Difference Between Disordered Eating and Eating Disorders

Teenage girl discussing problems with female therapist at community center

 

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Feeling guilty for eating when you are hungry is like feeling guilty for breathing when your lungs need oxygen. We have been taught to be ashamed of our basic human needs. Refuse to feel shame. You are allowed to eat.

In today’s society, we are inundated by food fads, trendy diets, technology apps that record our every move and calorie burned, and the pressure from society to lose weight to be viewed as beautiful.

So, what happens when we become obsessed with this culture and where do we draw the line to differentiate disordered eating and eating disorders? To understand the abnormal, we must first understand what the normal standard is.

There is a lot of controversy regarding what the standard daily calorie consumption is for adults. Still, the Food and Drug Administration has based the daily diet on a 2,000 daily caloric intake, which should include adequate servings of fruits and vegetables and proteins and minimal servings of carbohydrates and fats.

In other words, eating three balanced meals a day is the standard diet in the United States. Additionally, normalized, non-disordered eating is when individuals consume food when they are hungry and can stop eating once they are full. When individuals begin to consume food out of boredom or stress, normalized eating becomes a problem.

This article will include the differences between eating disorders and disorder eating, the signs and symptoms of each, underlying triggers and causes, and treatment approaches.

Types of Eating Disorder

Individuals struggling with an eating disorder will have obsessive thoughts about food all day, every day. The individual thinks about calories, taste, food avoidance, or where to buy food. They will spend hours meal planning, counting calories, exercising, and engaging in binging or purging activities to the point that it affects their everyday life.

The most common eating disorders are binge eating disorder, anorexia nervosa, and bulimia nervosa, and each one of these eating disorders can present differently in each individual and carry lifelong consequences.

Anorexia

Anorexia nervosa is an eating disorder classified by the unhealthy disturbance in body shape and image.

Individuals will go to extreme measures. They will not only to starve themselves but they might try to rid their bodies of any caloric intake they consumed through self-purging mechanisms such as self-induced vomiting, laxative, diuretics, and extreme exercise.

Bulimia

Bulimia nervosa is a serious eating disorder that involves eating excessive amounts of food in a short period (binging) followed by guilt and shame leading to self-induced vomiting, extreme exercise, or laxative abuse (purging). Many refer to it as a binge and purge eating disorder. The following are diagnostic criteria associated with bulimia nervosa:

  • Eating excessive amounts of food in a two-hour period (binging) accompanied by feeling a loss of self-control
  • Repetitive inappropriate self-induced compensated behaviors such a vomiting, diuretic use, laxative use, and extreme exercise (purging) in order to avoid weight gain potentially caused by the bingeing episodes
  • These behaviors occur at least once a week for at least three months in duration
  • Body shape and weight are the main influencing factors of this binging and purging behavior
  • These behaviors do not occur specifically with anorexia nervosa and these disorders must be completely separated

Although anorexia nervosa and bulimia nervosa are not the most common eating disorders (binge eating disorder is the most common), they are often depicted in the media regularly. Because of this, the general public has many false misconceptions regarding both of these eating disorders.

The major difference between anorexia nervosa and bulimia nervosa is behavior. The fear of gaining weight and distorted body image are common in both eating disorders.

Most individuals with anorexia are underweight, whereas individuals with bulimia nervosa are normal weight or overweight. However, according to the new DSM 5 standard for anorexia, patient's don't need to be below a normal weight. They can have lost a significant amount of weight through unhealthy means.

Signs and Symptoms of an Eating Disorder

The level of obsession around eating disorder thoughts and behaviors can distinguish disordered eating from an eating disorder. It is normal to think about or even obsess over food when you are hungry, especially if you have not eaten for a while. It is also normal to think about meal planning, grocery shopping, and cravings for dinner.

This level of obsession with food can impair concentration, the ability to stay present, and can hinder daily functioning. This level of obsession with food, calories, and weight changes and the behaviors that reinforce these obsessions is what differentiates a clinical eating disorder from a disordered eating pattern.

While it’s difficult to judge how much time and energy another individual spends thinking about food or dieting behaviors, the individual may discuss their thoughts with a friend, or it may be evident through their actions. The following are signs and symptoms associated with eating disorders:

  • Loss of control during binging episodes
  • Eating in secret or in privacy
  • Hiding food in abnormal places such as closets, cars, under the bed
  • Feelings of distress, guilt, and shame after the binge episode
  • Presence of many empty wrappers and containers
  • Stealing or hoarding food
  • Period of extreme food restriction or fasting
  • Extreme variation in weight
  • Low-self esteem
  • Excessive eating rituals such as only eating condiments
  • Feelings of depression or anxiety
  • Avoiding social situations where food may be present
  • Engaging in binge eating followed by self-induced vomiting
  • Laxative and diuretic abuse
  • Excessive exercise in order to lose weight or prevent weight gain
  • Wearing bagging clothes to cover up the excessive weight loss
  • Wearing layered clothing to keep warm even during warm temperatures
  • Cooking meals for others but refusing to eat them
  • Obsession with body size and shape
  • Adopting eating rituals such as cutting food into tiny pieces
  • Complaining about being overweight when you are actually underweight
  • Making excuses not to eat
  • Excessive dieting
  • Spending an enormous amount of time in the grocery store reading ingredient labels and counting calories

In addition to the obsession, extreme behaviors are prevalent in individuals who have an eating disorder.

From binging and self-induced vomiting to laxative abuse, food restriction, and excessive exercise, individuals will go to extremes on a daily or weekly basis to control their caloric consumption.

This desire for control takes predominance over their lives, and as a result, they may avoid family dinners, outings with friends, or stay home from school or work due to a fear of eating around other people.

What Is Disordered Eating?

Disordered eating is not an "eating disorder" per se. However, it is an abnormal behavior that can potentially become dangerous.

Although there is no definitive clinical definition for disordered eating, this term is often used among the eating disorder treatment community to describe various abnormal eating behaviors that do not yet fit the criteria for an eating disorder.

Some believe that disordered eating, if not treated, can lead to eating disorders, however, not every individual with a disordered eating pattern will develop a clinical eating disorder.

Disordered eating occurs when individuals eat for other reasons than hunger and nourishment. Individuals with disordered eating eat when they are bored, eat out of stress, eat to cover up their emotions, skip meals, engage in binging and purging behaviors on an irregular or limited basis, may skip out on major food groups, or eat the same thing every day.

Types of Disordered Eating

Disordered eating can vary from anything that is abnormal to a near-eating disorder. Examples include:

  • Binging and purging
  • Emotional eating
  • Restrictive eating
  • Extreme dieting
  • Laxative abuse

Binging and Purging

Anorexia nervosa and bulimia nervosa have a lot more in common than people think. Many individuals tie anorexia nervosa to the young girl who starved herself to lose weight or cut her food into tiny pieces. Others associate bulimia nervosa with the young girl who runs to the bathroom after every meal to purge any consumed food.

Although some of these depictions have some truth, anorexia nervosa and bulimia nervosa are very similar disorders as they both involve binging and purging. Anorexia nervosa has two subtypes: restrictive and binge/purge whereas bulimia is strictly characterized by binging and purging.

The restricting subtype in anorexia is characterized by restricting food to lose weight or prevent weight gain. The binging and purging subtype is characterized by binging episodes followed by self-induced vomiting, diuretic, and laxative abuse, and excessive exercise.

Self-Induced Vomiting 

Many assume that purging is equivalent to only self-induced vomiting. Although self-induced vomiting is one type of purging behavior, individuals with the binge/purge subtype of anorexia and individuals with bulimia nervosa do not have to engage in vomiting to be diagnosed with these eating disorders.

Other types of purging behaviors include excessive exercise, laxative abuse, and diuretic abuse. Individuals with restrictive anorexia nervosa do not engage in any form of purging. 

A loss of control characterizes binge eating disorder while eating. Individuals with this disorder will engage in “out of control” binging episodes at least once a week for three months and often have no concept or control of which foods they are consuming.

Additionally, individuals will eat extremely fast or eat regardless if they are full and will have feelings of guilt, shame, loss of control, and will often eat in secret out of embarrassment.

Strict and unhealthy diets can be examples of disordered eating patterns, especially when these diets are restrictive and involve regular weight checks and calorie counting.

Studies have shown that dieting can lead to disordered eating and eventually become full-fledged eating disorders. Research also shows that individuals who engage in dieting to lose weight are more likely to gain that weight back.

Emotional Eating

Emotional eating is a common characteristic of disordered eating. Emotional eating is characterized by using food in response to negative or positive emotions. Many people who engage in emotional eating will use food as an unhealthy coping mechanism to fill a void or to avoid painful feelings such as sadness, anxiety, rejection, or anger.

Most of us have experienced this to varying degrees at some point in our lives. Who has not eaten a bag of chips in one sitting because you are having a bad day? 

Food, especially sweets, savory and fried foods, trigger the chemical reward centers in the brain, resulting in a surge of dopamine. This temporarily makes us feel good and can even help soothe or distract us for a short period. However, this can be a slippery slope as "eating away our emotions" can turn into a regular pattern of food to make us feel better. 

Individuals who show increased food intake in a negative emotional state also tend to overeat in response to other cues such as a positive emotional state. For example, emotional eating can also be used as a reward when we feel happy. This can be ingrained within us since early childhood when our parents reward us with candy for a high grade or good behavior. As adults, we may rush to the nearest burger joint when we feel like we had a great day, We feed our positive and happy feelings with food, perpetuating a cycle of "reward and pleasure."

Food should be used to nourish the body and not indulge in temporary emotions, whether they are positive or negative emotions.

Emotional eating can begin in childhood or adolescence and carry into adulthood, and therefore, this learned pattern of eating can become problematic and trigger not only an unhealthy relationship with food but also lead to eating disorders such as binge eating disorder and bulimia nervosa. 

Signs and Symptoms of Disordered Eating

Signs and symptoms associated with disordered eating are extremely similar to those seen in eating disorders. The main difference is severity and frequency.

Signs and symptoms seen in eating disorders are much more severe and frequent compared to those seen in disordered eating. Signs and symptoms include:

  • Extreme dieting
  • Food rituals
  • Changes in weight
  • Social withdrawal

If you or a loved one are coping with an eating disorder, contact the National Eating Disorders Association (NEDA) Helpline for support at 1-800-931-2237. 

For more mental health resources, see our National Helpline Database.

Eating Disorders vs. Disordered Eating

The primary delineating factor between disordered eating and a diagnosable eating disorder is the frequency and severity of the abnormal eating pattern. Although both disordered eating and eating disorders are abnormal, eating disorders have very specific diagnostic criteria outlining frequent and severe behaviors.

Many of the individuals demonstrate problematic or disordered relationships with food, body, and exercise. Individuals may count calories, over-exercise, exercise solely to lose weight, and cringe at the sight of skin folds, thigh dimples, and cellulite. These are normal, and it is time to start normalizing bodies of all shapes and sizes. 

Unconscious Eating vs. Mindful Eating

Many eating disorder professionals believe that emotional eating is triggered by unawareness. We often pick at our food when we are finished with our meal even though we are no longer hungry or eating snacks just because they are placed in front of us.

Mindless or unconscious eating is a direct result of being unaware of being present in the moment. It is important to be mindful of what we are thinking, feeling, and doing in the present moment. Practicing mindfulness when it comes to eating can prevent us from eating endless amounts of food without even being aware.

How do I know if I should be worried? What if this gets worse? These are a couple of thoughts and questions, not only for those concerned for their loved ones but also for individuals who are unsure about whether they are abusing food and whether or not they should be concerned and seek help for their behaviors.

Prevention and Management

Regardless if you are experiencing disordered eating or an eating disorder, there is hope. There are many ways to treat and manage signs, symptoms, and behaviors. There are also ways to discontinue your disordered eating behavior before it leads to a full-fledged eating disorder:

  • Avoid trendy diets, including crash diets. Many diets are very restrictive in terms of variety and quantity, which can lead to feelings of deprivation. This can result in cravings and unsatisfied binging. Instead, try adopting a wholesome moderation way of eating, meaning that your daily diet should include all foods in moderation. 
  • Set healthy limits on exercise and learn to move your body in ways that bring you joy. Over-exercising is a sign of disordered eating, and this can potentially lead to restrictive eating disorders. Physical exercise is important and healthy, but be mindful about how frequently you exercise and the reason for exercising. Exercise should be something that you enjoy because it makes you feel good, rather than something you have to do to lose weight. 
  • Stop negative body talk. Instead of negatively critiquing your body every time you look in the mirror or get dressed in the morning, instead take notice of what your body can do for you. Your body is strong and it is a vehicle to move you through your day. Take time to appreciate the amazing things your body can do and also take note of the things that you do love about your body. Maybe you have freckles or a nice smile; focus on those things and replace negative self-talk with positive affirmations.
  • Throw away the scale. Having a scale in your bathroom or kitchen can be a slippery slope as you may find yourself continuously weighing yourself daily or after every meal. This scale can become an obsession and you may adopt extreme patterns to lose weight, especially if you are weighing yourself regularly. Ditch the scale and allow yourself to experience your body without constantly looking at your weight in numbers. Instead, take notice of how your body feels and how your clothes fit without the scale.

Seeking Help

Anorexia nervosa, binge eating disorder, and bulimia nervosa are the three most well-known eating disorders recognized by mental health professionals. Treatment consists of many psychotherapy approaches to recognize the underlying triggers associated with the present eating disorder.

Additionally, a multi-faceted treatment team must work closely together to develop positive coping skills and strategies to learn to deal with triggers more healthily. 

You are becoming more obsessed with food, weight, and body image. You may even be hiding food, hoarding food, binging, and engaging in self-induced vomiting. You often search websites about eating disorders. You don’t want to admit you may be developing anorexia nervosa, binge eating disorder, or bulimia nervosa because you are scared of what others may think of you or what may happen.

If you are exhibiting behaviors it is time to seek professional help before your early stages of a disordered eating spiral out of control. Malnutrition, dental complications, organ failure, menstrual abnormalities, depression, osteoporosis, anxiety, and substance abuse are well-known complications of eating disorders; however, they can all be prevented with early treatment intervention.

Benefits of Early Intervention

  • Early treatment is best accepted in the beginning stages of the eating disorder. 
  • Early identification and treatment improves the speed of recovery. 
  • Early interventions result in a reduction in symptoms following treatment.
  • Early interventions can improve the likelihood of staying symptom and craving-free after recovery is attained.
  • Early intervention treatment most likely will not require a high level of care such as inpatient treatment or residential treatment. Outpatient levels of care are more affordable and more flexible.

A Word From Verywell

We live in a culture that focuses on physical appearance instead of what is underneath the skin and as a result eating disorders and disordered eating habits are prevalent. However, there is hope.

From treatment centers, online resources, and support groups to body positive and body neutral movements; you can allow yourself the power to overcome your struggle with disordered eating.

Depending on the severity, frequency, and duration of your symptoms, you may benefit from professional treatment that includes different modalities of therapy with or without medications or you may only need support from your friends or family.

The best way to measure whether or not you need to seek professional help is to consult with a therapist who specializes in eating disorders.

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