What is Disordered Eating?

Understanding Disordered Eating

When the topic of eating habits comes up, it's essential to be aware of the complexities surrounding disordered eating. This term, often misunderstood, refers to a range of irregular eating behaviors that may not warrant a diagnosis of a specific eating disorder.

Definition of Disordered Eating

So what is disordered eating? Doctors describe disordered eating as the presence of one or more irregular eating patterns. These patterns may not constitute a diagnosis of an eating disorder, as they may be infrequent and less severe.

Disordered eating is used to describe a variety of abnormal eating behaviors that may or may not meet the criteria for a diagnosis of a specific eating disorder. Many individuals with disordered eating symptoms are diagnosed with "Eating Disorder Not Otherwise Specified" (EDNOS), which has specific criteria that must be met for diagnosis.

The most significant difference between an eating disorder and disordered eating is whether a person's symptoms align with the criteria defined by the American Psychiatric Association. Disordered eating is a descriptive phrase, not a diagnosis, and individuals with disordered eating patterns may not fit within the current confines of an eating disorder diagnosis.

Causes of Disordered Eating

The causes of disordered eating can be complex and multifaceted. Anecdotal evidence suggests disordered eating may develop as a result of many factors, including social, psychological, genetic, and familial factors. A 2021 study found that young adults with a history of disordered eating or self-harm had an increased risk for negative mental health and well-being during the COVID-19 pandemic [1].

Disordered eating behaviors are common among both young people and adults, with disordered eating appearing to be more prevalent in females than males in various studies. However, this does not necessarily mean it does not occur as often in males.

Understanding the causes and recognizing the symptoms of disordered eating is the first step towards seeking help and treatment. With appropriate support and guidance, individuals with disordered eating can work towards developing a healthier relationship with food.

Impact of Disordered Eating

Understanding the impact of disordered eating involves exploring both the physical and psychological consequences. Disordered eating patterns can lead to a variety of health issues, affecting an individual's overall well-being.

Physical Consequences

Many physical consequences can result from disordered eating patterns. These often include, but are not limited to, risks of obesity, bone loss, gastrointestinal disturbances, and electrolyte and fluid imbalances. Additionally, individuals may experience a low heart rate and blood pressure [2].

Specific types of disordered eating can lead to their own unique sets of physical health problems. For instance:

• Anorexia Nervosa: Characterized by a significant reduction in food intake, leading to extremely low body weight, long-term effects include brain damage, dry skin, hair, and nails, difficulty regulating body temperature, gastroparesis, pain, constipation, and damage to major organs.
• Bulimia Nervosa: This disorder is defined by episodes of binge eating followed by compensatory behaviors, such as purging. This can lead to long-term effects like tooth decay, gum disease, esophagus damage, stomach issues, intestinal damage, nerve damage, colon damage, and heart issues [3].
• Binge Eating Disorder (BED): Individuals with BED engage in binge eating episodes at least once a week for 3 months. The long-term effects include high blood pressure, high cholesterol, heart disease, gallbladder issues, Type II diabetes, joint and/or knee pain, and an increased risk of developing some forms of cancer [3].

Psychological Effects

In addition to the physical consequences, disordered eating can also have significant psychological impacts. Increased anxiety, depression, and social isolation are common among individuals with disordered eating patterns.

Moreover, individuals struggling with BED long-term are likely to experience increased emotion dysregulation and increased suicidal ideation. These psychological impacts underscore the importance of recognizing the signs of disordered eating and seeking professional help.

Understanding the physical and psychological impacts of disordered eating is crucial in identifying its presence and working towards appropriate treatment. It's important to remember that disordered eating is a complex issue that requires comprehensive care, involving both medical and mental health professionals.

Recognizing Disordered Eating

Recognizing disordered eating can be complex as the symptoms may vary and do not always fit into neat categories. Awareness of these symptoms and understanding the difference between disordered eating and an eating disorder can facilitate early intervention and treatment.

Symptoms to Look For

Disordered eating can manifest in various ways and is characterized by irregular eating patterns. Here are some common symptoms to look out for:

• Frequent dieting
• Anxiety about specific foods or food groups
• Rigid food rituals
• Skipping meals or taking small portions of food at regular meals
• A focus on body image
• A preoccupation with food, weight, and calories (EatRight)

It's important to note that these symptoms are not always present all at once and can vary across different types of eating disorders. Further, the impacts of disordered eating, which can include a greater risk of obesity and eating disorders, bone loss, gastrointestinal disturbances, electrolyte and fluid imbalances, low heart rate and blood pressure, increased anxiety, depression, and social isolation, may not be fully realized by individuals with disordered eating.

Differentiating Factors from Eating Disorders

While disordered eating and eating disorders share some similarities, they are distinct in terms of severity, frequency, and duration of symptoms.

Disordered eating refers to the presence of one or more irregular eating patterns. Although these patterns can be harmful and disruptive, they may not be frequent or severe enough to constitute a diagnosis of an eating disorder.

On the other hand, eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder are severe psychiatric illnesses characterized by severe disturbances in eating behavior and an intense preoccupation with body weight and shape.

Understanding these differences can help in recognizing when disordered eating behaviors have escalated into an eating disorder, which requires immediate medical attention.

In conclusion, understanding disordered eating, recognizing its symptoms, and differentiating it from eating disorders are crucial steps towards promoting healthy eating habits and seeking appropriate help when necessary.

Seeking Help for Disordered Eating

If you or someone you know are grappling with symptoms of disordered eating, it's crucial to get professional help. There are numerous national resources and support options available that provide help to individuals dealing with such issues.

National Resources

National resources provide an array of tools, hotline numbers, and informative content aimed at addressing disordered eating. These resources offer confidential assistance and can be accessed from anywhere.

One such resource is the National Eating Disorders Association (NEDA), which provides a confidential screening tool for individuals who are concerned they may be struggling with an eating disorder.

For individuals residing in Canada, the National Eating Disorder Information Centre (NEDIC) offers resources, referrals, and support to people impacted by disordered eating and related concerns. They also operate Canada's only national toll-free helpline and live chat services.

In case of a crisis, individuals can call or text the Suicide and Crisis Lifeline at 988 or the Crisis Text Line by texting "HOME" to 741-741 for support related to eating disorders.

Support and Education Options

Alongside national resources, there are also various support and education options available for individuals, as well as their families and caregivers. These resources provide knowledge and understanding about disordered eating, its effects, and the road to recovery.

F.E.A.S.T is an organization that offers support and education resources to parents and caregivers of individuals impacted by eating disorders [5].

NEDIC also provides support through their helpline, live chat, and email services. This includes resources, referrals, and support to individuals directly or indirectly affected by disordered eating and related concerns. The helpline operates from 9 am to 9 pm Monday to Thursday, 9 am to 5 pm on Friday, and 12 pm to 5 pm on Saturday and Sunday (all times EST).

By reaching out to these resources and seeking support, individuals battling disordered eating can take the first step towards recovery. Remember, seeking help is a sign of strength, and you are not alone in this journey.

Types of Disordered Eating

When understanding 'what is disordered eating?', it's crucial to recognize that disordered eating can take many forms, ranging from anorexia nervosa, bulimia nervosa, and binge eating disorder to a variety of other specified feeding or eating disorders.

Anorexia, Bulimia, and Binge Eating Disorder

Three of the most recognized types of disordered eating include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder (BED).

Anorexia Nervosa is characterized by a significant reduction in food intake leading to extremely low body weight, a relentless pursuit of thinness, distorted body image, and intense fear of gaining weight. Long-term effects of anorexia nervosa include brain damage, dry skin, hair, and nails, difficulty regulating body temperature, gastroparesis, pain, constipation, and damage to major organs. 5-10% of those with anorexia nervosa die within 10 years of the onset of the disorder. Men are more at risk of dying from anorexia nervosa due to often being diagnosed later [3].

Bulimia Nervosa involves episodes of binge eating followed by compensatory behaviors such as purging, laxative/diuretic use, and/or excessive exercise. The long-term effects of purging behaviors include tooth decay, gum disease, blood vessels bursting in the eyes, swollen salivary glands, esophagus damage, stomach issues, intestinal damage, acid reflux, nerve damage, colon damage, and heart issues. 3.9% of those with bulimia nervosa will die from their disorder due to complications from these behaviors.

Binge Eating Disorder (BED) involves individuals engaging in binge eating episodes at least once a week for 3 months. Long-term effects of BED include high blood pressure, high cholesterol, heart disease, gallbladder issues, Type II diabetes, joint and/or knee pain, increased risk of developing some forms of cancer, and increased risk of co-occurring mental health diagnoses. Individuals struggling with BED long-term are likely to experience increased emotion dysregulation and increased suicidal ideation.

Other Specified Feeding or Eating Disorders

In addition to anorexia nervosa, bulimia nervosa, and binge eating disorder, there are other types of disordered eating behaviors that fall under the category of Other Specified Feeding or Eating Disorders (OSFED). These disorders, as outlined by the National Eating Disorders Association and the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), include:

• Avoidant/Restrictive Food Intake Disorder (ARFID): People with this disorder experience disturbed eating due to a lack of interest in eating or food, or avoidance based on the sensory characteristics of food.
• Pica: This disorder is characterized by an appetite for substances that are largely non-nutritive, such as ice, clay, chalk, dirt, or sand.
• Rumination Disorder: This condition involves the regular regurgitation of food that occurs for at least one month. Regurgitated food may be re-chewed, re-swallowed, or spit out.
• Orthorexia: While not officially recognized in the DSM-5-TR, orthorexia is characterized by an obsession with healthy or "clean" eating to the point where it negatively affects a person's life.
• Excessive Exercise: While not an eating disorder itself, excessive exercise can often be a symptom of an eating disorder, particularly in the case of anorexia nervosa or bulimia nervosa.
• Diabulimia: This is an eating disorder which may affect those with Type 1 Diabetes. Diabulimia is characterized by the deliberate manipulation of insulin levels to control weight.
• Laxative Misuse: This involves the regular use of laxatives outside of their intended purpose in an attempt to lose weight.

These disorders, while different in their specifics, all involve a disturbed relationship with food and often result in both physical and psychological harm. It's crucial that individuals displaying any of these behaviors seek professional help.

Role of Nutrition Professionals

Nutrition professionals, particularly registered dietitian nutritionists, play a vital role in the detection, intervention, and treatment of disordered eating. This can be instrumental in preventing the progression of disordered eating to more severe eating disorders.

Dietitians in Detection and Treatment

Registered dietitian nutritionists are often the first line of detection for disordered eating. Patients referred to dietitians for nutrition counseling may be unaware that their eating patterns are problematic or harmful. By conducting a thorough assessment of a patient's eating habits, dietitians can identify signs of disordered eating and initiate appropriate interventions.

Treatment options for disordered eating are generally the same as for eating disorders, depending on the severity of a person’s condition. Because disordered eating may be a precursor for an eating disorder, it is important that people receive prompt treatment [1].

Working with a dietitian experienced in counseling patients with eating disorders is crucial in treating disordered eating. They can provide personalized dietary guidance and help patients develop healthier eating habits. Dietitians also collaborate with other healthcare professionals, such as psychologists and psychiatrists, to ensure a comprehensive approach to treatment.

Importance of Nutritional Counseling

Nutritional counseling plays a significant role in the treatment of disordered eating. It can help individuals understand the impact of their eating behaviors on their health and wellbeing. Counseling can also provide strategies to modify these behaviors and establish healthier eating patterns.

Through nutritional counseling, individuals can learn to recognize and challenge unhealthy thoughts and beliefs about food, weight, and body image. This cognitive restructuring can be a critical component in the recovery process.

Moreover, dietitians can provide education on the importance of balanced nutrition and the dangers of restrictive diets. They can also help patients understand the physical consequences of disordered eating, such as the risk of bone loss, gastrointestinal disturbances, electrolyte imbalances, and more.

Ultimately, the role of nutrition professionals in disordered eating is multifaceted, encompassing detection, treatment, and education. Their expertise can be a critical resource for individuals struggling with disordered eating, providing the necessary guidance and support throughout their recovery journey.

References

[1]: https://www.medicalnewstoday.com/articles/disordered-eating

‍[2]: https://www.eatright.org/health/health-conditions/eating-disorders/what-is-disordered-eating

‍[3]: https://www.eatingdisorderhope.com/long-term-effects-health

‍[4]: https://www.nationaleatingdisorders.org/warning-signs-and-symptoms/

‍[5]: https://www.nationaleatingdisorders.org/get-help/

‍[6]: https://nedic.ca/‍