Disordered Eating or Eating Disorder?
By Kelsey Chadwick, MS RDN
Friday February 23rd, 2024
Next week is a really important one and that’s because it is National Eating Disorder Awareness Week. It will be celebrated from Monday, February 26th to Friday, March 1st. This week I wanted to talk about the differences between a diagnosed eating disorder and disordered eating. While they share similarities, they do have important differences that I’d like to highlight today.
Eating disorders are complex mental illnesses that are characterized by severe and persistent disturbances in eating behaviors and impairment in psychological functioning, including distressing thoughts and emotions.
There are currently seven diagnosable eating disorders: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Other Specified Feeding and Eating Disorder, Avoidant Restrictive Food Intake Disorder (ARFID), Pica and Rumination Disorder. There are specific diagnostic criteria for each eating disorder outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 TR).
Disordered eating often refers to a spectrum of problematic eating and distorted attitudes and thoughts around food, weight, body image and appearance. Disordered eating behaviors can include dieting, restricting food intake, binge eating, fasting, purging, excessive exercising and eliminating specific foods. Eating patterns can vary in severity, however, they do not meet the criteria (in frequency and duration) for a diagnosable eating disorder. But it important to note that disordered eating and eating disorders can both cause a severe disruption in day to day life
Contrary to what some believe, eating disorders appear to be, at least in part, heritable conditions. They are NOT “disorders of choice.” Research shows that “incidence rates in individuals with a parent with a history of eating disorder have been found to be over twice as high compared to individuals with parents with no history of an eating disorder” (1).
There are several psychological conditions that can co-occur with eating disorders and disordered eating behaviors including depression and anxiety, OCD, PTSD and substance use disorders. Environmental factors can also contribute to disordered eating and these can include sexual or emotional abuse, neglect, traumatic events, loss of a loved one, bullying, discrimination and serious illnesses.
One of the most important things to be aware of is that eating disorders and disordered eating are not a choice and there are several biological, environmental and psychological factors that are associated with both. In addition to these factors, there are several sociocultural factors that can contribute to disordered eating. These include dieting, weight loss medications, fasting, body shaming and overall cultural beliefs about dieting and body ideals.
Everywhere you look diet culture is present, even from a young age. Eating disorders most often develop in childhood and young adult years, but can affect both men and women of all ages. Research shows that “the overall lifetime prevalence of eating disorders is estimated to be 8.60% among females and 4.07% among males” (2).
You cannot look at someone and know if they have an eating disorder. Research also shows that “despite the fact that individuals with higher body weight have a 2.45 times greater chance of engaging in disordered eating behaviors as patients of normal weight, such patients receive a clinical diagnosis of an eating disorder half as frequently as patients with normal weight or underweight” (3).
Eating disorder treatment is something that is imperative, no matter the type of eating disorder or severity of the eating disorder. Everyone should seek support and have experienced providers to support them. You are not alone. If you need support in beginning your recovery or ongoing support in maintaining recovery, we’re here for you. Just reach to us, or any other practice of experienced providers.
Barakat, S., McLean, S.A., Bryant, E. et al. Risk factors for eating disorders: findings from a rapid review. J Eat Disord 11, 8 (2023). https://doi.org/10.1186/s40337-022-00717-4
Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. June 2020.
Ramaswamy, N., & Ramaswamy, N. (2023). Overreliance on BMI and Delayed Care for Patients With Higher BMI and Disordered Eating. AMA Journal of Ethics, 25(7), E540-544.