Disordered Eating Vs Eating Disorder
Often, I get asked what the difference is between eating disorders and disordered eating. With the new year around the corner (and inevitably a barrage of people touting diet, exercise, and weight loss tips who have no business giving such tips), I figured it was a good time to set the record straight. What’s the difference between them? Not that much.
What is disordered eating?
While eating disorders have specific criteria regarding behaviors and their frequency, disordered eating occupies a much broader spectrum. Disordered eating can look incredibly similar to a full blown eating disorder, but the main difference will be in the frequency and severity of the behaviors. There may be restricting, bingeing, purging, or more subtle and socially praised behaviors such as counting calories, frequent yo-yo dieting, skipping meals, or eliminating food groups. One might create rules around food, such as needing to “earn” food or “make up” for food eaten.
What are the risks of disordered eating?
There are many risks that arise with disordered eating, including but not limited to:
Physical risks: stress fractures, bone or muscle loss, dry skin, heart abnormalities, low blood pressure, tooth sensitivity or erosion, constipation and other GI issues, dehydration or electrolyte imbalances, brittle nails, dizziness or fainting, fatigue, changes in sleep
Emotional and cognitive risks: changes in mood such as irritability, depression, and anxiety, increased worry or preoccupation with food and body, poor focus, difficulty making decisions, brain fog
Relational risks: decreased social interactions where food is involved, arguments with loved ones about food, tension or disconnection
In addition to these risks, the risk for developing a full blown eating disorder is significantly higher than someone not engaging in disordered eating.
Treatment for Disordered Eating
It is important to address disordered eating thoughts and behaviors to mitigate risk to emotional and physical health. While there can be a variety of ways to treat disordered eating based on each individual experience, having a team of a therapist, dietitian, and doctor who who specialize in food-related issues can help with the multifaceted nature of the behaviors.
Nutritional counseling: Oftentimes, clients feel reluctant to see a dietitian because of the concerns behind eating. However, working with a dietitian can be a vital step in healing your relationship with food. Contrary to common fears, they don’t make you “just eat.” They work alongside you to address nutritional needs in addition to providing valuable education and support related to food science. They are there to help, whether you want to challenge a fear food or debunk a wellness myth based on solid research and evidence-based care.
Medical monitoring: Medical monitoring is another essential part of addressing disordered eating to assure that your body is functioning as it should. Remember the list of physical risks mentioned above? Doctors can help assess for any risk and create a treatment plan for your specific needs. If you are not able to meet with a doctor who specializes in this area, consider bringing this list to your appointment to discuss which tests are warranted and ask the doctor and medical staff not to comment on your weight.
Therapy: When someone comes into my office struggling with their relationship with food, we explore their patterns related to food and the beliefs behind them. Disordered eating or chronic dieting does not exist in a vacuum- we consider the systemic issues that have led to disordered eating in the person’s life on a micro and macro level. Oftentimes CBT and DBT are used in sessions as well, as they are evidence-based treatments to help with managing distress.
Some people come into my office wary that I will try to convince them to think differently, stop dieting or pursuing weight loss, and join the body positivity movement. While I firmly believe that diets don’t work, health can be at every body size, and body liberation is for all bodies, your time in therapy is for your goals. Your definition of improving your relationship with food may look different than mine, and that’s ok.
Sometimes the idea of feeling good about your body or feeling comfortable around food seems unrealistic, so we explore a middle ground. The goal is to create more of a life worth living while interacting with food, day in and day out, instead of feeling controlled by food.
Additional Support: Depending on your personal circumstances, you may also benefit from working with a psychiatrist, occupational therapist or recovery coach. Support groups and process groups are another way to find connection and help in the process of healing.
Disordered Eating Recovery: “Am I Sick Enough?”
So how does one care for him or herself and address disordered eating in a world that praises it? It can be difficult to find food freedom when we have to constantly wade through information thrown at us from influencers, organizations, and healthcare professionals.
It can also be hard to consider getting help for disordered eating due to a myth that you need to be “sick enough” to go to therapy. Please hear me say right now that if your relationship with food is hard, you are deserving of help. Not when you have a diagnosis. Not when you lose 5 more pounds. Not when your lab work signals deficiencies. You are worthy of help now.
Consider the following steps towards making peace with food:
Alter your algorithm. Delete the accounts that make you feel lousy and add accounts that offer more self-compassion.
Acknowledge the increase in holiday diet talk for what it is and give yourself permission to disengage.
Read a book related to food freedom, like Intuitive Eating or Anti-Diet.
While these steps can be helpful, they likely will not be the end of your journey. If you would like more support, please don’t hesitate to reach out.