Disordered eating and eating disorders are both frequently used terms. You’ve probably heard them mentioned in articles, by doctors, or by schools. Disordered eating and eating disorders are already common among young people, and research suggests that both are increasing.
But while disordered eating and eating disorders often come together, they refer to different things. Eating disorders are psychiatric illnesses defined by certain criteria, including disordered eating behaviours and attitudes. On the other hand, disordered eating describes the full spectrum of eating-related problems, including dieting and clinical eating disorders.
This article offers some information on the difference between disordered eating and eating disorders, their prevalence, and the treatments available for young people.
What Are Eating Disorders?
Eating disorders are serious mental health disorders, characterised by specific symptoms and traits. They’re defined by diagnostic manuals, such as the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases. When someone has an eating problem that fits with one of these sets of criteria, they may be diagnosed with an eating disorder.
Many people associate eating disorders with a low body weight. But in reality, people of all genders, body shapes, and backgrounds can have eating disorders. In fact, most people with an eating disorder are at a normal or higher body weight.
Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes several types of eating disorders, including:
- Anorexia Nervosa (AN)
- Bulimia Nervosa (BN)
- Binge Eating Disorder (BED)
- Other Specified Feeding and Eating Disorder (OSFED)
- Pica
- • Rumination Disorder
- Avoidant/Restrictive Food Intake Disorder (ARFID)
- Unspecified Feeding or Eating Disorder (UFED)
Anorexia Nervosa
Anorexia nervosa is an eating disorder characterised by a very low energy intake, a fear of gaining weight, and a disturbance in the way they experience their body weight or shape. They may perceive their body differently from other people or not accept the seriousness of their condition.
Young people with anorexia may restrict their energy intake in different ways, including limiting their diet, over-exercising, or using laxatives.
Bulimia Nervosa
Bulimia nervosa is characterised by experiences of out-of-control eating (binges), followed by compensatory behaviours such as vomiting or using laxatives (purges). Young people with bulimia also over-evaluate the importance of their body shape and weight.
Binge Eating Disorder
Binge eating disorder involves recurrent episodes of out-of-control eating or eating a lot of food in a short period of time. Young people with binge eating disorder may experience feelings of disgust, depression, or guilt after overeating. Like anorexia and bulimia nervosa, binge eating disorder involves an over-evaluation of body shape or weight.
Other Specified Feeding and Eating Disorders (OSFED)
Other specified feeding and eating disorders (and eating disorders not otherwise specified) include eating disorders that are similar to one of the previously specified eating disorders, but don’t meet all of the criteria for a diagnosis. They include:
- Atypical anorexia nervosa, where all the other criteria for anorexia are met, but the person is at a normal or higher body weight.
- Purging disorder, where someone engages in purging behaviours but without binge eating episodes.
Eating Disorders, Interpersonal Relationships, and Cognitive Traits
The diagnostic criteria for eating disorders tend to focus on body shape, weight, and disordered eating behaviours. But eating disorders are not just about body shape and food. Instead, they’re complex conditions that develop from and are maintained by social, biological, and psychological factors. In particular, difficulties in interpersonal relationships, personality traits, and ways of thinking seem to be especially important in the maintenance of eating disorders.
Recognising the complexity of eating disorders is fundamental for effective treatment and lasting recovery.
What Is Disordered Eating?
Disordered eating, or disordered eating behaviours, refers to the full spectrum of eating problems, from simple dieting behaviours to clinical eating disorders. Disordered eating behaviours are part of the criteria for an eating disorder diagnosis, but many people experience disordered eating behaviours without meeting the criteria for any eating disorder.
Some examples of disordered eating are:
- binge eating
- diet restriction
- compulsive exercise
- use of laxatives
- avoidance of certain food groups
Disordered eating can be severe, even when a young person doesn’t meet the criteria for an eating disorder diagnosis. This means that disordered eating behaviours should never be overlooked and always require attention and support. Without adequate care, disordered eating behaviours often get worse over time, developing into more serious eating problems or eating disorders.
Disordered Eating Attitudes
Disordered eating behaviours (DEBs) are usually accompanied by disordered eating attitudes – harmful opinions and beliefs about food, body weight, and shape. Like DEBs, disordered eating attitudes often constitute some of the criteria for an eating disorder diagnosis.
Disordered eating attitudes may include:
- Placing a lot of self-value in body shape and weight
- Experiencing body dissatisfaction
- Feeling scared of gaining weight
- Experiencing guilt after eating
Disordered eating attitudes and behaviours sometimes reinforce one another, causing a spiral of worsening symptoms. For example, following strict diet rules can cause someone to become more preoccupied with their body shape and weight, leading, in turn, to stricter rules.
Defining What Is ‘Normal’
To identify disordered eating behaviours, it’s essential to understand what balanced, non-disordered eating looks like. While this can look a bit different for everyone, it includes some key themes. For example:
- eating a mixed and balanced diet with enough nutrients and energy to meet the body’s needs
- having a positive attitude towards food, without labelling foods as good or bad
- having flexible eating habits that vary in response to hunger, schedule, access to food, and feelings
- not being preoccupied with food and eating, but balancing meal planning with other aspects of daily life
Sometimes, people refer to non-disordered eating as ‘normal’ eating behaviours. But this can be misleading, especially when so many young people have disordered eating habits of some form. It’s crucial that disordered eating behaviours, including dieting, are never normalised or accepted, and always responded to with adequate support.
How Common Are Disordered Eating and Eating Disorders Among Children and Adolescents?
Recent data shows that disordered eating is prevalent in adolescents and young adults worldwide. A systematic review across 32 countries found that the proportion of children and adolescents with disordered eating was 22.36%. This number was even higher among girls, and increased with age and body mass index.
A study among Australian adolescents found that 31.6% experienced disordered eating. Of these:
- 25.7% had disordered eating behaviours that didn’t meet the criteria for a diagnosis
- 11.0% had suspected eating disorder
- 0.9% had an eating disorder diagnosis
Treating Disordered Eating and Eating Disorders
If you’re concerned that a young person is developing an unhealthy relationship with food, it’s important to seek professional support. You could speak to their doctor or another mental health professional. Write down the behaviours and attitudes that concern you, or, if a young person speaks to a doctor themselves, encourage them to list the things they’ve been experiencing.
Both disordered eating and eating disorders can be treated, but they require the right kind of support. That’s why it’s so important to speak with a professional. Moreover, early interventions are linked to better outcomes; the longer disordered eating continues, the harder it is to treat.
Some of the treatment options available for eating disorders and disordered eating among young people are:
- Individual therapy, including CBT-E (enhanced cognitive behavioural therapy for eating disorders) and RO-DBT (radically open dialectical behavioural therapy)
- Family-based treatment
- The Maudsley model of anorexia nervosa treatment for adolescents and young adults (MANTRa)
- Adolescent–focused psychotherapy
The Wave Clinic: Specialised Recovery Programs for Young People
The Wave Clinic is a specialist eating disorder treatment space, dedicated to child and adolescent psychiatry. Our programs combine a diverse selection of evidence-based treatments, designed and delivered by experts in the field.
At our residential space, we integrate clinical care with academic and vocational learning, enriching experiences, and internships, supporting young people to grow in self-confidence and develop the skills they need to pursue their goals.
If you’re interested in finding out more about our programs, get in touch today. We’re here to support you.
