Disordered eating happens when someone develops problematic and harmful attitudes or behaviours towards food. It might involve eating too much or too little or placing a lot of self-value on body shape or weight. It may also involve using food to cope with difficult emotions, as a distraction or temporary reward.
When disordered eating behaviours meet certain criteria, someone may receive a diagnosis of an eating disorder. Eating disorders are serious mental health conditions involving disordered eating behaviours that significantly harm a young person’s mental and physical well-being.
However, disordered eating behaviours can still be serious even when they do not meet the criteria for an eating disorder. Any eating problem requires care, help, and support.
This blog outlines the key differences between disordered eating and eating disorders, providing information on the causes of disordered eating and the treatment options available.
What Is Disordered Eating?
Disordered eating refers to any problematic behaviours or attitudes about food, body shape, or weight.
It’s normal for a young person’s eating habits to change from time to time. But sometimes thoughts and feelings about food and eating can become harmful. Some examples of disordered eating may include:
- restricting the amount of food you eat or avoiding certain food groups
- following strict exercise routines
- using food to cope with or avoid painful feelings, memories, or thoughts
- placing a lot of self-value in body shape and weight
- feeling out of control when eating
- spending a lot of time thinking about food and planning what to eat
- missing meals
- experiencing urges to get rid of food from the body, by using laxatives, vomiting, or excessive exercise
Disordered eating behaviours can vary in severity but do not meet the criteria for an eating disorder. This might be because of how long they have been experienced, how frequently they’re experienced, or the thoughts and feelings that accompany them.
What Are Eating Disorders?
Eating disorders are medical diagnoses with specific criteria about the duration, frequency, and psychological impairment of an eating problem. They involve persistent disordered eating behaviours that have a serious impact on a young person’s well-being.
The DSM-V (Diagnostic and Statistical Manual of Mental Disorders) defines several different types of eating disorders. These include:
- Anorexia Nervosa, characterised by a low body weight and restricted diet or excessive exercise
- Bulimia Nervosa, characterised by binging and purging behaviours
- Binge Eating Disorder – involving episodes of out-of-control eating
- Other Specified or Unspecified Feeding or Eating Disorders
Only a qualified psychiatrist or psychologist can give an accurate diagnosis of an eating disorder. Because eating disorders are complex conditions, it’s preferable to visit an eating disorder specialist.
If a young person is unhappy with their diagnosis (or lack of diagnosis) or feels like it doesn’t describe their experience, they may want to visit another professional.
What Are the Main Differences Between Eating Disorders and Disordered Eating?
The main differences between eating disorders and disordered eating relate to the duration, frequency and severity of eating attitudes and behaviours, as well as specific psychological criteria that define each type of disorder.
Severity and Persistence of Symptoms
The symptoms of disordered eating and eating disorders can be very similar. They might include an over-evaluation of shape and weight, body dissatisfaction, diet restriction, purging behaviours, out-of-control eating, and psychological distress.
However, a diagnosis of an eating disorder requires these symptoms to meet certain criteria for how long they have lasted, their severity, and their frequency. Young people with disordered eating (but without an eating disorder diagnosis) may not meet these criteria.
Distress and Impairment
Eating disorders involve serious psychological distress and significantly affect a young person’s daily life. While disordered eating can also be very distressing and harmful for a teenager or young adult, it doesn’t always meet the criteria required for an eating disorder diagnosis.
Co-Occurring Concerns
Young people with eating disorders often experience medical and physical problems alongside their disorder, including anxiety and depression. They may also struggle with interpersonal difficulties and problems at work or school.
It’s important to remember that eating disorders (as listed in the DSM-V) involve very specific criteria for a diagnosis. When a young person doesn’t meet this criteria, it doesn’t mean their problems aren’t serious. Sometimes, a person’s symptoms don’t fit well into common conceptions of eating disorders, and this can stop them from receiving a diagnosis.
Any young person with an eating problem, whether it’s disordered eating or a diagnosed eating disorder, should receive attention, care, and support.
What Causes Disordered Eating?
There’s no single cause of disordered eating. But several different factors can make the development of disordered eating more likely. Some people may begin disordered eating behaviours because of a single experience, while for others the pathway may involve a combination of factors.
Some of the risk factors for disordered eating include:
Experiences of Trauma
Experiences of trauma are common among young people with disordered eating and eating disorders. One study suggested that a majority (75%) of young people entering residential treatment for eating disorders had experienced at least one type of childhood trauma.
Young people who have lived through trauma, including abuse, neglect, or exposure to natural disasters, may experience a lasting impact on their mental and physical well-being. They may struggle with anxiety, find it hard to trust others, be hypervigilant, and feel low or hopeless about the world around them. They may also relive traumatic memories or disassociate to try and avoid them.
For some young people, focusing on food becomes a way to cope with or distract themselves from these painful memories, thoughts, and feelings. But disordered eating tends to only make these experiences worse.
Psychological Experiences and Traits
Certain psychological factors can also make the development of disordered eating more likely. These include things like perfectionism, low self-esteem, and difficulties managing emotions.
Negative body image and body dissatisfaction are also closely linked to disordered eating. Teenagers and young people who experience body dissatisfaction often begin disordered eating behaviours to try and change their body shape or weight in response to a distressing self-image.
Young people may be more likely to develop disordered eating if they are living with other mental health disorders like anxiety or depression, PTSD, or OCD.
Media Influence and Cultural Norms
While research suggests that eating disorders and disordered eating have existed and exist in many different cultures and societies, experts usually connect the rise in disordered eating across the globe to Western beauty ideals (and, more recently, ‘health’ ideals).
TV, film, advertisements, and social media present an ideal of a specific female body shape and type that is unrealistic and unhealthy for most young people. They also push forward ideas about health and fitness that are closely related to weight and encourage disordered eating behaviours such as strict diet and exercise routines.
Exposure to these ideas makes it more likely that young people will feel dissatisfied with their own bodies. They may experience feelings of failure and low self-worth that make developing disordered eating behaviours more likely.
Biology and Genetics
Research suggests that a person’s genes may make them more or less likely to develop disordered eating. Biological factors, such as changes in hormonal balances, may also increase the risk.
How Does Disordered Eating Lead to Eating Disorders?
Without interventions or other forms of support, young people with disordered eating are more likely to develop diagnosed eating disorders. This can happen because symptoms get more severe, frequent, or continue for a longer time.
Young people with disordered eating often experience negative cycles of body dissatisfaction, psychological distress, and disordered eating behaviours. As eating habits start to occupy more and more of their life, body shape and weight become increasingly important. This can intensify body dissatisfaction, psychological distress, and low self-esteem – feelings that may drive further eating disorder behaviours.
Dieting and Disordered Eating
Dieting is one of the most common forms of disordered eating.
Across the globe, strict diets and exercise routines are pushed to young people by social media, peers, and other parts of society. Sometimes these diets are focused on weight loss and other times around a specific idea of ‘health’ – that in reality is far away from what it means to be healthy.
These diets and routines involve disordered eating behaviours that can quickly start to take over more and more of a person’s life. They may place increasing importance on their body shape and weight and experience feelings of failure if they perceive their body to be different.
Dieting can result in changes in the body’s metabolism, appetite, and fullness signals, making binge-eating behaviours more likely. It can also stop the brain and body from producing and regulating hormones that affect mood, energy, and other essential functions. This can lead to anxiety, depression, and other mental health symptoms.
Young people who diet at a moderate level may be five times as likely to develop eating disorders than those who don’t diet. This means that understanding the risks of dieting – and challenging conceptions that dieting is healthy – is crucial in the prevention of eating disorders.
How Can Disordered Eating and Eating Disorders Be Treated?
Disordered eating and eating disorders can seriously harm a young person’s life. However, effective interventions can prevent disordered eating from developing into eating disorders – and support young people to recover from both.
Because disordered eating and eating disorders share very similar symptoms, the same treatment approaches are usually effective for both. These may include:
- Cognitive-behavioural therapy (CBT-E)
- Dialectical behavioural therapy (DBT)
- Interpersonal therapy (IPT)
- Family-based therapy (FBT)
- Integrated trauma approaches
Eating disorders are complex conditions that require specialist support. Treatment for young people should involve an eating disorder specialist with expertise in child or adolescent psychiatry. This might involve inpatient treatment or outpatient support, depending on a young person’s needs.
Early intervention is important for eating disorders and is associated with the best outcomes. This might mean receiving treatment for disordered eating behaviours before the criteria for an eating disorder are met, or seeking help as soon as the signs of an eating disorder are noticed. If you’re worried about a young person’s eating habits or attitudes, you should reach out to a professional immediately.
The Wave Clinic: The Eating Disorder Specialists in Asia
The Wave Clinic is a residential mental health treatment centre for young people that specialises in eating disorders. Our world-leading programs transform the lives of children, teenagers, and young adults who live with mental health symptoms. We support young people to find new life paths, grow in self-confidence, and plan and build the futures they dream of.
Our team is a specialist in eating disorders, bringing together extensive expertise and experience for each young person’s journey. Our centre is fully equipped with the medical equipment and monitoring necessary to ensure each person’s safety at all times. We believe there shouldn’t be any barriers to treatment and open our doors to all young people, promoting fairness and inclusivity.
If you’re interested in finding out more about our programs, get in touch today.
Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).
More from Fiona Yassin