Undereating & Your Health: 7 Signs You Are Undereating

Cherish DeOliveira, Psy.D. • September 21, 2026

Therapy can help you build a better relationship with food.

A person holding silverware sits in front of a plate holding only a small piece of food.

I value that my conversations as a clinical psychologist can be as multifaceted as the humans I interact with on a daily basis. In all of the complexities of what unfolds in a therapy office, I find myself predictably revisiting with clients again and again the conversations around food. This has been one of the most common topics I discuss with my clients, most of whom are female-identified and between the ages of 20-50. What has become clear to me over the years of clinical practice is the deeply rooted connection between food and someone’s self concept. How they relate to food tells me a lot about how they relate to themselves.

Since I am not strictly working with clients addressing eating disorder recovery, it was initially surprising to me to watch a pattern of undereating across my client caseload. I began to work with clients around understanding the disconnect between a universal human need (i.e., eating food to survive) and the resistance to acknowledging the importance of and taking responsibility for meeting that need (i.e., reliably eating for nourishment).

The more questions I asked, the more I learned that what I hold as a given–“Eating is a life-saving behavior”--was not a firmly held belief for many of my clients. Some experienced food as an indulgence, a distraction from productivity, and most shared a view of hunger as an inconvenience. They noted how much “easier” life would be if they just didn’t have to think about food and take all the necessary steps to make sure they were well fed, nourished, and energized by food. Here are some of the most common excuses I’ve heard from clients as they attempted to convince me (and themselves!) that eating was a luxury they had neither the time, energy, nor resources to indulge.

Most Common Reasons Clients Reported for Skipping Meals and Not Eating Enough

1. Busy/No time: “Eating slows me down”

This is undoubtedly the most common reason I hear from clients when I ask them what led to them skipping meals or undereating. The “I’m too busy” script was ready to go even before I finished my question! I have heard every variation of this excuse and learned to be open to listening, but also ready to challenge. As humans, we are all contending with our own limitations on how to meet our competing needs. We need to balance our productivity efforts with enough sleep, our social activities with enough recovery time, and our energy output with how well we are fueling ourselves. We are also, to varying degrees, navigating multiple stressors and hardship we do not choose. This can lead to the occasionally missed meal, eating something for convenience, and even emotional eating that is more for comfort than nourishment. However, for my clients who have gone months and sometimes years not nourishing their bodies and undereating as a response to chronic stress, there is no such thing as “temporary” in their relationship to missed meals. They can always find another reason to reinforce their belief that anything else on their to-do list has the potential to be a priority over their need to eat. Here is what they tell me:

They didn’t eat because the meeting ran late.
They didn’t eat because they forgot to bring lunch to work.
They didn’t eat because they got stuck in traffic and would be late for a workout class.
They didn’t eat because someone else needed them to [insert any caretaking responsibility here].

The list is endless, and I have learned to interrupt the excuses with a simple question: “When was the last time you were so busy you decided to not feed your [child, elderly parent, pet]?” I am usually met with a wide-eyed look of shock and a vehement “Never!” as a reply. As we dig into their reactions, I work with clients to examine why it would be unthinkable for them to not meet the needs of someone they love and care for when it comes to food and nurturance, but they have become desensitized to depriving themselves of food on a daily basis. We’ll discuss further in this post the signs you may be experiencing chronic undereating, but for now, notice what comes up for you when you hear: “I am too busy to eat.” Does this sound like a familiar thought you might have in response to missing a meal?

2. Forgetting to eat: “I just don’t think about food until nighttime”

The second most common excuse I hear is relating to “forgetting to eat.” For these clients, they usually approach the topic of eating with a degree of confusion and at times, frustration. It’s almost as if they have been surprised about the inevitability of hunger showing up again, each and every day. When they experience hunger, the signal can be so delayed it might be that their first meal is in the late afternoon or early evening.

For these clients, they name a deep disconnect between hunger signals, time awareness, and what can feel like an unpredictable pattern around their appetites. Many will say they enjoy eating, understand logically that they have to eat in order to meet survival-based needs, yet they seem distraught that hunger is not (in their experience) an easy-to-anticipate need.

I watch them struggle to spend enough time in their own bodies to notice hunger signals are present, and in that difficulty, often end up eating less calories and missing the much-needed nourishment and energy to sustain them in their busy lives. In this case, I start with some psychoeducation on interoception (our internal sensory system that drives an “inner knowing” regarding our needs for, among other things, food, water, and rest). This can be a helpful starting point to decrease the confusion, as clients learn they may have low awareness of what signals accompany these basic survival needs.

3. Overwhelmed with Choices: “It’s too hard to make good food choices”

For some of these clients, the decisional overwhelm that can accompany the multiple steps involved with meal planning is where they report “getting stuck.” I understand what they mean by this. Planning meals can feel like an exhausting, multi-step process: checking what they would find appetizing/enjoyable to eat, deciding on what to make and when, what ingredients to buy, time and energy to shop for and prepare the meal, timing of when to eat meals. Thinking of all of these steps at once is usually enough to put my clients in a “freeze.” Others can also experience difficulties in making “ethical choices” or “healthy choices” around food, which then can lead to avoidance of planning meals since no option is “perfect” and free from engendering guilt, shame, and other self-critical responses. Also in this group I find clients who never learned what a healthy and balanced diet looks like. They might have grown up eating mostly processed foods and left to fend for themselves at meal times, or relying on food served at school for most of their calories. They are lacking the basic understanding of nutrition and struggle with the anxiety, self-doubt, and even shame around their lack of knowledge. This can stop them from taking steps to learn more, ask for help, and develop a healthier framework to meet their nutritional needs.

4. Wanting to lose weight: “I am trying lose weight, and I saw online this diet that works”

For my clients seeking to lose weight, the daily “battle” with food can become a central part of our therapy sessions. Most clients share that as a part of their weight loss goal, they are hoping to lose weight by undereating and skipping meals. This could take on the form of an intermittent fasting regimen, a keto diet, or some other popular “miracle diet” that guarantees quick weight loss.

As an example, take intermittent fasting. My clients have shared with me they have learned about intermittent fasting on one of the many social media platforms they use, and that the endorsements for this diet is from influencers, not licensed dietitians. The issue with this excuse is that most clients are resistant to my questioning of how safe this is for their health. “It IS healthy!” they argue back, “And I know lots of other people who do this and say it’s great for them, too!”

One trap I notice these clients fall into is that they are not seeking out trusted and competent medical professionals to offer them an individualized approach based on their medical history, and current goals and needs. They are taking a template offered as a “one-size-fits-all” from an unreliable online source who has never met them, does not know their health history, and many times does not have the necessary education and training to offer guidance on a diet for weight loss. Since many of my clients are women in the life phase of perimenopause, this is especially risky since intermittent fasting has been studied in male patients in mid-life who are medically obese. Therefore, it can be risky to make generalizations beyond that population of how “effective” this approach is for weight loss.

5. Too much activity/exercise: “I am fit so I must be eating enough”

Though this is a smaller subset of my clients, I also observe that my “fit” clients who are engaged in multiple weekly athletic activities also suffer from the consequences of undereating. Many times, this is because they are essentially “under fueled” when compared to the energy expenditures of their active lifestyles. Clients who engage in strenuous exercise more than 4x a week can be in a caloric deficit even if they are eating what is considered a “standard” diet for their weight and size. In this case, I will recommend clients work with their primary care physician or a dietitian. This way, they can have support and guidance to examine how to best eat a complete and nourishing diet that allows them to continue with their preferred activities, to address issues with fatigue, hormonal imbalance, and to reduce the harm to their bodies from undereating.

Now that we have reviewed some of the most common reasons for undereating, let’s look into possible signs that you could be stuck in this pattern.

Signs you are undereating:

1. You are tired all the time

If we understand that food is a source of energy, not eating enough food over extended periods of time can lead to a predictable drop in your energy. Some clients will complain of fatigue, a tiredness that does not improve with more sleep or naps, and feeling “slowed down” when in a caloric deficit. Some notice that in addition to a physical tiredness, they also experience “brain fog” and are slowed down in their thinking, with reduced memory recall and reporting a sense of confusion at times. Since our brain requires an enormous amount of energy expenditure in order to operate with our highest level of cognition–planning, organizing, anticipating future events, and emotional regulation–it makes sense that in an underfueled body, the “cost” of undereating can be that our brain is processing at a reduced capacity.

Your body is just trying to save energy, and while this was adaptive for our early human ancestors during periods of famine, it will likely now lead to increased stress for you and possible challenges at work, home, and in social relationships. Being tired all the time can also have negative impacts on your self-esteem and your ability to feel contentment in your life. You feel yourself operating on “autopilot” and that can decrease your overall sense of being present and energized by what gives your life purpose and meaning.

2. You frequently have GI issues

In chronic undereating, because your body is dealing with inconsistent and unpredictable eating patterns, your GI (gastrointestinal) system becomes dysregulated. Malnutrition in response to undereating can affect your gut health, with common symptoms including diarrhea, stomach cramping, bloating, and nausea. You may also have changes to your appetite that can increase confusion regarding signals for hunger and fullness. For those using undereating in order to lose weight, these changes to your metabolism and how well your digestion is working can also lead to lack of progress towards weight loss as your body fights to hold onto weight in response to and in anticipation of lack of reliable food sources. In order to protect you from what your body experiences as early signs of famine, when you are undereating you might find you are not able to lose the weight due to a slowed down metabolism.

3. You feel anxious all the time

In our history as a species, we have developed highly sophisticated responses to help us survive in times of famine. These same responses can become activated in chronic undereating because our physiology has not evolved to the point of differentiating a period of famine and knowing we are “just too busy to eat.” This means your body engages in a full-on survival response when you skip meals and are exerting more energy than you are consuming in calories. The burden of stress on your body as it attempts to “survive famine” leads to hyper activation of your “fight-flight-freeze.” That “nameless” anxiety you woke up with today? The constant feelings of being “on edge” and “waiting for the next bad thing”? That could be a “storyline” your brain is coming up with in order to make meaning of your overactive stress response due to malnutrition.

4. You are easily irritated

Food and mood are interconnected! Understanding how chronic neglect around your need to eat can drastically alter your patience, decreasing your ability to handle stress, and increasing your irritability can be a significant “lightbulb” moment in therapy for many clients. Our brains when experiencing malnourishment are less capable of emotional regulation, leading to more reactive emotional states (e.g., anger, annoyance, frustration, overwhelm). You think you are a failure because everything annoys you and you cannot handle stress and stay “cool, calm, and collected.” What may have historically been viewed as “just as part of my personality” takes on a new twist when we connect how dysregulation from being hungry can significantly alter your ability to respond to stress. What if you are just always hungry and unaware that this can influence how you relate to others and yourself?

5. You often feel dizzy or lightheaded

When our bodies are fighting hard to stay alive with not enough energy from food sources, we can have many physiological changes that cause worrisome symptoms. This happens because our body is engaging in our stress response in order to increase our chances of survival. Our bodies understand undereating as a threat and signals that the lack of certainty of reliable food sources puts our own survival in jeopardy. In that “survival mode,” our body can experience being “off balance,” leading to symptoms of dizziness or feeling lightheaded. Some people can even experience fainting as a result of dangerously low blood sugar from not eating for extended periods of time.

6. You are always cold

It takes energy to keep our body in homeostasis, which includes sustaining our body temperature in response to external changes in our environment. When we are stuck in patterns of chronic undereating, we are missing the essential energy from calories in our foods in order to maintain a well-regulated body temperature. With less “fuel” from your foods as an energy source to keep you warm, you may frequently experience coldness that feels unresponsive to your efforts to warm yourself (e.g., being under a blanket, in a temperate room and still shivering).

7. You get stuck in overthinking

A malnourished brain has many of the same patterned responses to what we observe in individuals experiencing obsessions. Our brains become less flexible and more rigid in response to chronic undereating, and this can lead to worsening preoccupation, rumination, and obsessive thinking.

Where Do You Go From Here?

If you are reading this post and hearing experiences that sound familiar to you, it is possible you would benefit from working with a psychologist to reduce undereating and for support in building a better relationship to food. At Aviva Psychology Services, we have many providers that work with clients of all ages, genders, and backgrounds to build a healthier sense of self, including tools for addressing food-related issues.

If you identify with the “I’m too busy to eat” or “I forget to eat” group of folks, it is possible that working with Somatic therapies to support embodiment and develop intuitive eating would help you interrupt cycles of undereating. If you identify with the decisional overwhelm group, executive function skills can support you developing approach behaviors to reduce avoidance and tackle multi-step processes for meal planning. If you are wanting to lose weight, learning tools for self acceptance and self compassion can help you get out of shame-based and fatphobic narratives that erode your self-esteem.

If you would like to learn more about how the psychologists at Aviva could help, we encourage you to reach out to our practice. You can get connected with a psychologist by filling out the Request an Appointment form.