The Difference Between Disordered Eating & Eating Disorders
During a recent meal out at one of my favorite restaurants, I noticed a mom dining with her two young kids. As they were finishing their meals, one little boy boldly announced, "I'm not hungry anymore. I'm done!" To which the mother blithely responded, "Okay, we'll take the rest home." This is a completely normal exchange, and shouldn't have stuck so stubbornly in my brain, but it did. Why? Because the mother didn't say, "You need to finish what's on your plate," and the kid seemed so sure of himself. He was hungry, he ate some food, and when he was full enough, he was done. Eating is so damn simple, and we've made it so complex.
There is a fine line between eating disorders and disordered eating, and our culture of fad diets and weight obsession can lead to both. An estimated 45 million Americans start a new diet each year, yet we remain unhealthy and engage in terrible relationships with food. A culture that promotes any diet as the secret to happiness/fulfillment/optimum health/love/worthiness/sexiness/spirituality is inherently flawed, yet we collectively choose to ignore these flaws. It doesn't matter if you weigh 100, 200, or 300 pounds if you dislike yourself. Weight loss cannot change the deeper issues, and there's almost always a deeper issue. The health halo surrounding diets can lead to disordered eating, which can in turn lead to eating disorders.
"Disordered Eating" is a term used to describe a range of irregular eating behaviors that may or may not warrant a diagnosis. Anorexia, Bulimia, and Eating Disorder Not Otherwise Specified (EDNOS) are diagnosed according to a very specific set of criteria set forth by the American Psychiatric Association. The only difference between an eating disorder and disordered eating is whether or not someone's symptoms align with this criteria. "Disordered Eating" is a descriptive phrase, "Eating Disorder" is a diagnosis.
I began exhibiting diet-like behaviors when I was about 12. I set forth specific food rules, became obsessed with exercising, and would write out lists of Do's and Don'ts in my journal, such as: do 50 sit-ups every morning and every night. Don't eat school lunch. Don't eat dessert. Do go for a run before basketball practice. Et cetera, et cetera, et cetera. These rules were my way of controlling my body and environment in an effort to feel safe and "good enough." By creating rules around "good foods" and "bad foods," I was exhibiting signs of disordered eating, but I was not yet suffering from an eating disorder. That would come much later and would affect my mental, physical, and social health in myriad, complex, and damaging ways. When I was 12 and showing signs of disordered eating, I thought I was being healthy. Similarly, those who adhere to strict, disordered diets often do so in the name of "health," and may not realize their relationship with food is doing them an enormous disservice.
Having a harmful relationship with food or your body is serious: eating disorders are the most deadly psychiatric disease. Something called the Arcelus study, based on an analysis of data collected in 36 different studies published between 1966 and 2010, shows the gravity of eating disorders:
5.1 deaths per 1,000 people with anorexia per year.
1.7 deaths per 1,000 people with bulimia per year.
3.3 deaths per 1,000 people with EDNOS per year.
Knowing signs and symptoms of an eating disorder is crucial in preventing these unnecessary and tragic deaths. However, the signs of disordered eating and eating disorders often overlap, making the line between the two a bit blurry. Below are just a few signs of an unhealthy, disordered relationship with food.
Frequent dieting, anxiety associated with specific foods, and/or skipping meals
Chronic weight fluctuations
Rigid rituals and routines surrounding food and exercise
Feelings of guilt and shame associated with eating
Preoccupation with food, weight, and body image that negatively impacts one's quality of life
A feeling of loss of control around food, including compulsive eating habits
Using exercise, food restriction, fasting, or purging to compensate for eating.
Diets can easily lead to these disordered eating habits. Personally, I didn't realize (or refused to realize) that my habits were causing me pain until I was at a breaking point. The first therapist I saw looked me in the eye and said, "You can either seek a higher level of care, or you can continue to live like you are. But I want you to know that that if you continue, the end result is death."
I was already experiencing other negative consequences of my eating disorder: lack of my period, possible bone loss, gastrointestinal disturbances, electrolyte and fluid imbalances, low heart rate and blood pressure, anxiety, depression, and social isolation. My therapists bold, unabashed statement that I could die was an enormous wake-up call. My slow devolution into an eating disorder was years in the making, but it all started with a diet that turned into disordered eating, that turned into an eating disorder.
While eating disorders might seem "worse" that disordered eating, both can lead to significant physical, emotional, and mental distress.
I can't begin to count the number of times I've overheard a coworker, family member, or friend bemoan the nutrient content of a particular food or demonize a macro-nutrient (carbs anyone?). When a culture of dieting is so pervasive, it's easy to feel dissatisfied in your own body or feel guilt for eating a certain food that many people deem unhealthy or "bad." There are no bad foods. I cannot emphasize this statement enough. There are, however, damaging attitudes about certain foods. Once I learned that food is not an enemy and properly nourished my body, I was more present in my life. I had energy to get through my day, perform well at work, feel good during exercise, and interact with friends and loved ones.
Seeking help from a Registered Dietitian (R.D.) or a Dietitian who specializes in Intuitive Eating is a good place to start. If other psychological issues are the underlying cause of disordered food behaviors, seek help from a licensed professional.
P.S. I recently went through a difficult breakup, and in the midst of my emotional distress, turned to my previous disordered habits as my only way to cope. I started seeing a new therapist who also recommended I attend a support group for women who have experienced emotionally abusive relationships. The path through disordered eating and/or eating disorders is not linear. Life isn't linear. But if you're stuck, you don't have to stay stuck. If you need similar help, reach the National Domestic Violence Hotline HERE, or contact the National Eating Disorder Association hotline at (800) 931-2237.