It’s not uncommon to be in a love-hate relationship with food, working out and the scale. Whether salty snacks are your thing or you have a self-proclaimed sweet tooth, struggling to balance a healthy diet, exercise and weight can be emotional. Registered Dietitian Carrie Leiran, MS, RDN, LD, CEDRD, UnityPoint Health, explains when certain eating patterns become more serious, like disordered eating or an eating disorder. She clarifies what disordered eating is, possible causes and how to know if you should seek help.
Disordered Eating or Eating Disorder?
Leiran defines an eating disorder as practicing harmful eating and/or exercise behaviors to deal with chronic stressors, which negatively impacts someone’s mental and physical health. On the other hand, she says disordered eating includes many of the features of an eating disorder, such as eating out of emotion, but without the compensation behaviors (ex. binge eating, vomiting, going without food), degree and frequency of an eating disorder.
“Feelings of guilt and shame may not be as strong with disordered eating as with an eating disorder,” Leiran says. “But, chronic dieters or fad dieters (eliminating carbs, etc.) would fall into disordered eating.”
She describes normal, non-disordered eating as when a person looks at his/her hunger level, decides what he/she is hungry for, eats and is able to stop in a natural way when full. A normalized eater doesn’t associate calories to foods eaten or the amount of exercise needed to burn it off.
“When we practice normal eating habits, we look at our appetite and satisfaction. Occasionally, we may over or under eat, but it isn’t a regular pattern,” Leiran says.
Disordered Eating Symptoms
Leiran says of those who develop an eating disorder, 65 percent start out with dieting. Disordered eating also usually starts in the same way. Here are the top symptoms associated with disordered eating:
- Eliminating food groups, such as carbs, from the diet
- Constant talk about food, calories and/or exercise
- Restrictive, or limited, eating
- Hiding body shape with clothing
- Daily, compulsive exercise of 2-3 hours or more
- Avoiding eating with others
- Sudden weight gain or loss
- Obsessive weighing
- Sudden changes in lifestyle habits
“Dieting can start simply enough, but quickly, dieters can become out-of-touch by obsessively looking at the ‘extrinsic,’ such as counting calories from food or exercise. Being in-touch with hunger, fullness, appetite and satisfaction are keys to being mindful about eating in general,” Leiran says.
Excessive exercise also relates to disordered eating and eating disorders. Instead of being a routine lifestyle, Leiran says it, too, can spiral into an unhealthy practice.
“For some, exercise is a calorie-counting thing. If I ate ‘X,’ then I must exercise ‘Y’ to offset the food I ate. For others, it’s a need to have a certain body type. Yet still, others exercise to burn fat and weigh less, so the more exercise the better. Excessive exercise behaviors may help some feel less anxious and depressed at first, but as the behavior continues, it flips to compulsion,” Leiran says.
What Could Cause Disordered Eating?
Possible causes of disordered eating are thought to be like those of eating disorders. Leiran says reasons for disordered eating range from a variety of stressors:
- Peer pressure at school or work
- Sports that focus on thinness, like running, gymnastics, etc.
- Media emphasis on thinness and fitness, as well as judgment of what someone eats
- Character traits including perfectionism and low self-esteem
- Loss of a loved one
- Anxiety and/or depression
“Having a negative body image can play a large part in disordered eating and the development of an eating disorder. Body image is typically one of the first messages to develop and the last to come back in recovery from an eating disorder,” Leiran says.
Gender and age are certainly factors, too. While disordered eating and eating disorders impact both men and women, females make up 70 percent of those diagnosed with an eating disorder. All ages can suffer from disordered eating, but Leiran says men and middle-age women are the fastest growing groups for eating disorders. But, that doesn’t mean disordered eating behaviors don’t start young.
“A recent study shows in a sample of 1,600 adolescents, 61 percent of females and 28 percent of males reported disordered eating behaviors. Disordered eating remains less quantified than eating disorders, but other studies are under way for various age ranges,” Leiran says.
Disordered Eating Treatment
It’s important to identify and address disordered eating, as Leiran says people who show signs of disordered eating are more likely to develop an eating disorder.
“If you believe you have disordered eating patterns, talk to your provider for a referral to a therapist and a registered dietitian who specializes in the treatment of disordered eating or eating disorders. It’s helpful to see a dietitian with a background in intuitive eating approach or eating competence,” Leiran says.
If you believe someone close to you might struggle with disordered eating habits, Leiran offers this advice for starting the conversation on how to get help.
“Approach this person with non-attacking language. Try something like, ‘For me, I notice [insert what you observe] behavior, and it concerns me. Can you tell me what’s going on?’”
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