Whether it be for yourself, your child, your partner, a friend, etc., understanding eating disorders and disordered eating could make an important difference in your/their healing journey. Some of you might be well versed in the topic, while others might not have ever heard the term “disordered eating.” Regardless of your current level of expertise on the topic, here is a general starting point for grasping the concept of disordered eating.
Living in the world of “diet culture” and “fad diets,” we are constantly surrounded by talk of “good” foods, “bad” foods, a range of expectations and myths around food and weight, and a moral hierarchy of body shapes and sizes. Typically, we are taught from a very young age that thin is ideal, weight loss is always good, and thin equals healthy. This mindset and persuasive set of cultural beliefs has created a pathway to glorifying disordered eating, which makes you wonder, when does someone’s focus on calories, food, and weight become a health concern?
First, what is disordered eating?
Disordered eating is a term used to describe a broad spectrum of irregular eating behaviors. These behaviors may or may not warrant a clinical diagnosis of an eating disorder. These behaviors may be very closely aligned with those of Anorexia Nervosa, Bulimia Nervosa, or another eating disorder, however, the criteria for eating disorders are very specific and often exclude the majority of people suffering from body image and eating concerns.
So, what exactly is the difference between disordered eating and an eating disorder? The most significant difference is simply whether a person’s symptoms align with the criteria defined by the American Psychiatric Association and are documented in the Diagnostic and Statistical Manual, or the DSM. That being said, disordered eating is not a diagnosis, but rather a term used to describe disordered eating patterns. Despite not being a clinical diagnosis, these patterns still deserve the attention and treatment that eating disorders do as they can often lead to eating disorders and cause severe health problems.
Behavioral Symptoms of Disordered Eating
Restrictive eating
Fasting
Avoiding certain food groups (Not recommended by a physician. I.e. not avoiding gluten for someone with Celiac disease)
Frequently skipping meals
Refusing to eat
Denial of hunger
Making excuses for not eating
Only eating foods deemed “safe” by the person, usually those low in fat, calories, and sugar
Lying about their food intake
Purging
Self-induced vomiting
Misuse of laxatives, enemas, or diet aids
Exercising excessively
Binge eating
Eating unusually large amounts of food in a short period of time
Eating despite feeling full or not hungry
Eating until you are uncomfortably full
Continuing to eat despite not wanting to
Eating alone or in secret to avoid embarrassment
Feeling significantly distressed, ashamed, or guilty about your eating
Physical Symptoms of Disordered Eating
Restrictive eating
Extreme weight loss or not making expected developmental weight gains
Thin appearance
Dizziness
Fainting
Absence of menstruation
Low blood pressure
Bluish discoloration of the fingers
Thinning head hair
Increased production of hair covering the body
Purging
Chronically inflamed and sore throat
Swollen salivary glands in the neck and jaw area
Acid reflux disorder
Gastrointestinal problems
Severe dehydration (from purging of fluids)
Electrolyte imbalances
Worn tooth enamel and decaying teeth (from excessive vomiting)
Signs of Disordered Eating
Intense fear of weight gain
Repeatedly weighing or measuring the body
Frequently checking in the mirror for perceived flaws
Often stating they are fat
Covering up in layers of clothing or large clothing
Social withdrawal
Irritability
Not wanting to eat in public
Preoccupation with food
Distorted body image
Who is at Risk and Common Myths
It is extremely important to note that eating disorders can affect people of all races, ages, ethnic backgrounds, body weights, body sizes, and genders. Men also have disordered eating patterns, it is not a women-specific concern. Older adults are also at risk for disordered eating, not just young adults and teenagers. You can be overweight or within a “normal” weight range and have an eating disorder or disordered eating. People who appear healthy can also have eating disorders, for example, athletes. That being said, the highest rates of eating disorders are among women between the ages of 12-25.
*** Dieting is one of the most common forms and risk factors of disordered eating.
The Diet Cycle and How Eating Disorders Are Maintained
While many people struggling with disordered eating develop an eating disorder, others do not and continuously live in this cycle of maintaining their disordered eating patterns. If not intervened, this is also how eating disorders are developed and perpetuated and increasingly harmful as well. This cycle, or the diet cycle, often begins with feeling unhappy with one’s weight or shape, resulting in the beginning of a diet or restriction period. This period leads to feelings of emotional and physical deprivation and then breaking the diet and overeating. Lastly, one may feel guilty about their eating patterns and unsure of “how to eat.” Then, the cycle begins again.
Complications of Eating Disorders
Eating disorders can cause a multitude of physical and psychological complications. In addition to the physical symptoms listed above, at its most severe, eating disorders can be fatal. This can happen to anyone, even when someone is not severely underweight. Heart problems including mitral valve prolapse, abnormal heart rhythms, and heart failure are some of the most serious concerns. Additionally, osteoporosis, or bone loss, loss of muscle, fertility concerns for women, decreased testosterone for men, anemia, and kidney problems are also prominent complications. Furthermore, eating disorders are often coupled with other mental health disorders, primarily depression, anxiety, personality disorders, obsessive-compulsive disorders, alcohol and substance misuse, self-injurious behaviors, and suicidal thoughts/attempts. The most deadly mental disorder in the world is Anorexia Nervosa as a result of these physical and psychological complications.
What do I do if I, or a loved one, is experiencing disordered eating?
Unfortunately, there is no guaranteed way to prevent eating disorders, much like any other health concern. However, physicians and mental health professionals could be in a good position to identify early indicators of disordered eating and help prevent the development of eating disorders. If you notice that a loved one is experiencing severe food restriction, purging, or binge eating behaviors, as well as low self-esteem and dissatisfaction with their appearance, consider talking to them about these behaviors and seeking help from a professional for treatment options and/or promote and discuss healthier behavior.