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Physical Feeling tired and not sleeping well Changes in weight Feeling bloated, constipated or developing intolerances to food Psychological Preoccupation with eating, food, body shape and weight Body dissatisfaction and shame about their appearance Feelings of extreme distress, sadness, anxiety and guilt during and after a binge eating episode Low self-esteem Increased sensitivity to comments relating to food, weight, body shape, exercise Depression, anxiety, self-harm or suicidality Behavioural Evidence of binge eating such as disappearance or hoarding of food Secretive behaviour around food such as not wanting to eat around others Evading questions about eating and weight Increased isolation and withdrawal from activities previously enjoyed Erratic behaviour such as shoplifting food or spending large amounts of money on food It is never advised to watch and wait