What is Disordered Eating?
Disordered Eating describes a variety of abnormal eating behaviors such as restrictive eating, fasting, compulsive overeating, excessive exercising, or irregular or rigid eating patterns that can be harmful to you both physically and psychologically. Disordered eating can affect all kinds of bodies and you cannot tell by looking at someone if they are experiencing a disordered relationship with food or their bodies.
The phrase Disordered Eating is used to cover the range of thoughts, feelings, and behaviors about food and body size and shape that lie between healthy eating habits and eating disorders such as anorexia, bulimia, and binge eating disorder. These behaviors are about more than food; they are often done in the name of losing weight or looking “healthier,” but they can put you at risk for significant health problems.
Disordered Eating vs Eating Disorder
The difference between an Eating Disorder and Disordered Eating comes down to whether a person’s symptoms align with the established criteria for an Eating Disorder as defined by the American Psychiatric Association. A therapist who specializes in Eating Disorders can help determine if someone meets criteria or not.
While Disordered Eating is a descriptive phrase, not a diagnosis, it is important to recognize that it can still be a cause for concern and may indicate an unhealthy relationship with food and body image.
We know that Disordered Eating often is born out of the normalization of diet culture, masquerading as wellness, health, or lifestyle, which often creates the conditions for Eating Disorders to manifest.
Examples of Disordered Eating behaviors include:
- Restrictive Eating: Imposing strict dietary rules, avoiding certain food groups, or severely limiting calorie intake.
- Binge Eating: Consuming large amounts of food in a short period, often accompanied by a feeling of loss of control.
- Emotional Eating: Turning to food as a way to cope with emotions, stress, or boredom.
- Compulsive Eating: Engaging in repetitive, uncontrollable eating patterns, often without feeling physically hungry.
- Orthorexia: Obsession with consuming only “pure” and “healthy” foods, which can lead to rigid dietary restrictions and an unhealthy fixation on food quality.
- Yo-yo Dieting: Frequent cycles of weight loss and weight regain due to extreme dieting methods, which can be detrimental to physical and emotional well-being.
Types of Eating Disorders
There are several types of Eating Disorders that are recognized by medical and mental health professionals.
The most common Eating Disorders include:
- Anorexia Nervosa: This disorder involves an intense fear of gaining weight, a distorted body image, and severe restriction of food intake, leading to significant weight loss and often malnutrition.
- Bulimia Nervosa: Bulimia involves cycles of binge eating followed by compensatory behaviors such as self-induced vomiting, excessive exercise, or the misuse of laxatives or diuretics. People with bulimia may also have a distorted body image.
- Binge Eating Disorder: This disorder is characterized by recurrent episodes of uncontrollable binge eating, during which individuals consume large quantities of food within a short period of time. Unlike bulimia, there are no regular compensatory behaviors.
- Avoidant/Restrictive Food Intake Disorder (ARFID): ARFID involves the avoidance or restriction of food intake, often due to sensory issues with food, lack of appetite, or fear of negative consequences. This disorder may lead to nutritional deficiencies and weight loss.
- Rumination Disorder: Rumination disorder, also known as rumination syndrome, is a relatively rare eating disorder that primarily affects infants, children, and individuals with developmental disabilities. It involves the repetitive regurgitation and rechewing of partially digested food that is then either expelled or re-swallowed. Unlike other Eating Disorders, rumination disorder does not involve a distorted body image or a fear of gaining weight.
- Other Specified Feeding or Eating Disorders (OSFED): This category includes Eating Disorders that do not meet the specific criteria for Anorexia, Bulimia, or Binge Eating Disorder but still involve significant disturbances in eating patterns, body image, and weight.
Eating Disorder Signs and Symptoms
The symptoms of Eating Disorders can vary depending on the specific type of Eating Disorder. However, some common symptoms and signs that may indicate the presence of an Eating Disorder include:
- Significant weight changes: Rapid and noticeable weight loss or weight gain that is unrelated to other medical conditions.
- Distorted body image: A distorted perception of one’s body weight, shape, or size. Individuals may believe they are overweight or have a distorted perception of specific body parts.
- Restrictive eating patterns: Extreme or rigid dietary restrictions, avoiding certain food groups, or drastically reducing calorie intake.
- Purging behaviors: Engaging in behaviors to compensate for food intake, such as self-induced vomiting, misuse of laxatives, diuretics, manipulation of insulin, or excessive exercise.
- Preoccupation with food: Constantly thinking about food, obsessing over meal planning, calorie counting, or excessively researching nutrition information.
- Changes in eating habits: Unusual eating behaviors, such as eating in secret, cutting food into tiny pieces, chewing food excessively, or arranging food on the plate but not consuming it.
- Compulsive exercising: Compulsive and excessive exercising, feeling compelled to burn off calories consumed or an intense fear of weight gain.
- Physical signs: Physical signs may include frequent weight fluctuations, feeling weak or tired, dizziness, fainting, hair loss, dental problems, and changes in menstrual cycles (in females).
- Diet pill and weight loss medication misuse and abuse.
- Avoidance of social situations involving food: Avoiding social events or situations that involve food, making excuses to avoid meals or eating in public.
- Eliminating certain foods, macronutrients, or food groups.
- Characterizing certain foods as “bad” or “toxic” but others as “good” or “pure.”
Who is at Risk from Disordered Eating
Several factors can contribute to the risk of developing an Eating Disorder, and it is important to note that anyone, regardless of age, gender, or background, can be at risk. However, certain individuals may be more vulnerable to developing Eating Disorders. The following groups tend to have a higher risk:
- Adolescents and young adults: Eating Disorders often emerge during adolescence and young adulthood, although they can occur at any age. This period is characterized by significant physical, emotional, and social changes, making individuals more susceptible to body image concerns, peer pressure, and societal influences.
- Females: While Eating Disorders can affect people of all genders, they are more commonly diagnosed in females. However, it is important to recognize that males and individuals of diverse gender identities can also experience Eating Disorders.
- Individuals with a history of mental health conditions: Conditions such as anxiety, depression, obsessive-compulsive disorder (OCD), and body dysmorphic disorder (BDD) can increase the risk of developing an Eating Disorder.
- Those with a family history: Having a family member, particularly a first-degree relative, with an Eating Disorder can increase an individual’s susceptibility to developing one themselves. Genetic factors, as well as shared environmental and social influences, may contribute to this increased risk. It is widely recognized that there is a biological basis to eating disorders.
- Participation in certain sports or activities: Certain sports or activities that emphasize thinness, weight requirements, or a focus on appearance, such as ballet, gymnastics, modeling, or competitive bodybuilding, may put individuals at a higher risk of developing Eating Disorders.
- Individuals with a history of dieting or weight-related issues: Engaging in repeated cycles of restrictive eating, weight loss, and weight gain can disrupt a person’s relationship with food and body, increasing their vulnerability to developing an Eating Disorder.
It is essential to note that these risk factors do not guarantee the development of an Eating Disorder, and individuals without these risk factors can still develop one. Eating Disorders are complex conditions influenced by a combination of genetic, biological, psychological, environmental, and sociocultural factors.
Eating Disorders in Children 12 and under
Eating Disorders in children younger than 12 are less common than in adolescents but can still occur.
Here are two specific eating disorders that can affect younger children:
- Avoidant/Restrictive Food Intake Disorder (ARFID): ARFID can occur in children of any age, including those younger than 12. Children with ARFID have an extremely limited range of accepted foods and may refuse to eat certain foods based on sensory issues, aversions, or fears of negative consequences such as choking or vomiting. This can lead to significant nutritional deficiencies and impaired growth and development.
- Pica: Pica is an Eating Disorder characterized by the persistent consumption of non-food items. Children with pica may eat substances such as dirt, clay, chalk, paint chips, or paper. This behavior is not developmentally appropriate and can lead to serious health complications if the ingested items are toxic or indigestible.
Health Consequences of Eating Disorders
Physical Harm Caused by Disordered Eating
You don’t need an Eating Disorder diagnosis to suffer from serious effects of disordered eating. Many people who exhibit Disordered Eating patterns do not fully realize the impact it is having on their mental and physical health. This lack of understanding may make the harm caused by Disordered Eating greater. Consequences of Disordered Eating include a greater risk of health consequences or developing an Eating Disorder. Physical risks include bone loss, gastrointestinal disturbances, fluid imbalances, and low heart rate and blood pressure.
The Emotional and Social Impact of Disordered Eating
Disordered Eating has been linked to a reduced ability to cope with stressful situations. Feelings of guilt, shame, and failure are common in people who engage in Disordered Eating. A person with Disordered Eating behaviors may avoid situations where people will be eating, which can contribute to low self-esteem and social withdrawal. Other mental health risks include irritability, difficulty concentrating, decreased motivation, emotion dysregulation, fatigue, and difficulty sleeping.
Seeking Help with Eating Disorders
People with Disordered Eating are often unaware that their eating patterns are problematic.
The diagnosis of an Eating Disorder typically involves a comprehensive assessment conducted by a healthcare professional, such as a psychiatrist, psychologist, or a specialized eating disorder clinician. The diagnostic process may include the initial evaluation, physical examination, psychological assessment, and laboratory tests.
If you think you or someone close to you is suffering from Disordered Eating, it is important to reach out for support as soon as possible.
People who suspect they have Disordered Eating should seek treatment with a mental health professional as soon as possible. Eating disorders are severe and life-threatening mental illnesses. An eating disorder is not a lifestyle choice.
Disordered Eating FAQs
Normal eating doesn’t follow a schedule or rules because it is different for everyone, but in general it means being able to enjoy your food without feelings of shame or anxiety. Normal eating is trusting your body to make food choices that feel good for you, without judging yourself.
It can. People with Disordered Eating are at higher risk of having that develop into an eating disorder such as anorexia, bulimia, or binge eating disorder.
Missing an occasional meal isn’t cause for concern. However, if you notice that a friend or family member frequently skips meals or makes excuses not to eat, it can indicate a pattern of Disordered Eating.
Yes. Disordered Eating is prevalent among people with diabetes and can significantly increase diabetes mortality and morbidity, which makes it even more important to seek a diagnosis and treatment.
At its most severe, disordered eating can lead to a weakened state, significant health complications, and even death. If you or someone you know is in this condition, it is important to seek medical help immediately.
Men and women are both susceptible to Disordered Eating and developing Eating Disorders. The truth is that many of us eat in a disordered way, which explains why many of us don’t see these behaviors as being disordered or out of the ordinary. Women, however, are often more at risk because of societal standards of weight and beauty. One survey estimated that 75% of American women engage in some sort of Disordered Eating behavior.
Here are some statistics regarding Eating Disorders and gender:
- Anorexia Nervosa: Anorexia nervosa is more commonly diagnosed in females, with estimates suggesting that around 90% of individuals with anorexia are female. However, it is important to note that males can also develop anorexia, and the prevalence among males is estimated to be around 10%.
- Bulimia Nervosa: Bulimia nervosa is more evenly distributed between males and females, although it is still more commonly reported in females. It is estimated that around 75% to 85% of individuals with bulimia are female, while approximately 15% to 25% are male.
- Binge Eating Disorder: Binge eating disorder appears to affect both males and females more equally compared to other eating disorders. The prevalence of binge eating disorder is estimated to be slightly higher in females, but the gender distribution is relatively balanced.
- Other Specified Feeding or Eating Disorders (OSFED): OSFED, previously known as Eating Disorder Not Otherwise Specified (EDNOS), encompasses a range of eating disorder presentations that do not meet the full criteria for specific diagnoses. The prevalence of OSFED tends to be higher in females, but males can also be affected.
ARFID stands for Avoidant/Restrictive Food Intake Disorder. It is an Eating Disorder characterized by a persistent avoidance or restriction of food intake that leads to inadequate nutrition and/or significant distress and impairment in functioning. ARFID was added as a distinct diagnosis in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Individuals with ARFID often have a limited range of accepted foods and may exhibit avoidance or refusal of certain foods or food groups. This avoidance is not due to body image concerns or a fear of gaining weight, as seen in other Eating Disorders like anorexia nervosa. Instead, it may be driven by factors such as sensory sensitivity, food texture aversions, concerns about the consequences of eating (e.g., fear of choking or vomiting), or a lack of interest in food.