Both disordered eating habits and eating disorders have distinct signs and symptoms, some of which overlap. Knowing the difference between the two can help you figure out whether you may need professional help and which coping strategies could bring you relief.
For many people, excessive thoughts about food and eating, especially as they relate to body weight and shape, can be preoccupying and anxiety inducing, and can even impede their ability to function.
It’s completely normal and even enjoyable to think about food, meal planning, grocery shopping, or whatever you’re craving for dinner tonight, says Susan Zinn, a licensed certified professional counsellor and eating disorder specialist in private practice in Santa Monica, California.
But approximately 28.8 million Americans, or 9 percent of the U.S. population, will develop an eating disorder at some point in life, according to the National Association of Anorexia Nervosa and Associated Disorders. Even more common are disordered eating habits, such as frequent dieting, which can raise your risk of an eating disorder down the road.
What Does It Mean to Have Disordered Eating Habits?
According to Carrie Wasterlain, LCSW, disordered eating can take many forms, and sometimes it’s hard to spot. “Unfortunately, due to societal fixation on food choices, fad diets, and fixation on body shape and size, disordered eating is so pervasive that it has become normalised,” says Wasterlain, who serves as assistant director at the Dorm, a New York City mental health practice for young adults, and works primarily in the fields of eating disorders and dual diagnoses.
Disordered eating typically stems from the desire to control one’s physical appearance, and when these behaviours lead to the desired changes, one’s attachment to those behaviours strengthens and sometimes leads to a diagnosable eating disorder later on, explains Wasterlain.
Signs of Disordered Eating Habits
Any attempt to ignore your body’s natural hunger and fullness cues fuels disordered eating behaviour, advises Wasterlain. Common examples are:
- Skipping meals
- Diet cleanses
- Misusing supplements or using diet pills
- Picking apart food into small pieces
- Fearing certain foods
According to the Academy of Nutrition and Dietetics, other signs of disordered eating include:
- Significant weight fluctuations over time
- Strict routines and rituals related to food and exercise
- Feeling shame or guilt related to eating
- Constant and distressing thoughts about food, body image, and weight
- Feeling like you can’t control yourself around food or eating compulsively
- Exercising, fasting, restricting food, or purging to make up for “bad foods” you ate
What Does It Mean to Have an Eating Disorder?
Eating disorders are serious, potentially life-threatening mental health conditions that have become increasingly common in the United States, says Zinn. They can develop in people of any age, weight, size, shape, gender identity, sexuality, cultural background, or socioeconomic group.
Per Mayo Clinic, the three most common eating disorders are:
1. Anorexia Nervosa
People with anorexia nervosa have a dangerously low body weight, a significant fear of weight gain, and a distorted view of body weight and shape. They attempt to control their weight in extreme ways, such as severely limiting their calorie intake, over-exercising, or forced vomiting after a meal.
2. Bulimia Nervosa
This eating disorder is characterised by cycles of food restriction, binge eating, and purging in ways such as forced vomiting, over-exercising, or misusing laxatives.
3. Binge Eating Disorder
People with binge eating disorder consistently eat too much food, even if they’re not hungry or are feeling uncomfortably full, and have a hard time controlling how much they eat. However, unlike people with anorexia or bulimia, people with binge eating disorder don’t engage in compensatory measures to attempt to offset how much they ate.
Eating disorders are complex and can have a variety of causes, including biological, social, and psychological, says Zinn. According to the National Eating Disorders Association (NEDA), risk factors include:
- Having a parent or sibling with an eating disorder
- Having a history of an anxiety disorder
- Experiencing teasing, bullying, or weight stigma, defined as discrimination based on body weight
- Exposure to social or media messages related to the ideal body
Signs of an Eating Disorder
“Individuals struggling with an eating disorder will have obsessive thoughts about food, weight, and shape that will occupy most of their day, every day,” says Zinn. These thoughts may include specific foods, exercising, avoiding or hiding food, or where and when someone will be purchasing food. And when people with eating disorders act on these thoughts, they often feel very ashamed.
According to the National Institute of Mental Health and NEDA, other potential signs of an eating disorder are:
- Changes in eating behaviour or increased use of weight-loss-related behaviours
- Extreme concern with body size and shape, including frequently checking one’s appearance in the mirror
- Increased fixation on food, discussion of food, or voiced fears around food
- Increased secrecy or lying about eating
- Extreme mood swings
- Withdrawal from family, friends, and activities once enjoyed
- Adopting new food practices or fad diets, including cutting out entire food groups
- Cuts and calluses on the knuckles caused by induced vomiting
- Dental issues, such as cavities, enamel erosion, or tooth sensitivity
- Dry skin
- Brittle hair and nails
- Difficulty concentrating
- Dizziness and fainting
- Hormonal changes leading to menstrual irregularities, such as missed periods
How to Distinguish Between Disordered Eating and an Eating Disorder
The difference between disordered eating habits and an eating disorder isn’t always obvious. The two can look a lot alike. After all, engaging in disordered eating behaviour increases one’s risk of developing an eating disorder later on.
But according to the American Psychiatric Association, mental health professionals use specific criteria described in the Diagnostic and Statistical Manual of Mental Disorders to determine whether someone has a clinical eating disorder, such as anorexia, bulimia, or binge eating disorder.
The criteria for eating disorders include many disordered eating habits, but not everyone who engages in disordered eating meets the criteria for an eating disorder, notes Wasterlain. How many disordered eating behaviours you engage in, how often you practise this behaviour, and their impact on both your physical and mental health often distinguish disordered eating habits from a clinical eating disorder.
The degree of obsession with food, calories, shape, weight, and the behaviour that reinforce these obsessions can also signal the difference between the two, explains Zinn. “When the obsession with food hinders your daily functioning, it is time to seek professional help,” Zinn advises, especially if what you’re experiencing leads you to deprioritide things you used to care about, such as work, relationships, school, and hobbies.
And people with eating disorders also often feel powerless over their behaviour and have a hard time controlling them, Zinn adds.
How to Get Help
If you’ve been diagnosed with an eating disorder or think you may have one, you could benefit from professional help – and the sooner you seek help the better.
“The chance for recovery increases the earlier an eating disorder is detected,” Zinn says.
If you think you may have an eating disorder, reach out to your doctor or a mental health professional for an evaluation.
And even if you haven’t been diagnosed with an eating disorder but find that you’re engaging in disordered eating habits, seeing a mental health professional could still be helpful for you to learn how to manage these habits.
You don’t have to have an eating disorder to seek professional help.
Care for an eating disorder often involves a team approach, Mayo Clinic states. Your treatment team may include your primary care doctor, a mental health professional, and a registered dietitian/nutritionist experienced in eating disorders. Standard, evidence-based treatment plans for eating disorders may involve hospitalisation, psychotherapy (also known as talk therapy), medications for co-existing mental health conditions such as depression or anxiety disorders, and meal plans designed to meet your recovery needs.
Developing healthy coping skills is also crucial to recovery adds Zinn, as many people with eating disorders turn to disordered eating behaviour to cope with life’s stresses and difficult emotions. Activities that have been found to help people with eating disorders include:
- Making Gratitude Lists
Make a list of what you are grateful for in your life, such as family, friends, pets, or hobbies. “The act of writing things down help you focus on your positive renewing emotions rather than your depleting ones,” says Zinn.
- Try New Activities
Becoming more involved in activities that interest you and that can boost your self-esteem.
- Practise Positive Affirmations
Look at yourself in the mirror and repeat an affirmation each morning and night for 30 days, Zinn advises. One example is, “I am enough just as I am.” With practise, the affirmation becomes part of you, increases your confidence, and you will start to notice the things you like about yourself.”
- Going for Walks
Taking walks, particularly in the first 30 minutes of waking up, can calm your nervous system and help you feel better for the rest of the day, says Zinn. But if your treatment team has placed limits on your daily physical activity, be sure to clear this with them first.
- Seeking Support From Loved Ones
Sharing your feelings with your loved ones and asking for support when you’re struggling can help you stay on track, says Zinn. Eating disorders thrive on secrecy, so having people hold you accountable while in recovery can help.
Recovery from an eating disorder can take time, and the process is not a linear progression, according to NEDA. Recovery journeys vary from person-to-person – how long it takes one person to recover may be very different than the time it takes someone else to recover. Some people may be successfully treated the first time, while others may need to resume treatment again in the future, NEDA states. And the psychological work behind recovery often needs to continue throughout one’s life.