It’s hard to have a good relationship with food in a world where diet culture is so loud. At a young age we learn that food choices often come with judgement and we learn to not trust our bodies 1. Disordered eating can be difficult to identify when the cultural “norm” is to obsess over size, weight, excessive exercise, and dieting. Ironically, these are often the same behaviors that can contribute to eating disorders (EDs) and disordered eating in the first place.
Though eating disorders and disordered eating are similar, they are also distinct. Distinguishing between the two can sometimes be tricky. A Registered Dietitian Nutritionist (RDN) or therapist who specializes in ED recovery can help determine where a person falls on the spectrum between a diagnosable ED and disordered eating behaviors. The difference often lies in the frequency and severity of the behavior’s interference with the individual’s day to day life.
What is an Eating Disorder?
The National Eating Disorders Association defines EDs as “treatable mental and physical illnesses that can affect all people regardless of body size, weight, gender, race, sexual orientation, ethnicity and ability” 3. Specific diagnostic criteria exist for each of the following eating disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V):
- Anorexia Nervosa: An intense fear of gaining weight. Often coupled with a distorted body image that leads to excessive dieting and severe weight loss.
- Bulimia Nervosa: Eating past a point of discomfort followed by compensatory behaviors, such as induced vomiting and laxative use.
- Avoidant Restrictive Food Intake Disorder (ARFID): Restrictions in the amount or types of food, but not related to body image or fear of gaining weight.
- Binge Eating Disorder: Overeating to a point of pain in a short timeframe, followed by feelings of guilt or shame.
- Other Specified Eating Disorder: Frequent and severe disordered eating behaviors that do not meet the diagnostic criteria for the above eating disorders.
However, just because someone isn’t diagnosed with an eating disorder doesn’t necessarily mean that they have a healthy relationship with food.
What is Disordered Eating?
Disordered eating can be identified as a range of irregular behaviors commonly associated with eating disorders that don’t fit the full criteria for ED diagnosis.
Some examples of disordered eating include, but are not limited to:
- Obsessively counting calories
- Extreme anxiety about certain foods or food groups
- Chronic weight fluctution
- Constantly weighing/measuring/tracking food
- Avoiding social events and/or restaurants to adhere to diet
- Drinking excess caffeine or water to quiet hunger cues
- Using compensatory strategies such as excessive exercise, diet pills, laxatives, diuretics, and/or induced vomiting
- Basing self-worth on size of body
- Eating in secret
- Feeling guilt/shame during or after eating
- Feeling a loss of control around food
Regardless of diagnosis, disordered eating behaviors are serious. They deserve attention and treatment. If left untreated, these behaviors may develop into diagnosable EDs, which can put individuals at risk for serious mental and physical health problems 2.
What Can Be Done?
There are various factors that contribute to disordered eating, including struggles with body image and self-esteem. A treatment team with a Health at Every Size dietitian and therapist can help an individual improve their relationship with body, food, and exercise. This team can help the individual get back to honoring their internal hunger and fullness cues, practice intuitive eating, and give themselves permission to eat in a flexible manner.
Whether an individual is struggling with an eating disorder or disordered eating, unlearning the harmful impacts of diet culture and re-learning body trust can be a powerful step one can take to improve their physical and mental health.
If you are looking to improve your relationship with food and body, get in touch with us and schedule an appointment today. We would love to be a part of your health team!
Written by Aster Galloway, MS, RDN
Aster’s nutritional approach is guided by a Health at Every Size (HAES) philosophy and that it is not our size that determines our health but our lifestyle. She also practices Intuitive Eating principles which encourages clients to eat in a flexible manner that honors internal hunger cues. Aster’s end goal with every client is creating peace with food and body.
- Gustafson-Larson, A., & Terry, R.D. (1992). Weight-related behaviors and concerns of fourth grade children. Journal of the American Dietetic Association, 92, 818-822.