Eating Disorders vs. Disordered Eating

What’s the different between an eating disorder and disordered eating? Why does it even matter? Let’s define what these things mean and why it’s important to recognize both eating disorders and disordered eating patterns.

In the last decade or so we’ve continued to see a rise in the number of people being diagnosed with and seeking treatment for an eating disorder. Because of the stigma around eating disorders and mental health, lack of access to eating disorder treatment, and normalization of eating disorder behaviors thanks to diet culture we can easily conclude that there are millions of people struggling to live with an eating disorder they have yet to recognize or get help for.

Eating disorders are not just a “phase,” a choice, or a cry for attention. Eating disorders are not uncommon and they certainly aren’t a minor illness to brush under the rug. Eating disorders are not limited to anorexia nervosa or bulimia nervosa. And eating disorders do not only affect white females with type A personalities who want to be skinny.

Eating disorders are the second most deadly mental illness and someone dies from an eating disorder every 52 minutes. Eating disorders can affect people of any age, skin color, culture, socioeconomic status, or background. And binge eating disorder is actually the most common eating disorder (not anorexia or bulimia). AND, on a hopeful note, eating disorders are able to be recovered from 100%, especially if treatment is received as early as possible.

By definition, an eating disorder is a serious and life-threatening mental illness with medical, nutritional, and psychiatric consequences. Eating disorders often involve an obsession with food, eating, weight, and/or exercise. The currently recognized diagnoses include:

• Anorexia nervosa - restricting type and binge-purge type

• Bulimia nervosa

• Binge eating disorder

• Avoidant restrictive feeding and eating disorder (ARFID)

• Other specified feeding and eating disorder (OSFED) - which includes atypical anorexia, orthorexia, night eating syndrome, and diabulimia

To receive an actual diagnosis, someone needs to be seen by a licensed medical or mental health professional.

But what about disordered eating?

The term “disordered eating” describes a range of irregular eating behaviors that may or may not warrant an actual eating disorder diagnosis. All eating disorders involve disordered eating, but not all disordered eating leads to a full-blown eating disorder. Disordered eating also refers to any disruption in a normal, healthy relationship with food, eating, exercise, or body image. Obviously this encompasses a lot!

Personally, I believe almost everyone struggles (or has struggled) with some level of disordered eating, whether or not they know it. The problem is that we live in a society absolutely and utterly soaked in diet culture, which normalizes disordered eating patterns and beliefs. Most of us may not even realize that the way we interact with food, exercise, or our bodies is disordered! But once you see diet culture and start to recognize disordered eating patterns, you can’t unsee it.

Examples of disordered eating include:

• Frequent dieting (ALL kinds of dieting)

• Skipping meals

• Cutting out food groups, macronutrients, or specific foods without a medical reason

• Having strict rules around eating

• Tracking food, calories, or macros

• Restricting food to “save up” for a meal or event

• Anxiety related to certain foods

• Feelings of guilt and shame related to eating

• Restrict-binge eating cycles

• Obsessively weighing on the scale

• Feeling out of control with food and eating

• Compensating for what you ate with exercise to “make up for” or “burn off” food

• An obsessive relationship with exercise

• Any purging via self-induced vomiting, laxative use, diuretic use, or excessive exercise

As you can see, SO many of the behaviors and patterns that our culture says are totally normal or even “healthy” are actually super disordered! And as an eating disorder specialized dietitian I will unashamedly say that I believe dieting is inherently disordered eating. Dieting is the number one predictor of the development of an eating disorder and will wreck havoc on a person’s relationship with food, exercise, and their body. We see it in the research. I’ve seen it with my clients. And I’ve experienced it in my own life (hello, basically doing Weight Watchers with my mom at age 12 and then developing a severe eating disorder…).

If you think you struggle with disordered eating, I’ll be honest, you probably do. Working with an eating disorder professional will help determine whether or not it could even be a full-blown eating disorder diagnosis. Even if you don’t have an eating disorder, a non-diet, intuitive eating dietitian can help you create a healthier relationship with food, exercise, and your body.

Contrary to what diet culture will lead you to believe, you absolutely do not have to spend your life struggling with food and eating. Disordered eating may be normalized in our culture but it certainly is not normal. Nor does it have to be your normal. Cheers to food freedom and recovery!

References:

• Social and economic cost of eating disorders in the United States: Evidence to inform policy action: https://doi.org/10.1002/eat.23486

• Risk factors across the eating disorders: https://doi.org/10.1016/j.psychres.2014.05.054