Eating Disorder & Disordered Eating Awareness – It’s Time to Talk About It

Today’s post about eating disorder and disordered eating awareness is a topic close to my heart and an important one for me to share. My passion for this topic stems from a very personal place — my own struggles with food and body for a very large chunk of my life.

This is National Eating Disorder Awareness week (Feb. 26th through March 4th). If you (or someone you love) are struggling with an eating disorder or disordered eating, please know that there is help available. It’s OK to speak up and ask for help. And most importantly, please know that you are not alone.

Eating Disorder & Disordered Eating Awareness – It’s Time to Talk About It

Did you know that, according to the National Eating Disorders Association, national surveys show that an estimated 20 million women and 10 million men in the United States will develop an eating disorder at some point in their lives?

It is likely that these numbers are underreported, especially for men, because of the shame and embarrassment that comes with an eating disorder. When it comes to men and eating disorders, it can be even more deeply embarrassing for them to admit that they are struggling with something that is considered by society to be “a woman’s issue.”

It’s also important to understand that these statistics just reflect the disorders that are diagnosed at a clinical level. There are a lot of people who may not meet the clinical definition of having an eating disorder, yet they have a very unhealthy relationship with food, body, and/or exercise.

Disordered eating and eating disorders often hide in plain sight. They can affect anyone and everyone, regardless of age or gender. They can develop quickly, or they can develop slowly over time. Each person’s experience will be different, but there will always be similarities as well.

Someone may be struggling and no one even knows. Or, even if people do notice that something is “off,” their doctors, family, and friends may skim over these issues or not know how to help. Because eating disorders are most commonly associated with bulimia and anorexia, people who don’t immediately demonstrate signs of these types of disorders may get ignored or not feel like they qualify for help.

This often leaves the person feeling even more alone, unloved, unworthy, and unhealthy. Eating disorders bring with them a lot of shame, guilt, and fear. Speaking up is quite often difficult for the person suffering from the disorder and many go undiagnosed for years or even decades.

Eating disorders and disordered eating can rob the sufferer of happiness, joy, and life fulfillment. They can cause people to become withdrawn and isolated. They can lead to further health problems, chronic illness, or other psychiatric disorders.

Eating disorders have the highest mortality rate of any mental disorder but recovery is absolutely possible and early intervention greatly improves the chances of success.

Beyond Bulimia and Anorexia

Bulimia and anorexia are the most commonly known eating disorders. According to the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders), which is the “bible” when it comes to healthcare professionals and diagnosing of mental disorders, there are several more, including:

• Binge Eating Disorder
• Pica
• Rumination Disorder (RD)
• Avoidant/Restrictive Food Intake Disorder (ARFID)

The DSM-5 also includes two “umbrella” diagnoses:

• Other Specified Feeding or Eating Disorder (OSFED)
• Unspecified Feeding or Eating Disorder (UFED)

(If you’re a practitioner, or otherwise interested in reading more about the changes regarding eating disorders when the DSM-5 was released, this is a great article)

As you can see, people can fall into a number of different categories when it comes to clinically diagnosable eating disorders, and again, disordered eating is a very real and prevalent thing. People who have disordered eating may not suffer to the extent that those with clinically diagnosed eating disorders do, but it doesn’t mean they don’t suffer and are not in need of help or attention.

Symptoms of Eating Disorders & Disordered Eating

When it comes to eating disorders (and disordered eating), symptoms and behaviors are going to depend on the disorder and the person. Here some of the symptoms of each of the DSM-5 eating disorders. These are not comprehensive lists and I encourage you to research a specific disorder in more depth if you suspect an issue for yourself or someone you love.

Anorexia Nervosa Behaviors and Symptoms (source)

• Preoccupation with body shape, weight and/or appearance and/or an intense fear of gaining weight
• Negative or distorted body image
• Low self-esteem
• Rigid thinking regarding food (i.e. “good” and “bad” foods) and/or a preoccupation with food or food-related activities
• Feeling out of control
• Mood swings, anxiety, and/or depression
• Suicidal or self-harm thoughts or behaviors
• Constant or repetitive dieting and/or restrictive or rigid eating patterns
• Excessive or compulsive exercise
• Obsessive rituals around food and/or changes in food preferences
• Frequent avoidance of eating meals and/or excuses not to eat
• Social withdrawal and/or avoidance of social situations involving food
• Deceptive or secretive behavior around food

Bulimia Nervosa Behaviors and Symptoms (source)

• Difficulties with activities involving food and/or deceptive behaviors relating to food
• Self-imposed isolation and/or a reluctance to develop personal relationships
• Fear of the what others will think if the illness becomes known
• Mood swings, anxiety, depression, emotional outbursts, erratic behavior, and/or changes in personality
• Substance abuse, self-harm, and/or suicide attempts
• Sensitivity to references about weight or appearance
• Guilt, self-disgust, self-loathing
• Frequent trips to the bathroom, especially after eating
• Food avoidance and/or dieting behavior
• Fluctuations in weight

Binge Eating Disorder Behaviors and Symptoms (source)

• An overwhelming sense of lack of control regarding eating behavior
• Eating more rapidly than normal and/or periods of uncontrolled, impulsive, or continuous eating, often resulting in feeling uncomfortably full
• Eating when not physically hungry
• Repeated episodes of binge eating which often results in feelings of shame or guilt
• Eating in secret and/or hiding evidence of a binge (i.e. hiding food wrappers)
• Avoiding social situations, particularly those involving food
• Eating “normal” quantities in social settings and then binging when alone
• Low self-esteem and embarrassment over physical appearance and/or being overly sensitive to references to weight or appearance
• Feeling guilt, self-disgust, distress, shame, and/or anxious during and after a binge episode
• Fear of the disapproval of others
• Self-harm or suicide attempts
• Anxiety and/or depression

Pica Behaviors and Symptoms (source)

Pica often occurs in correlation with other mental disorders that are associated with impaired functioning. According to the DSM-5, a person must display the following symptoms in order to be diagnosed with Pica:

• Persistent eating of nonnutritive substances for at least one month.
• The eating of nonnutritive substances is inappropriate to the developmental level of the individual.
• The eating behavior is not part of a culturally supported or socially normative practice.
• If occurring in the presence of another mental disorder (e.g. autistic spectrum disorder), or during a medical condition (e.g. pregnancy), it is severe enough to warrant independent clinical attention.

Rumination Disorder (RD) Behaviors and Symptoms (source)

According to the DSM-5, a person must display the following symptoms in order to be diagnosed with RD:

• Repeated regurgitation of food for a period of at least one month (regurgitated food may be re-chewed, re-swallowed, or spit out).
• The repeated regurgitation is not due to a medication condition (e.g. gastrointestinal condition).
• The behavior does not occur exclusively during the course of Anorexia Nervosa, Bulimia Nervosa, BED, or Avoidant/Restrictive Food Intake disorder.
• If occurring in the presence of another mental disorder (e.g. intellectual developmental disorder), it is severe enough to warrant independent clinical attention.

Avoidant/Restrictive Food Intake Disorder (ARFID) Behaviors and Symptoms (source)

According to the DSM-5, In order for someone to be diagnosed as having ARFID, they must display a feeding or eating disturbance that manifests by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

1. Significant loss of weight (or failure to achieve expected weight gain or faltering growth in children)
2. Significant nutritional deficiency
3. Dependence on enteral feeding or oral nutritional supplements
4. Marked interference with psychosocial functioning

In addition:

• The behavior is not better explained by a lack of available food or by an associated culturally sanctioned practice.
• The behavior does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way one’s body weight or shape is experienced.
• The eating disturbance is not attributed to a medical condition, or better explained by another mental health disorder. When it does occur in the presence of another condition/disorder, the behavior exceeds what is usually associated, and warrants additional clinical attention.

Other Specified Feeding or Eating Disorder (OSFED) and Unspecified Feeding or Eating Disorder (UFED) (source)

These two eating disorders are kind of the catch-all for anything that falls outside of the disorders listed above. To be diagnosed with OSFED, the person must display eating behaviors that are causing clinically significant functional distress and impairment but do not meet the full criteria for any of the other feeding and eating disorders.

Disordered Eating Behaviors and Symptoms (source)

Disordered eating is a term that was coined to describe issues surrounding food that do not meet the clinical requirements for an eating disorder. Disordered eating can quite often lead to a serious eating disorder down the road, so it’s important to pay attention to your habits and beliefs around food and body, or those close to you, in order to recognize potential issues before they become a serious eating disorder.

Disordered eating symptoms are very similar to that of eating disorders, though they do vary in quantity and severity depending on the person. The main thing that separates disordered eating from an eating disorder is the frequency of the behavior(s) and the level of severity of each behavior(s). According to Eating Disorders Victoria, disordered eating behaviors include:

• Binge eating
• Dieting, skipping meals regularly, fasting, or other restrained eating patterns
• Self-induced vomiting and/or misusing laxatives or diuretics
• Obsessive calorie or macronutrient counting (i.e. fat grams, carb counts, etc.)
• Self-worth based on body shape and weight and/or fear of gaining weight
• Creating rules or rigidness around foods (i.e. “good” and “bad” foods lists)

Orthorexia Behaviors and Symptoms (source)

While not recognized by the DSM-5 as a clinical eating disorder, orthorexia can lead to serious issues around food and health. The term Orthorexia describes an obsession with healthy eating where people become excessively fixated on quality (rather than quantity). Orthorexia can start out as simply a desire to “eat healthy” or “eat clean,” but then it can progress into further damaging behaviors around food. Orthorexia is common among people suffering from binge eating disorder, bulimia, and anorexia.

As many of you know, I am a big advocate of eating real food and healthy living. Many of you reading this blog post also believe in healthy eating and strive to “eat clean.” There’s nothing wrong with wanting to nourish your body and feed yourself in a way that creates vibrant health. That said, serious issues arise when this desire to eat well and take care of your body turns into an obsession and starts interfering with normal life. Symptoms can include:

• Strong anxiety about food choices
• Worry about their diet not meeting their own high standards of “purity”
• Social isolation due to withdrawing from activities and people who do not align with their strict dietary rules
• A desire to be “perfect” when it comes to food
• Experiencing guilt after a “slip-up” or “falling off the wagon”
• Heightened self-esteem when consuming foods that are “healthy”
• Mood swings, anxiety, and/or depression

It’s important to take note of these symptoms for orthorexia. If present, these can be warning signs that the focus on “healthy eating” is progressing into a serious eating disorder.

Recovery and Peace with Food and Body

Everyone deserves to have peace around food and body. Everyone deserves to live a life that is full of joy and freedom. Everyone deserves to nourish their body in the way that best suits their own health needs.

Eating disorders and disordered eating strip these rights from those suffering with them.

But help is available and recovery is possible.

It may not be easy to ask for help, but please do.

You are worth it.

It may not be easy to explore your eating disorder or disordered eating, but please do.

You are worth it.

It may not be easy to open up to friends and family that you have been struggling, but please do.

You are worth it.

Recovery is possible. It may not be easy…but you ARE worth it.

If you suspect that you, or someone you love, may be suffering from an eating disorder or disordered eating, there are some great resources out there. Here are a few of my favorites:

• National Eating Disorders Association (NEDA)
• Recovery Spark
• Project Heal
• Proud to Be Me
• Eating Disorder Hope

You can also do a Google search for eating disorder therapists, coaches, or treatment facilities in your own city or state.

In reflecting on my own struggles with food and body, much of the time I have felt completely overwhelmed, ashamed, lost, and alone. Even my closest friends and family never knew the struggles I was having. It’s only been in the last year or two that I have had the courage to start speaking about it openly (and even now, those fears of judgment and shame come creeping in at times).

Looking back on how these issues have controlled me, and how much of my life I missed, is what fuels me to help spread information about this subject. I want to help women achieve peace with food and body so they can truly live the vibrant, magical life they deserve.

Everyone deserves help if they need it. If you suspect an eating disorder or disordered eating for yourself or a loved one, please check out the resources above. The NEDA site also has a short quiz that can give you valuable insight and help you make the first step towards healing.

Speak up, seek help, and know you are not alone.

You. Are. Worth. It.

If you’ve been struggling with your relationship to food and body and are ready to find the peace and freedom you’ve truly been craving, I would love to help. Whether you’re dealing with binge eating, overeating, yo-yo dieting, body shame/hate, or a combination of the above, know that these symptoms are holding a deeper message for you.

Come join my 7-day Food & Body Freedom eCourse (it’s free!) here. This eCourse came from my passion for helping women transform their relationships to food and body. What you desire IS truly possible if you are ready, open, and willing. It is time to say goodbye to the years of control, compulsive behaviors, limiting beliefs, scarcity of joy, and actions driven from a place of fear and feelings of unworthiness, once and for all. Learn more and sign up here.