What Is Disordered Eating, and How Do I Get Help?
A Psychotherapist Explains How to Tell If You Have Disordered Eating and How to Get Help
For someone whose eating is disordered, their life around food can be stressful, complicated, and even painful. Psychotherapist Lynsey McMillan, MSc, who specializes in disordered eating, explained that "in cultures where thinness is prized, we see more incidences of disordered eating, so it is definitely a significant contributing or exacerbating factor." She explained how to tell if you have disordered eating and how to get help.
What Is Disordered Eating?
Lynsey shared this list of behaviors that could be characterized as disordered eating:
- Being preoccupied with dieting, either thinking a lot about losing weight, planning their next diet, or engaging in one diet after another.
- Being preoccupied with their weight, shape, and size; making unhelpful self-comparisons with other's bodies; or being negative, self-critical, and unaccepting of their body.
- Being preoccupied with food and also feeling that food has power over them or they are powerless to resist food and must exert willpower or abide by rigid rules to avoid loss of control.
- Engaging in exercise to excess, restricting food, skipping meals, fasting, or purging (vomiting or laxatives) with the sole aim of altering their body.
- Chewing food and spitting it out.
- Believing being a better person or having a better life means having the right body and eating in a certain way that is "perfect" or "right."
- Feeling food is their best friend, worst enemy, or both; having a love-hate relationship with food.
- Experiencing weight fluctuations.
- Frequently weighing themselves.
- Finding eating in social situations stressful or difficult.
- Finding shopping for food as well as cooking stressful and fraught with too many decisions.
- Experiencing feelings of shame and self-loathing, anxiety, depression, low self-esteem, and poor or distorted body image.
- Having difficulty managing emotions, and perhaps a lack of other coping strategies, so may use food to manage the ups and downs of day-to-day life.
- Having a tendency to turn toward food and away from other people when times are tough. These people are frequently very self-reliant or conflicted about trusting others.
Lynsey said people with disordered eating patterns often have had difficult early attachments, loss, or trauma in their lives. They tend to view things in black-and-white terms, may be perfectionists, and may also suffer from depression and anxiety. Disordered eaters also usually have obsessions and compulsions in relation to other areas of life. If a person is preoccupied with thoughts about food, what they should or shouldn't eat, when and how much, their weight, and how eating affects how they look, it's bound to affect the person's life and relationships negatively.
What Is a Normal Eater?
"'Normal' is a tricky concept, as we all have our own definition of what normal is," Lynsey explained. She asks clients what normal means for then, and they'll describe a "calm or peaceful relationship with food that is free of conflict." She explained that a "normal" eater isn't preoccupied with thinking about food, weight, and their bodies, and eating is free from daily judgment.
A "normal eater" might miss a meal or overeat from time to time, but the difference is they don't attach any shame or judgment to those times. When it happens, they move on. She said a "normal eater" might see food as fuel but equally might really love food and enjoy cooking. "Either way, they are not caught up in a shameful relationship with food and would have a good sense of when they are hungry, when they are full, and what foods they like and dislike," she said. "Chances are, a 'normal eater' is also more secure in other areas of life."
What Causes Disordered Eating?
As mentioned above, in cultures where body size is so important and being thin is seen as beautiful, Lynsey said it can trigger disordered eating behaviors. She added that when problems with eating emerge, they often have "no single cause but instead are born out of a concoction of personal, social, cultural, biological, and genetic factors that are unique to the sufferer, yet share broad commonalities to us all."
Does Having Disordered Eating Mean You Have an Eating Disorder?
"Engaging in disordered eating behaviors does not necessarily mean you have an eating disorder," Lynsey explained. According to the National Eating Disorders Association (NEDA), eating disorders may include the disordered eating behaviors mentioned above, but they are complex psychiatric illnesses with biological components and can be life-threatening. NEDA explains, "eating disorders are 50 to 80 percent genetically-based; they are not a choice."
Lynsey said that to be diagnosed with an eating disorder such as anorexia, bulimia, orthorexia, or binge-eating disorder, you must fit within a specific and narrow frame of behaviors and symptoms as determined by the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5). She said, "Disordered eating is a description rather than a diagnosis, and it is possible to have disordered eating behaviors but not find yourself fitting within the current parameters of a diagnosable eating disorder — even if you are in great distress."
She added that it's a broad spectrum. "Someone could be in recovery from an eating disorder and still have some disordered behaviors, which may or may not lead to a full-blown diagnosis of an eating disorder," she said. "What is true across the board is that anyone on this spectrum is not at ease with their body and their relationship with food."
What Can Someone Do If They Have Disordered Eating?
Lynsey said it's essential to recognize that the relationship you have with yourself requires some care and attention and that healing that often requires us to seek out helpful relationships with others. You want to be curious about what lies behind the problem. Don't ask yourself, "What is wrong with me?," but rather, "What happened to me?"
Above all, be compassionate with yourself. Lynsey said, "There are many good reasons why you have disordered eating, and it's not your fault, but it is your responsibility because we can't wait for the world to change." You can start by educating yourself about how "diet culture and consumerist values drive unrealistic expectations" and focus on loving and appreciating yourself, be grateful for what your body allows you to do, and not focus so much attention on what it looks like.
Lynsey suggested you seek out professional and social support to help you understand your relationship with food and learn skills for emotional management and intuitive eating. She said, "Find your tribe in any way you can. Going it alone only gets you so far."
If you or someone you know is struggling with disordered eating or an eating disorder, the National Eating Disorder Association (NEDA) has resources available including a 24/7 helpline at (800) 931-2237.