulsive exercise.

An increasingly common sign of disordered eating is a fear of food that results in eating only a limited number of "healthy foods." This obsession with eating only healthful food is a disorder termed orthorexia that can readily lead to nutrient deficiencies, especially shortages of iron and zinc. Orthorexia may include eating only nonfat food, drinking water exclusively and strictly avoiding anything with added sugar. Environmental sustainability issues or a new-found vegetarian focus may be used to justify the new eating style.

Possible signs that may be an indication of bulimia include secretive eating that involves bingeing on large amounts of food, immediate visits to the bathroom after meals, preoccupation with food, weight fluctuations, increased anxiety and depression, and attempts to purge calories through either laxative use, vomiting or excessive exercise.

Q: What should be discussed with a loved one who appears to be heading into eating problems?

A: The Alliance for Eating Disorders suggests that a concerned parent or friend first do their homework to learn about eating disorders using its website at www.allianceforeatingdisorders.

com. Then, find a good time and place to talk privately about your sincere concerns with carefully placed words that assure the person of your continued support. Don’t invalidate the loved one’s feelings and struggles, and don’t try to solve his or her problems.

It is best to avoid negative comments or teasing about body weight, shape or size. Also, avoid putting value judgments on foods that label them as "good" and "bad." Encourage physical activities for fun and socializing rather than for "burning" calories.

If it becomes clear that a loved one has developed or seems to be developing disordered eating habits, helping them find acceptable professional help in a supportive way can be the greatest gift.

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Alan Titchenal, Ph.D., C.N.S., and Joannie Dobbs, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii-Manoa. Dobbs also works with University Health Services.