Up to three out of four American women report having disordered eating, aka an unhealthy relationship with food and their bodies. But that stat is from 2008 (the most recent one available). And is likely low, considering we now have a close relationship with Instagram and a pandemic.
Let’s start with the basics. Disordered eating is…
A preoccupation with food, body, and/or movement. According to Anna Sweeney, a certified eating disorder registered dietitian and body image expert who we consulted for this guide, it describes “anything that separates a person from being able to rely on their own inner wisdom when it comes to food.”
A possible precursor to an eating disorder. Though disordered eating isn’t a diagnosable psychiatric illness, an eating disorder is. And disordered eating habits that might seem minor could possibly lead to a bigger problem.
A byproduct of diet culture. We live in a place where thinness is celebrated, ‘eating clean’ sounds virtuous, and exercising to ‘burn off’ calories is the norm. It’s hard to fight that influence.
Warning signs may include…
Guilt over eating ‘bad’ foods. Practices like 'clean eating' create an unhealthy food hierarchy. And no, you’re not ‘cheating’ if you eat a sweet or carb.
Frequent dieting. That also includes skipping meals so you can ‘save up’ for dinner (which many dietitians wouldn’t suggest you do).
Negative thoughts about body image. This includes an obsession with weight loss.
Feeling like you have to move your body to ‘earn’ your calories. Because you don’t.
Terms to know…
Eating disorders. Sweeney says they’re “the most lethal of all mental health conditions,” and involve distressing thoughts and behaviors like restrictive eating, binge eating, compulsive exercise, purging, regurgitation, and eating things other than food. See: anorexia, bulimia, binge eating disorder, ARFID, rumination syndrome and pica.
Orthorexia. Not an officially recognized eating disorder. But an emerging term for people who obsessively focus on ‘proper’ eating and exercise.
Factors to consider…
There’s not one cause. And it’s definitely not a choice. There are biological, psychological, and social causes and risk factors that contribute to disordered eating and eating disorders.
The pandemic has made things worse. One study found hospitalizations for eating disorders doubled during the pandemic. Isolation, plus an obsession with building up your immune system to fight a virus, worry about food scarcity, and fear over gaining the ‘quarantine 19’ is a particularly dangerous combo. Not to mention the fact that loss of taste — a common COVID-19 symptom — did major damage to some people’s relationship with food.
Holidays can be triggering. “I'm speaking to my clients about seeing family or friends that they haven't seen for a long time, and there's an increased sense of pressure and body comparison,” says Sweeney. Plus, there’s all the talk about holiday food.
Genetics may play a part. Studies on twins and families show that someone could be more genetically predisposed.
People with certain chronic conditions can be more susceptible. Having diabetes or gastro issues where you have to keep close tabs on food and your body could put you more at risk.
Eating disorders don’t discriminate. They’re not limited to a certain size, age, gender, sexuality or race (as Skimm’r Tierra will tell you). And stereotypes around who has eating disorders has made it tough for people who aren’t straight, cis, white women to feel comfortable seeking care.
Issues that could be related…
OCD, depression, and/or anxiety. Having any number of underlying mental health conditions and/or trauma “can lay the groundwork for the development of an eating disorder,” says Sweeney.
Irregular periods. One theory on how it’s related: If you’re extremely low on calories, your body’s probably going to default to using the little fuel it has just to stay alive, not on getting your body ready for a baby.
Dental issues. If you repeatedly vomit, you could have acid-related problems like tooth decay.
Organ failure and loss of bone density. No hyperbole: If left untreated, an eating disorder can go on to impact every organ system in the body, and can make your bones more frail.
If you think you have disordered eating, you should…
Take a deep breath. If you think your relationship with food isn’t quite right, you’re definitely not wrong. Now it’s time to get on a better path.
Talk to someone. That person can be a friend or family member to start. Then, consider professional help.
Go to the NEDA site. The National Eating Disorder Association can help you get screened for a diagnosable eating disorder, and connect you with local and virtual groups and professionals who can help.
Find a health care team. There are dietitians (like Sweeney) and psychotherapists who specialize in eating disorders. If you have insurance and a referral from your PCP, their services may be covered. And you might be able to pay for them with savings from your FSA or HSA. Check with your insurance provider to learn more about your benefits.
Reframe the way you think about movement and food. Instead of thinking of exercise as a calorie-cutter, try to appreciate it as something that can make your body and mind feel good. (More on that here.) And when it comes to food, work on listening to your hunger and feeding yourself regular meals and snacks. Yeah, it’s easier said than done.
Avoid weight goals. Weight isn’t a good measure of health, anyway. See: weight stigma.
Exercise when you’re up for it. If you’re tired, your body probably needs rest.
Go on a follow (and unfollow) spree. You can find community online and follow supportive Instagram accounts (like Sweeney’s). But there are also many social media images that can make you feel bad. You don’t need those.
Know that recovery can take time. The good news: That same brain that may have rewarded disordered eating patterns before…it's adaptable. Meaning you can rewire it with lots of practice and support.
Our diet-focused society has made obsessing over scales and steps and servings a way of life. It doesn’t have to be. You’re allowed to enjoy food and movement. But if you have trouble giving yourself that kind of permission, don’t be afraid to seek help.
theSkimm consulted with Anna Sweeney, certified eating disorder registered dietitian and body image expert, for this guide.