Disordered Eating vs. Eating Disorders
By Zeina Wu
The terms “disordered eating” and “eating disorder” are sometimes used interchangeably. However, it’s important to understand that while these fall on the same spectrum, there is a difference between the two. While it is possible that disordered eating behaviors can develop into an eating disorder, that is not always the case. Both disordered eating and eating disorders can share similar signs and symptoms.
“Many of the eating behaviors that are considered normalized in our culture are actually disordered,” explains Adee Levinstein, MS, RD, LD, CEDS-C, clinical dietitian training specialist at Eating Recovery Center (ERC). “The hyperfixation and attempts to control every aspect of our food intake can lead to distress and disordered eating.”
It is important to know what signs to look for -- and what care is available if your clients need more support.
What is disordered eating?
You can probably think of a time that you’ve heard a client (or maybe even a colleague) assign moral value to a food, calling it (or themselves) “good” or “bad” when eating it. You have also likely heard a person say they are avoiding certain foods or even skipping meals to lose weight. These are just two examples of behaviors that can be red flags for an eating disorder or disordered eating.
At Eating Recovery Center (ERC), we believe that all foods can fit in a balanced diet and that health is not black and white. Embracing this nutrition philosophy will help you identify potentially harmful behaviors your clients are engaging in.
So, how can you tell the difference?
Disordered eating refers to behaviors and beliefs surrounding food/exercise that can negatively impact an individual’s health -- but are often less severe/frequent in nature, without completely impairing their daily functioning . Disordered eating behaviors are typically less rigid, less consuming, and often fluctuate in severity.
Unfortunately, there is no clear frequency or specific behavior that determines when this disordered eating has crossed over into a full-blown eating disorder. An individual may also move on the spectrum throughout different times in their life.
Disordered eating is pervasive in our current society and often individuals are praised for their efforts despite the potential harm such behavior can cause. This praise can not only result in increased drive to engage in behaviors but also discredit the health risks that engaging in disordered eating behaviors can cause.
It is important to note that individuals who engage in disordered eating behaviors are at higher risk for developing an eating disorder – and early intervention for eating disorders is key.
What is an eating disorder?
An eating disorder is a serious mental illness characterized by highly distressing attitudes, beliefs and behaviors related to one’s food intake, body shape and weight. Eating disorders have one of the highest mortality rates of all mental illnesses.
There are many misconceptions regarding eating disorders and the populations impacted. Eating disorders are often overlooked and misdiagnosed by medical professionals, especially when providers do not follow a weight-inclusive approach to health. It is imperative to remember that eating disorders do not discriminate and can affect people of all ages, races, ethnicities, genders, shapes and sizes.
Signs of disordered eating
These common behaviors are signs of disordered eating that can snowball into an eating disorder (which is why early identification and help is key):
- Skipping meals
- Avoiding certain food groups (e.g., carbohydrates, fats)
- Limiting eating to only certain times of day
- Using exercise as a means of “burning” or “earning” food
- Assigning moral value to food choices (“good” or “bad”)
- Frequently dieting
- Imposing food rules
- Avoiding events involving food
- Feeling anxiety surrounding food choices
- Restricting certain food choices to specific days/times
- Eating large amounts of food at one time
- Being rigid about exercise routines
- Preferring to eat alone
Note: This is not a comprehensive list of disordered eating behaviors. Some of the behaviors listed are also characteristic of an eating disorder. If your client is exhibiting any of these signs, call us at 877-825-8584 and we’ll match them with the exact support they need.
Helping patients with disordered eating
As a dietitian, you play a critical role in identifying disordered eating and ensuring your patients receive the care they need. When you notice a patient is exhibiting these signs, it is important to meet them with compassion and curiosity.
Often people develop rules or distorted beliefs about food because of a lack of true understanding around the role food plays in the human body. If you suspect your patient is struggling with an eating disorder, Levinstein suggests:
“First approach the conversation indirectly, asking about how different aspects of their lives are going, if anything is challenging, to build up to discussing your concern.”
Providing weight-neutral nutrition education can be a great first step when helping a patient resume normative eating habits. Asking questions can help you understand more and meet them with the level of support/care that they need.
Here are a few questions to ask:
- Can you tell me about when these behaviors/thoughts started?
- Can you tell me what prompted you to change the way you think and feel about food?
- How often do you find yourself thinking about your food and exercise choices?
- Do you notice you’re avoiding eating around loved ones because you’re worried about the food options?
“It's best to refer a patient to ERC for an assessment if their symptoms and behaviors aren't improving with outpatient care.”
Our dietitians are here to help you support your patients on their journey cultivating a peaceful relationship with food. If you find yourself wanting to learn more about eating disorders or if you’re unsure about the level of care that best supports your patient, we are here to help.
Call us at 866-622-5914 or fill out this brief form to learn more about our services.
Useful blogs to learn more ways to support your clients:
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