Most of us have done it from time to time — used dessert to deal with stress, skipped meals to lose a few pounds, made a late-night raid on the fridge. There’s a name for these behaviors: disordered eating. It’s not a “disorder” in the clinical sense. Rather, disordered eating can describe any eating behavior that veers from the norm. Even a child at camp who’s too homesick to eat can be said to be experiencing disordered eating.
But these examples are, of course, at the mild end of the spectrum. And disordered eating encompasses a very wide range. At its other end are behaviors that fall just shy of an “eating disorder.” So what’s the difference? While “eating disorder” and “disordered eating” may sound like two ways to say the same thing, more than the “ed” differentiates them. It breaks down this way: An eating disorder refers to a group of behaviors that meet specific criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the standard guide used by mental health professionals to diagnose patients.
The DSM-5 defines the main eating disorders this way:
- Anorexia nervosa: A pathological fear of becoming fat and a distorted body image that leads to excessive dieting and severe weight loss.
- Binge eating disorder: Significant overeating in a short timeframe that’s followed by feelings of disgust and distress.
- Bulimia: Binge eating followed by behaviors designed to avoid weight gain, such as self-induced vomiting or the use of laxatives.
“Disordered eating” describes eating behavior that falls outside of what is generally considered healthy, but that misses the clinical diagnosis of an eating disorder —sometimes by a lot, other times by a hair. For example, the DSM-5 definition of bulimia describes it as occurring at least once a week. If someone purges only once a month, they still have a serious problem with disordered eating that deserves immediate attention, but they wouldn’t technically have an eating disorder.
The Disordered Eating Path
Sondra Kronberg, a spokesperson for the National Eating Disorders Association (NEDA) and director of Eating Disorder Treatment Collaborative/F.E.E.D., headquartered in Jericho, New York, sees disordered eating and eating disorders as on a continuum; where you are on that continuum can be defined by “the degree to which your thoughts about food, weight, body image and exercise interfere with your responsiveness, your spontaneity, your aliveness, your socialization and, ultimately, your health,” she explains. Some people are more genetically prone to starting down the path of problematic eating, she says, especially those who tend toward anxiety, depression, low self-esteem, perfectionism and obsessive behavior. But anyone can be at risk. “I do think we live in a very disordered culture,” she says. “We have a hyperfocus on food, weight and body image. You know, we’re not walking around talking about people’s essence or kindness. We’re looking at what they’re eating; we’re looking at what they’re wearing. It’s a very competitive, image-conscious culture.”
How to keep this hyperfocus from moving you into dangerous territory? Kronberg stresses balance, which means not only striking a balance between food and all the other important things in our lives — family, friends, work, faith — but also in a diet that includes essential macronutrients (carbohydrate, protein and healthy fat) and micronutrients (vitamins and minerals).
Just as important as health, she believes, is flexibility — a willingness to go with the flow a bit when navigating the food world rather than setting up rigid eating rules. For example, insisting on eating only organic food may seem like a positive approach, but it can backfire if the alternative is not to eat at all if a preferred food isn’t available. The aim, she says, should be not to stress about whether everything on the plate is perfect, but to make a reasonable effort to seek out nutritious, whole foods and then, she suggests, “to listen to your hunger and eat when you are hungry and stop when you are full.”
If you recognize the signs of disordered eating or an eating disorder in yourself or someone you love, organizations such as NEDA provide resources as well as information on treatment options. Kronberg advises reaching out to a therapist, nutritionist or physician trained in eating issues, who will be up-to-date on the latest findings in the field. By choosing someone experienced in eating issues, you’ll have an expert who understands that problems with eating are “often a creative adaptation for survival,” in Kronberg’s words, meaning that problems with eating is “a way of coping with anxiety, anger, pain, frustration, compulsion, not feeling good about ourselves. So in order to get rid of it, we have to feel as though we have other tools instead. And that’s what takes place in treatment.”