Disordered Eating

What Is Disordered Eating?

Disordered eating is a term used to identify eating behaviors that don’t meet the diagnostic criteria for an eating disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition).

These unusual eating behaviors are often motivated by shame or guilt about your body and appearance.

Disordered eating behaviors may include restricting calories for diets, emotional eating, and worrying about the effect certain foods will have. These patterns can be subtle and are often normalized by popular diet culture.

Disordered eating sits somewhere between regular eating and an eating disorder. Not all individuals with disordered eating will develop an eating disorder, but some will.

Although disordered eating is not an actual diagnosis, it can still negatively affect someone’s mental and physical health.

Types of disordered eating patterns may include:

• Cleanses or detoxes
• Fad diets
• Skipping meals or fasting
• Laxative abuse
• Diet abuse
• Supplement abuse
• Emotional eating
• Overeating

How Common Is Disordered Eating?

We are still learning how common disordered eating is. Most studies focus on eating disorders rather than disordered eating, and for good reason—according to a Harvard study, about 10,200 deaths each year are the direct result of an eating disorder.

Eating disorder prevention is key. Thankfully, more studies are being conducted to better understand the disordered eating behaviors that may eventually lead to the development of an eating disorder.

Current studies indicate the following statistics about disordered eating:

• According to a recent global study, 22% of children and adolescents worldwide show disordered eating.
• Research published in the journal Medicine and Society reports that Individuals with higher body weight are 2.45 times more likely to engage in disordered eating behaviors than patients of normal weight.
• A study from the University of Minnesota found that Hispanic, Black/African American, and Asian Americans are more likely to engage in disordered eating behaviors than their white counterparts.

Types of Disordered Eating Behaviors

Identifying disordered eating behaviors can be tricky. Society has normalized diet culture and many dieting eating patterns exist in a gray area. Some behaviors are unhealthy for individuals with disordered eating and perfectly healthy for others.

Common Disordered Eating Behaviors

Some common disordered eating behaviors may not be a problem in some contexts. However, if you or someone you love exhibits many of these behaviors, it might be worth considering whether these are harmful patterns of a larger issue.

Common disordered eating behaviors include:

• Chronic or long-term dieting
• Calorie restriction or engaging in extreme diets
• Eating large amounts of food due to stress or other negative emotions (emotional eating)
• Overeating to the point of feeling sick
• Avoiding entire food groups or nutrients such as carbs, fats, or sugars
• Eating the same foods every day
• Misusing supplements, diet pills, diuretics, laxatives, or enemas
• Only eating certain foods or food groups
• Exercising compulsively
• Labeling certain foods as “good” or “bad”
• Self-induced vomiting

Disordered Eating VS. Eating Disorders

Someone with disordered eating is at higher risk of developing an eating disorder. The symptoms of disordered eating are the same symptoms of common eating disorders like anorexia nervosa, bulimia nervosa, and binge-eating disorder.

The main difference between disordered eating and eating disorders is the severity of the symptoms.

Eating disorders are only diagnosed when the patient exhibits life-threatening, extreme symptoms of disordered eating.

A patient with an eating disorder has become consumed by their obsession with eating and/or exercise. Depending on the type of eating disorder, an individual may spend all their time thinking about food restriction, binging and purging, or over-exercising.

Causes and Risk Factors for Disordered Eating

The causes and risk factors of disordered eating are complex. Societal influences, genetics, and mental health problems can play a huge role in the development of disordered eating and eating disorders.

There is no single cause of disordered eating; it is often a combination of elements.

Society and Cultural Influences

Thanks to social media, the pressure to look a certain way is more intense than ever. Social media platforms allow anyone to make a career in the diet and fitness industry, but not all “influencers” give good advice or are honest about their results.

Between photo and video editing and plastic surgery, it’s hard for the average internet user to know what’s realistic vs. impossible.

Users of all ages, but especially young adults, are vulnerable to dangerous content and may begin to feel shame over their own bodies when compared to online models or fitness influencers.

Over time, individuals may begin to experience body dysmorphia, a condition where you obsess over your perceived physical flaws and develop a warped body image.

Combined with the pressure to achieve a certain body type, disordered eating habits may develop as a result.

Biological Influences

Individuals with mental illness or with a family history of eating disorders are at higher risk for developing disordered eating. These risk factors can be passed down through your genes by your parents.

Gender can also play a role in disordered eating. Although cisgender women are statistically more likely to develop disordered eating habits or eating disorders, cisgender men also struggle with disordered eating and may be overlooked for treatment.

Individuals on the gender spectrum who identify as transgender or non-binary may also be at heightened risk of developing disordered eating habits.

According to research from 2020, LGBTQ+ adults and adolescents experience a greater prevalence of disordered eating behaviors than their heterosexual and cisgender counterparts.

In addition, certain medical conditions may increase the chances of disordered eating developing, such as:

• Joint pain
• Type 1 and 2 diabetes
• Menstrual problems
• Hypotension
• Polycystic ovarian syndrome (PCOS)
• Osteopenia and osteoporosis
• Gastrointestinal issues
• Headaches and migraines

Psychological Influences

Stress and anxiety can play a huge role in disordered eating. For some people, food restriction or binge eating can help them feel in control of their lives when they typically feel out of control. Others may binge eat to cope with depression or anxiety, also called “emotional eating.”

Certain mental illnesses may increase the likelihood of developing an eating disorder. For example, individuals with autism and/or ADHD may be more likely to develop avoidant/restrictive food intake disorder (ARFID).

Mental illnesses that are most likely to be co-occurring with disordered eating and eating disorders include:

• Obsessive-compulsive disorder (OCD)
• Anxiety disorders
• Major depressive disorder
• Substance use disorder
• Post-traumatic stress disorder (PTSD)
• Personality disorders

Signs of Disordered Eating

If you suspect that you or a loved one has an issue with disordered eating, it’s important to know what to look for. Signs of disordered eating may be normalized in society, especially in fitness and diet circles.

Disordered eating can lead to a decrease in quality of life and the development of a serious eating disorder if left unaddressed.

Physical Symptoms

Physical symptoms of disordered eating may include:

• Sudden weight gain or weight loss, or weight “yo-yo-ing”
• Obesity or extreme thinness
• Stomach problems
• Difficulty concentrating
• Dry skin
• Brittle nails
• Muscle weakness
• Cuts on finger joints from inducing vomiting
• Dental issues due to vomiting

Behavioral Symptoms

Behavioral symptoms of disordered eating may include:

• Preoccupation with food
• Meal skipping
• Binge-eating or overeating
• Excessive exercise
• Eating for reasons other than hunger
• Using food to cope with stress or intense emotions
• Occasionally engaging in calorie restriction or binging and purging
• Hiding or lying about eating habits
• Tracking calories or macronutrients to the point of obsession
• Fixating on your weight, measurements, or body mass index (BMI)

Emotional Symptoms

Emotional symptoms of disordered eating may include:

• Social and emotional withdrawal
• Low self-esteem about your body or weight
• Feeling guilt over eating certain foods
• Eating food every time you feel anxious or sad
• Feeling depressed when you eat certain foods or can’t exercise
• Believing your self-worth is tied to your body size or weight
• Feeling anxious at meal times or when certain foods are on offer

Treatment and Management

The treatment and management of disordered eating may vary depending on the severity of the symptoms.

Disordered eating can be a warning sign that an eating disorder may develop, so catching the symptoms early and seeking treatment can help you avoid serious health risks.

How Is Disordered Eating Diagnosed?

Disordered eating is not an official diagnosis, as it describes a collection of symptoms that do not meet the criteria for the diagnosis of an eating disorder. However, it’s still important to discuss your disordered eating symptoms with a mental health professional.

If your provider feels you have symptoms of disordered eating, they may recommend a preventative treatment plan to address the issues before they manifest in a serious eating disorder. At this stage, treatments will likely include therapy or nutritional counseling.

Therapy for Disordered Eating

Cognitive behavioral therapy (CBT) is the most common type of psychotherapy and is often recommended for disordered eating.

A therapist can help you identify what thoughts are contributing to disordered eating behaviors and help you develop strategies to avoid them.

Your therapist can also help you identify things to avoid, like fad diets, and things to incorporate into your life, like mindful eating and positive self-talk.

By reframing your relationship with food to be healthier and neutral, you can avoid triggers for disordered eating habits.

Nutritional Counseling

Sometimes, disordered eating can cause individuals to become confused or misinformed about their own nutritional needs.

Understanding how nutrition works and what your body needs can help lessen the fear around certain “bad” foods and reinforce healthier habits.

Working with a dietitian or nutritionist is a great way to learn healthy eating habits and achieve your fitness goals.

Getting Help for Disordered Eating

Disordered eating can indicate the potential for developing an eating disorder. By treating your disordered eating behaviors early, you can avoid the serious mental and physical health risks associated with eating disorders.

Talk to your doctor or mental healthcare professional about your eating behaviors. They can help you determine how serious your disordered eating is and what the best path forward is for your unique situation.

There are also helplines and treatment directories available for disordered eating and eating disorders. Check out the National Alliance for Eating Disorders Helpline.