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 counselor and eating disorder specialist in private practice in Santa Monica, California. But 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. 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. 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.
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 normalized,” 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 behaviors lead to the desired changes, one’s attachment to those behaviors 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 behaviors, advises Wasterlain. Common examples are:
Skipping mealsTrying diet cleansesMisusing supplements or using diet pillsPicking apart food into small piecesFearing certain foods
According to the Academy of Nutrition and Dietetics, other signs of disordered eating include:
Significant weight fluctuations over timeStrict routines and rituals related to food and exerciseFeeling shame or guilt related to eatingConstant and distressing thoughts about food, body image, and weightFeeling like you can’t control yourself around food or eating compulsivelyExercising, 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:
Anorexia Nervosa People with anorexia nervosa have a dangerously low body weight, significant fear of weight gain, and distorted view of body weight and shape. They attempt to control their weight in extreme ways, such as severely limiting their calorie intake, overexercising, or forced vomiting after a meal.Bulimia Nervosa This eating disorder is characterized by cycles of food restriction, binge eating, and purging in ways such as forced vomiting, overexercising, or misusing laxatives.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 ones, says Zinn. According to the National Eating Disorders Association (NEDA), risk factors include:
Having a parent or sibling with an eating disorderHaving a history of an anxiety disorderExperiencing teasing, bullying, or weight stigma, defined as discrimination based on body weightExposure 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 behaviors or increased use of weight-loss-related behaviorsExtreme concern with body size and shape, including frequently checking one’s appearance in the mirrorIncreased fixation on food, discussion of food, or voiced fears around foodIncreased secrecy or lying about eatingExtreme mood swingsWithdrawal from family, friends, and activities once enjoyedAdopting new food practices or fad diets, including cutting out entire food groupsCuts and calluses on the knuckles caused by induced vomitingDental issues, such as cavities, enamel erosion, or tooth sensitivityDry skinBrittle hair and nailsDifficulty concentratingDizziness and faintingHormonal 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 behaviors increases one’s risk of developing an eating disorder down the road. What exactly is the difference? 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 behaviors you engage in, how often you use these behaviors, 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 behaviors 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 deprioritize things you used to care about, such as work, relationships, school, and hobbies. And people with eating disorders also often feel powerless over their behaviors 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 hospitalization, psychotherapy (also known as talk therapy), medications for coexisting mental health conditions such as depression or anxiety disorders, and meal plans designed by a dietitian 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 behaviors to cope with life’s stresses and difficult emotions. Potential coping skills for people with — and without — eating disorders include: 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.
