What is the Difference between Disordered Eating and an Eating Disorder? (December 2018)
A common question by many people is: “what is the difference between disordered eating and an eating disorder?” This article written by my colleague Erica Leon, MS, RDN,CDN,CEDRD and Certified Intuitive Eating Counselor will discuss the difference between them both.
This article has been republished with Erica Leon’s, MS, RDN,CDN,CEDRD Certified Intuitive Eating Counselor permission.
As a certified eating disorder registered dietitian, this is a question I am frequently asked:
What is the Difference between Disordered Eating and an Eating Disorder?
I am going to shed some light on this for you today and explain it.
Picture this: You or your child decide to “get healthier” so you start increasing your intake of fruits and veggies. Sounds great! Yes, it sounds great until you slowly start cutting out other foods like breads, cereal, potatoes, pasta, brown rice, etc. You don’t remember where you heard it, but someone told you that eating “carbs” is “bad”. Well, since you are feeling saintly, you decide to cut out anything else with carbs, including fruit and yogurt, because you heard these foods have too much sugar. What? Where did you read this?!
You have now become a “disordered” eater; your food intake has become very limited and the only foods you eat include chicken, fish and vegetables. You have become afraid to eat anything with carbs for fear of it being “unhealthy.” Forget having a piece of cake on your birthday. Forget going out to dinner with friends on the weekend because who knows what “unhealthy” foods the menu will have on it! Or you decide to go out to dinner with friends and eat something you considered “bad” so you will have to pay penance tomorrow by going another hour on the elliptical. You are potentially on your way to slip into a true eating disorder if these behaviors intensify.
So, what is the difference between disordered eating and an eating disorder?
In a nutshell, the difference boils down to a few factors: the degree to which a person’s life is impaired emotionally by obsessive thoughts and behaviors around food and body image, and the potential physical damage caused by some of the eating behaviors.
Disordered eating and diagnosable eating disorder behaviors exist along a continuum, and there can often be a fine line separating one from the other,” according to Lisa Ellis, certified eating disorders registered dietitian and therapist.
Both will usually develop as an ineffective way of managing uncomfortable feelings. Both can cause distress and may require outside help in the form of therapy, nutrition therapy and/or medical monitoring for a person to fully heal.
Disordered eating is far more common than people realize. We live in a society that “normalizes” eating for the pursuit of weight loss. We are told by just about everyone to eat healthfully, cleanly and/or organically. Mainstream media promotes the latest fad diet du jour — the method seems to change with the season. Diets are often a predictor of disordered eating behaviors and, according to The National Eating Disorders Association, “35% of “normal dieters will progress to pathological dieting and that of those individuals, 20-25% will develop full-blown eating disorders.”
Someone with disordered eating does not eat according to internal cues of hunger, fullness, or satisfaction. Some people follow a plan that cuts out whole foods or food groups, while others eat in a rigid, non-flexible manner. They might restrict their food intake or eat emotionally or use the compensatory behavior of over-exercise to control body weight. A disordered eater may be very concerned with their body size, weight and body image, but it does not necessarily impair daily functioning. The distinction really has more to do with the degree of obsessive thinking about food, how the person functions in the world, and the frequency and severity of coping behaviors used.
Eating disorders, such as anorexia, bulimia, binge eating disorder, and other specified eating disorders (OSFED), have very specific criteria that have been developed by the American Psychiatric Association in a document referred to as the DSM-V. This is used by insurance companies to help direct treatment, as these are serious mental illnesses, which pose the risk of physical harm to the person, including death due to malnutrition, electrolyte and fluid imbalances and organ damage.
According to the Alliance for Eating Disorders Awareness:
Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. The four most common eating disorders are Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Other Specified Feeding or Eating Disorders (OSFED). Eating disorders currently affect approximately 25 million Americans, in which approximately 25% are male. Anorexia has the highest mortality rate among all psychological disorders.”
Eating Disorder or Disordered Eating: Words Matter.
We can’t put people into neat little boxes and recovery from either can be a lengthy process. It is how a person experiences their level of distress that is more important than a label. What’s most important is having a person get the help they need to feel comfortable with their food intake and body image. And helping them find the words that work for them.
To find a dietitian nutritionist that specializes in eating disorders and disordered eating in your local area that can help you with these challenges is readily available. The website to find a trained clinician is www.eddietitians.com.