What's the Difference Between an Eating Disorder and Disordered Eating?
Disordered eating has become increasingly normalized and prevalent in our society, making it difficult to discern disordered eating behaviors from an eating disorder. Individuals with eating disorders exhibit disordered eating behaviors, but not all disordered eaters meet the criteria for a full-threshold eating disorder. The difference lies in the inherent preoccupation and distress that the disordered behaviors cause the individual.
By: Sadie Grant
In our weight and diet-obsessed culture, disordered eating has reached epidemic proportions. The International Journal of Eating Disorders reports that about 35 percent of people in the United States will develop a pathological pattern of eating during their lifetime.[1] In fact, research suggests that up to 50% of the population exhibits a disordered approach to body, food, and movement. Full-threshold eating disorders, on the other hand, affect about 1-3% of the United States population.[2]
So what is disordered eating, anyway? How serious is it? When do normalized dieting or exercising behaviors become disordered?
And what distinguishes disordered eating from a full-blown eating disorder? How can we address disordered eating patterns to prevent the development of more severe, life-threatening symptoms?
In the following, we are going to discuss the differences and connections between eating disorders and disordered eating. We will clarify symptoms and criteria, outline common patterns of development, and offer tips for prevention and treatment.
What Is an Eating Disorder?
An eating disorder is a combination of biological, psychological, and sociocultural factors that can severely impact an individual’s life and wellbeing. The Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) recognizes 4 categories of eating disorders: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Other Specified Feeding or Eating Disorder (a category of eating disorders that cause significant physical and emotional disturbances but do not meet the diagnostic criteria for the other 3 disorders).[1]
For someone to be diagnosed with an eating disorder, they must meet at least the minimal diagnostic criteria described in the DSM-5. However, just because a person does not meet the criteria for an eating disorder does not mean that they have a healthy relationship with food and body. Individuals with any degree of disordered eating can also experience significant physical and emotional distress.
What Is Disordered Eating?
Those with disordered eating often experience similar symptoms and behaviors to those with full-threshold eating disorders. Even though individuals with disordered behaviors around food may not meet the criteria for an eating disorder, they often feel extreme anxiety related to food and body image. Common symptoms of disordered eating include:
Restricting food intake
Binge-eating
Purging (i.e., self-induced vomiting, excessive exercise, use of laxatives/diuretics)
Believing that self-worth is based on weight/appearance
Overexercising
Experiencing body dysmorphia (i.e., when one fixates on defects in their appearance that others often cannot perceive)
Counting calories obsessively
Rigid eating (i.e., only eating certain food groups, only eating at certain times, refusing to eat food prepared by others)
Experiencing anxiety around certain foods or food groups
While disordered eating is not always as severe as a full-blown eating disorder, the behavior can still cause significant physical and emotional disturbances. Furthermore, disordered eating often leads to the development of a diagnosable eating disorder.
What Is the Connection Between Diet Culture, Disordered Eating, and Eating Disorders?
We know that disordered eating can be a precursor to an eating disorder, but how does disordered eating develop? Disordered eating can arise from a number of factors, such as family history, co-occurring mental disorders, perfectionism, and a history of trauma, but diet culture may most often be to blame.
Most of us can say we have heard a friend or colleague say they were “bad” for eating a donut during a meeting, or we may have noticed loved ones make remarks that they need to workout to “burn off” a big meal. Many of us may have even made similar remarks. These types of shaming comments reflect the pervasiveness of diet culture, or the idea that our worth is tied to how we look, eat, and exercise. By sending the message that we should feel guilty for eating certain foods or for not exercising enough, diet culture can encourage and normalize disordered behaviors around food, and make us more susceptible to develop a full-blown eating disorder.
For example, current “healthy” eating trends, such as intermittent fasting and eliminating certain food groups (without medical reason), have made many disordered eating symptoms socially “acceptable”. One eating disorder that can arise from diet-disguised disordered eating is Orthorexia. Orthorexia is an unhealthy obsession with healthy eating and falls under the category of Other Specified Feeding or Eating Disorder in the DSM-5.[3] Fad diets that encourage disordered eating can also develop into other full-threshold eating disorders, such as Bulimia Nervosa, Anorexia Nervosa, and Binge Eating Disorder.
What Are Options for Prevention and Treatment?
Whether someone is experiencing disordered eating or an eating disorder, treatment is always possible and essential. In fact, early prevention and treatment of disordered eating can protect individuals from developing more severe, life-threatening symptoms and behaviors.
One way to prevent or combat disordered eating is to reject diet culture. This may include avoiding fad or restrictive diets and instead adopting an inclusive, diverse meal plan. Or this may look like setting boundaries around exercise, and choosing movement activities that elicit joy and relaxation. Part of rejecting diet culture also involves avoiding negative body talk. By refraining from criticizing our bodies or the bodies of others, we can move away from the mentality that worth is connected to weight and appearance.
Although actively working to reject diet culture can be a powerful preventative measure, psychotherapy and nutrition counseling are the best strategies to treat disordered eating and eating disorders. Psychotherapy can support individuals understand the complex relationship between self-esteem and body image, identify underlying psychological issues, and discover other sources that contribute to disordered eating. Additionally, a nutritionist who specializes in eating disorders and utilizes a non-diet approach can support individuals to eat and appreciate food, recognize hunger and fullness cues, and develop a more intuitive approach to eating.
At BALANCE eating disorder treatment center, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. We offer a variety of programs and services targeted at helping clients overcome fear foods and develop a healthy relationship with food. We offer nutrition counseling with a licensed dietitian, meal support, a Food & Mood Group, and a variety of other groups and resources to help those seeking help for food concerns.
Our admissions team would be happy to answer any questions you may have regarding our programs & services. Book a free consultation call below or read more about our philosophy here.
This post was written by BALANCE Blog Intern, Sadie Grant.
Sadie is a recent graduate of Oberlin College with a B.A. in psychology. After recovering from disordered eating, Sadie became passionate about eating disorder awareness, body neutrality, and destabilizing beauty standards that are established by social and cultural norms. While earning her Bachelor’s degree, Sadie conducted quantitative research, worked with populations experiencing barriers to essential services, and studied Spanish. Sadie hopes to use her developing research and interpersonal skills to work in the field of eating disorders and address the way in which expectations around eating and beauty vary across different populations.
Resources
[1] Shisslak, C. M., Crago, M., & Estes, L. S. (1995). The spectrum of eating disturbances. International Journal of Eating Disorders, 18(3), 209-219.
[2] Gottlieb, C. (2014, February 23). Disordered eating or eating disorder: What's the difference? Retrieved February 16, 2021, from https://www.psychologytoday.com/us/blog/contemporary-psychoanalysis-in-action/201402/disordered-eating-or-eating-disorder-what-s-the
[3] The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association [APA], 2013)
[4] Ekern, B. (2019, April 16). Disordered eating vs. eating disorders: What is the difference? Retrieved February 16, 2021, from https://www.eatingdisorderhope.com/blog/eating-disorders-disordered-eating