Disordered eating vs. eating disorders: what is the difference? And does it matter?
In this post, I’ll define these two terms and discuss behaviors common to both disordered eating and eating disorders. I’ll explain how maladaptive eating behaviors can impact health and how to get help for disordered eating and eating disorders.
What is disordered eating?
Disordered eating describes a wide range of irregular and unhealthy eating behaviors, attitudes, and habits. In essence, disordered eating includes eating habits or thoughts related to food, body image, and weight that fall outside the realm of normal behavior.
Restrictive eating patterns and an obsession with food and body weight or shape is common in disordered eating. Individuals are often preoccupied with dieting and weight loss. The frequency, severity and/or duration of disordered eating behaviors determine whether disordered eating merits an eating disorder diagnosis.
Even if there is no formal diagnosis, disordered eating is still a cause for concern.
Someone with disordered eating behaviors may need support to improve their relationship with food and body image. If disordered eating behaviors become more frequent or severe, an eating disorder may develop.
What are eating disorders?
Eating disorders are serious mental health conditions. Persistent disturbances in eating patterns and body image, and a preoccupation with food, weight, and shape are hallmarks of eating disorders. Disordered eating behaviors are a part of an eating disorder.
There are several types of eating disorders, each with its own distinct diagnostic criteria. Here are some common eating disorders, outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):
Restrictive eating leading to weight loss (which can be severe) is a hallmark of Anorexia Nervosa (AN). People with AN have an intense fear of gaining weight or becoming fat, even when underweight. They also may have a distorted body image.
Atypical Anorexia Nervosa
Those with Atypical Anorexia Nervosa meet all the criteria for AN, but despite significant weight loss, they may not be “underweight.”
People with Bulimia Nervosa (BN) experience recurrent episodes of binge eating. Binges are characterized by eating an excessive amount of food within a discrete period and a sense of lack of control during these episodes. These episodes are followed by compensatory behaviors (called purging) to prevent weight gain.
Purging can include self-induced vomiting, misuse of laxatives, diuretics or other diet pills, fasting, or excessive exercise. These behaviors are influenced by body shape and weight.
Binge Eating Disorder (BED) is diagnosed when someone has recurrent episodes of binge eating. Unlike BN, binge eating is not followed by inappropriate compensatory behaviors (purging). Those with BED feel quite distressed regarding these eating episodes.
Avoidant/Restrictive Food Intake Disorder (ARFID)
Individuals with ARFID have avoidant or restrictive food intake, leading to insufficient nutrition or weight loss. Unlike Anorexia Nervosa, those with ARFID do not engage in these behaviors due to concerns about body weight or shape. ARFID may be associated with sensory sensitivities, fear of choking, or other factors that limit food choices.
Other Specified Feeding or Eating Disorder (OSFED)
When eating disorder symptoms are present that do not meet the criteria for specific disorders, clinician’s use the OSFED diagnosis. Atypical anorexia nervosa, purging disorder (e.g., recurrent purging behavior without binge eating), and night eating syndrome are examples of OSFED.
Unspecified Feeding or Eating Disorder (UFED)
The UFED diagnosis is used when an eating disorder does not fit the criteria for other specific diagnosis. but still causes significant distress or impairment in daily life.
These diagnostic criteria provide a framework for healthcare professionals to assess and diagnose eating disorders. Early intervention and treatment are crucial for individuals with eating disorders, as they can have serious physical and psychological consequences.
What are examples of disordered eating?
The spectrum of behaviors associated with disordered eating can vary widely in terms of severity and presentation. The presence of these behaviors does not necessarily indicate the presence of an eating disorder. They may signal a compromised relationship with food and/or body image and deserve our attention.
Here are some common behaviors associated with disordered eating:
- Frequent Dieting: extreme dieting or fad diets, to losing weight or drastically alter one’s body shape.
- Calorie/Macro Counting: Obsessively tracking/limiting daily intake, even when it’s unnecessary for good health.
- Food Restriction: Eliminating entire food groups or specific foods from one’s diet, often without medical necessity.
- Skipping Meals: Frequently skipping meals or avoiding eating altogether, which can disrupt normal hunger and fullness cues.
- Binge Eating: Consuming large quantities of food in a short period, followed by feelings of guilt or loss of control.
- Food Rituals: Strict rituals/rules around food, ie. eating foods in a specific order or cutting food into tiny pieces.
What can the term “disordered” include?
Some disordered behaviors related to trying to compensate for eating with exercise or purging. Intrusive thoughts about weight, body image, food guilt, anxiety or challenges with mental health may also fall into this category.
Other common eating disorder or disordered eating behaviors:
- Fixation on Food and Weight: Constantly thinking about food, weight, and body size.
- Compulsive Exercise: Exercising excessively or compulsively to “burn off” calories or relieve guilt about eating.
- Self-Induced Vomiting: Engaging in purging behaviors, such as self-induced vomiting, after eating to prevent weight gain.
- Laxative or Diuretic Use: Misusing laxatives or diuretics as a means of controlling weight.
- Negative Self-Talk: Constantly criticizing one’s body or appearance.
- Isolation: Withdrawing from social situations that involve food to avoid eating in front of others.
- Use of Diet Products: Relying on diet pills, supplements, or other products with unproven or harmful effects on health.
- Excessive Comparison: Frequently comparing one’s body, eating habits, or exercise routines to others.
- Extreme Guilt and Anxiety: Feeling intense guilt, anxiety, or shame related to food, eating, or body image.
Disordered eating behaviors exist on a spectrum, and individuals may exhibit a combination of these behaviors to varying degrees. As disordered eating behaviors increase or worsen, the risks of developing an eating disorder also increase.
Disordered eating can have negative physical and psychological consequences. Seeking support or treatment from healthcare professionals may be necessary to address these issues.
The spectrum: disordered eating vs eating disorders
We don’t have to think in terms of disordered eating vs. eating disorders because both exist on the same spectrum. Disordered eating may represent a milder or less severe form of problematic eating behaviors. Diagnosed eating disorders represent a more severe and clinically recognized condition, but the core behavior (restrictive eating, for example) may be the same.
Here’s how disordered eating vs. eating disorders relate on this spectrum:
Disordered Eating Behaviors:
Disordered eating behaviors encompass a broad range of unhealthy attitudes and habits related to food, body image, and eating. These behaviors can be less severe and may not meet the diagnostic criteria for a specific eating disorder.
Disordered eating behaviors can manifest with varying degrees of intensity. Some individuals may engage in occasional or less extreme behaviors, while others may exhibit more frequent or intense behaviors.
Lack of Formal Diagnosis:
Disordered eating behaviors do not typically meet the criteria for a specific eating disorder as outlined the DSM-5. However, they can still have a significant impact on an individual’s physical and mental health.
Diagnosed Eating Disorders:
Diagnosed eating disorders are characterized by more severe and enduring patterns of disordered eating behaviors. These behaviors have reached a level of severity, frequency and duration that warrants a formal diagnosis.
Specific Diagnostic Criteria:
Each eating disorder (e.g., anorexia nervosa, bulimia nervosa, binge-eating disorder, etc.) has specific diagnostic criteria outlined in the DSM-5. To receive a diagnosis, an individual must meet these criteria.
Diagnosed eating disorders are recognized by healthcare professionals. Individuals with these disorders require specialized treatment and support to recover from their eating disorder.
The spectrum between disordered eating behaviors and diagnosed eating disorders illustrates that eating-related issues exist on a continuum. Some individuals have disordered eating behaviors without meeting the criteria for a full-blown eating disorder. However, it’s important to recognize that disordered eating behaviors, if left unaddressed, can potentially progress to more severe eating disorders.
How do disordered eating vs eating disorders affect health?
Disordered eating and eating disorders can have a profound and often devastating impact on an individual’s physical and mental health. The specific health effects can vary depending on the type and severity of the disordered behaviors. In general, disordered eating and eating disorders can lead to a range of serious health complications.
Here are some ways in which eating disorders can affect someone’s health:
- Malnutrition (which may lead to growth impairment and delayed puberty in children)
- Vitamin and mineral deficiencies
- Compromised immune system, increased risk of illness and infections
- Insufficient energy, extreme fatigue, dehydration
- Constipation, nausea and other GI discomfort
- Dizziness, lightheadedness, fainting
- Hormone imbalances that may affect periods (amenorrhea), sex drive, long-term fertility and bone health (osteoporosis)
- Electrolyte imbalances that can be fatal
- Heart, liver and kidney problems
- Poor bone health – increased risk of fractures, stress fractures, osteoporosis
- Increased risk of suicide
- Increased anxiety, depression and other mood disorders
- Cognitive and memory impairment
It’s crucial to recognize that eating disorders are serious medical conditions. They require comprehensive treatment, including medical, nutritional, and psychological interventions. Early intervention is key to preventing further health deterioration and improving the chances of full recovery.
What causes disordered eating vs. an eating disorder?
Disordered eating and eating disorders have similar root causes, although there is no distinction to how one begins versus the other. Disordered eating behaviors can be triggered or influenced by a combination of factors. It’s important to note that each individual’s experience may be unique. The causes and triggers for disordered eating and eating disorders are complex and multifaceted.
Causes of eating disorders include:
- Societal and media pressures to be thin/muscular
- Diet culture that promotes weight loss
- Peer and family influences, such as teasing/bullying
- Body dissatisfaction and the pursuit of the thin ideal
- Past trauma and stressful events
- Personality traits such as perfectionism
- Child and adolescent food experiences
- Mental health
- Involvement in certain sports
Societal and Media Pressures
The pervasive influence of media, including images of thin or idealized bodies, can lead to unrealistic beauty standards and pressure to conform to these standards.
Living in a culture that promotes dieting, weight loss, and restrictive eating can encourage individuals to engage in disordered eating behaviors in an attempt to achieve or maintain a certain body shape.
Peer and Family Influences
Peer pressure, teasing, or family comments about weight and appearance can contribute to disordered eating patterns.
A negative body image or dissatisfaction with one’s appearance may lead individuals to engage in disordered eating behaviors as a means of control or self-improvement.
Trauma or Stress
Experiencing trauma, such as sexual abuse, emotional trauma, or bullying, can be a trigger for disordered eating as individuals may use food as a coping mechanism.
A strong desire for perfection and a fear of failure can lead to rigid eating habits and a preoccupation with body image.
Childhood and Adolescent Experiences
Childhood experiences related to food, such as being forced to finish meals or strict dietary rules, can contribute to disordered eating patterns later in life.
There may be a genetic predisposition to disordered eating or eating disorders, as certain genetic factors can influence an individual’s susceptibility.
Mental Health Issues
Conditions such as anxiety, depression, and obsessive-compulsive disorder can sometimes be connected to disordered eating behaviors as individuals may use food as a way to cope with emotional distress.
Sports and Athletics
In some cases, sports or activities that emphasize weight or body shape, such as gymnastics, running, ballet or wrestling, can lead to disordered eating habits in an attempt to meet specific weight or appearance standards.
Repeated cycles of restrictive dieting and weight loss attempts can contribute to the development of disordered eating behaviors.
It’s important to recognize that these factors can interact with one another, and individuals may have multiple contributing factors. Disordered eating is a complex issue, and understanding its causes and triggers is crucial for providing appropriate support and intervention. Seeking help from healthcare professionals, therapists, or counselors is often necessary to address disordered eating and its underlying causes effectively.
Eating Disorder Treatment and Recovery
Treatment for disordered eating and eating disorders typically involves a multidisciplinary approach. Addressing both the physical and psychological needs of the person is critical. The choice of treatment will depend on the type and severity of the eating disorder.
Here are some common eating disorder treatment options:
Registered dietitians specializing in eating disorders provide education, support, and guidance on balanced eating. They work with clients to normalize eating and physical activity patterns.
Psychotherapy, or talk therapy, is a fundamental component of eating disorder treatment. Various therapeutic approaches can be effective, including:
- Cognitive-Behavioral Therapy (CBT): Identify and challenge negative thought patterns and behaviors related to food, body image, and weight.
- Dialectical-Behavior Therapy (DBT): DBT focuses on emotional regulation and coping strategies to address impulsive behaviors, common in some eating disorders.
- Family-Based Treatment (FBT): FBT involves the family in the treatment process and empowers parents to help their child recover.
- Acceptance and Commitment Therapy (ACT): ACT emphasizes mindfulness and values-based actions to promote behavior change.
- Creative therapies like art, music, dance, or drama therapy can help individuals explore and express their emotions and experiences.
Medical Monitoring and Nutritional Rehabilitation:
Medical professionals, such as physicians and dietitians, play a crucial role in addressing the physical health aspects of eating disorders. They monitor vital signs, assess nutritional status, and develop individualized meal plans. These efforts help restore and maintain a biologically appropriate weight and nutritional balance.
Medical and Psychiatric Management:
Medications may be prescribed to address co-occurring conditions like depression, anxiety, or obsessive-compulsive disorder. In some cases, medication can help reduce binge eating or purging behaviors.
Group Therapy and Support Groups:
Group therapy sessions allow individuals to share their experiences, receive peer support, and practice new skills in a supportive environment.
Inpatient or Residential Treatment:
Inpatient or residential programs provide intensive, 24-hour care, including medical monitoring, therapy, and meal support. When there is a risk of medical complications or when outpatient treatment is insufficient, these levels of care are invaluable.
Partial Hospitalization or Intensive Outpatient Programs:
These programs offer structured treatment during the day or evening while allowing individuals to return home at night.
Effective treatment often involves a combination of these approaches, tailored to the individual’s unique needs. The lenght of treatment varies widely. It is important to prioritize a comprehensive, long-term approach to achieve and maintain recovery from eating disorders.
A supportive network of healthcare professionals, family, and friends can make a significant difference in the treatment process. Chances of successful recovery increase with early intervention and lots of support.
Final thoughts on disordered eating vs. eating disorders
In summary, disordered eating and eating disorders sit on a spectrum. They represent a range of attitudes and behaviors related to food and body image. Diagnosed eating disorders sit at the more severe end of the spectrum.
Disordered eating and eating disorders have a wide range of complex causes, with each person’s experience being unique. No one is at fault for having disordered eating vs. eating disorder or vice versa.
Identifying and addressing problematic eating behaviors at an early stage is important, potentially leading to better outcomes for recovery. Treatment teams include primary care providers, dietitians, therapists, family and friends, among others. There are many treatment options.
If you or someone you know may be struggling with an eating disorder, professional help is available. Contact your healthcare provider, registered dietitian or therapist for assessment and treatment options..
Hello there! I’m Britt, a Registered Dietitian Nutritionist and Certified Intuitive Eating Counselor. I can help you find freedom from life-long dieting, disordered eating and eating disorders. When I’m not writing about ditching diet culture, joyful movement or improving body image, you can find me hiking in Vermont’s Green Mountains, eating pizza, making modern quilts or sipping a hot cup of tea. Let’s connect!