Think about how many food-related decisions you make in one day—it’s probably too many to count. For example, your thought process may go something like this: “Carrot sticks or chips for a mid afternoon snack? I know what I should choose, but I’m craving something salty. I’m probably going to regret the chip decision later, so carrot sticks it is.” While being mindful of what you eat is important, there is definitely a fine line between conscious eating and disordered eating. “Defining an eating disorder is not all cut and dry. You may ask yourself, ‘Do I have a healthy relationship with food?’ ‘Is food nourishing or a source of distress?’ Most ’normal’ eaters don’t follow a perfect daily eating routine,” says Nicole R. Evry, LCSW. “The biggest factor is not what is eaten, but an overwhelmingly negative emotional response to eating along with dysfunctional thoughts or behaviors around food.” When it comes to disordered eating, there’s a lot to think about and understand. And living with an eating disorder—or having a close relationship with someone who has one—can feel difficult, to say the least. “Obsessing over food is usually coupled with compulsive—and possibly dangerous—behaviors around excessive eating, abstaining from food, compensatory actions, or food preparation rituals,” Evry states. “There may be rigid attempts to stay in control, or feeling resigned to one’s loss of control. There are a variety of diagnoses to determine exactly which eating disorder an individual may have, with the potential for cross-over.
What is disordered eating?
An eating disorder is a disturbance of thoughts, behaviors, and emotions relating to food. These can be severe and even life-threatening, Dr. Steven Powell, Psychiatrist and Clinical Specialty Advisor of Hims & Hers, explains. Eating disorders involve an extreme fixation on body image or food with negative consequences. People who suffer from eating disorders are noted tend to display specific characteristics. Dr. Powell shares some of the most common ones:
Changes in food intakeEating in secretDramatic changes in weightPreoccupation with foodBingeing/purgingRestricting of foodDry skinHair lossMenstrual irregularitiesFaintingDizzinessGastrointestinal symptomsAbusing diet pills or laxatives
In many cases, there is a distortion of what is healthy versus unhealthy behavior. Physical activity, eating, and weight management can all be on a spectrum of normal to abnormal depending on the degree to which a person focuses on it and if they are fixated to the point where these behaviors become unhealthy, Dr. Powell adds. It is important to understand risk factors of eating disorders, too, which can include social influences: Impulsivity, genetics, perfectionism, and past trauma.
Types of eating disorders
There are a handful of different types of eating disorder out there. Here are the ones you should be aware of:
Anorexia nervosa
This is likely the most well-known eating disorder. It most often develops during adolescence or young adulthood and affects more women than men. “People with anorexia generally see themselves as overweight, regardless if they are severely underweight,” says Dr. Powell. “They will constantly monitor their weight, severely restrict their calories, and avoid eating certain types of foods. For some, bingeing and purging is a major component, and for others it is restricting.”
Bulimia nervosa
This type of disordered eating occurs when someone eats unusually large amounts of food in a defined period of time. This often leads to the person becoming overly full and subsequently purging to control how many calories they are actually eating. “Bulimia tends to develop during adolescence and early adulthood and also occurs more often in women than men,” Dr. Powell explains. “Common purging behaviors include excessive exercise, purposeful vomiting, diuretics, enema, fasting, laxatives and excessive exercise. People affected by bulimia are often of normal weight.”Symptoms may appear very similar to those of the binge eating or purging subtypes of anorexia nervosa. However, individuals with bulimia usually maintain a relatively normal weight, rather than becoming underweight.
Binge eating
Binge eating is when a person eats an unusually large amount of food in a relatively short period of time and feels a lack of control during binges. “People with binge eating disorder do not usually restrict calories or purge or excessive exercise to compensate for their binges,” says Dr. Powell. “It typically begins during adolescence and early adulthood, although it can develop later in life as well. People affected by this will have symptoms similar to those of bulimia or the binge eating subtype of anorexia.”
Pica
Pica is an eating disorder where people carve a non-food item to eat that can occur in adults, children, and adolescents. It is most commonly observed in pregnant women, children, and individuals with mental disabilities. Common cravings are for dirt, wool, pebbles, soil, chalk, soap, ice, paper, hair, cloth, laundry detergent, cornstarch, or other items, Dr. Powell explains.
Orthorexia
On the surface, orthorexia often presents as a person engaging in a fad diet like Atkins, Keto, or Paleo, but internally involves obsessing over meal planning, limiting food intake, and avoiding certain foods. Sufferers experience feelings of anxiety, guilt, and self-loathing especially when confronted with scenarios that will compromise one’s meal plan, Evry states.
Avoidant Restrictive Food Intake Disorder (ARFID)
This eating disorder resembles anorexia with limited food intake. “The main difference is that the behavior stems from one’s revulsion toward certain foods more than a desire to lose weight (DSM-5),” says Evry. “ARFID patients may avoid all but one very specific food such as Lay’s Potato Chips, leading to weight loss and malnourishment.” If you or anyone you know is suffering from any of these disorders, it’s important to take action sooner rather than later, as eating disorder can be life-threatening. Depending on the disorder’s severity, you can seek treatment through a nutritionist, certified eating disorder specialist, or (if medical intervention is needed) an Intensive Day Treatment or Inpatient Visit may be warranted. Be sure to consult a mental health expert or doctor if you’re worried about disordered eating in yourself or someone else, and check out the National Eating Disorders Association for more information and resources. Next up: Taylor Swift Reveals She Had an Eating Disorder: ‘It’s Not Good for Me to See Pictures of Myself Every Day’
Sources
Nicole R. Evry, LCSWDr. Steven Powell, Psychiatrist and Clinical Specialty Advisor of Hims & Hers
