When is it an Eating Disorder and Not Disordered Eating?

April 02, 2019

We all have our idiosyncrasies around eating. So when do our behaviors around eating become a problem? When are our eating patterns considered disordered and when are they considered an eating disorder? What defines “normal” eating and is there even such a thing? Is the fact that I eat virtually the same thing for breakfast every day problematic? Does having rigid rules around eating, for example refraining from eating carbohydrates or being gluten-free without a Celiac Disease diagnosis, indicate a problem?

How are we “supposed” to eat? What did cavemen eat? For those who have heard of the Paleo diet, the meal plan is based on foods consumed during the Paleolithic era including a low intake of carbohydrates and high intake of animal protein. However, a University of Chicago study (Hardy, 2015) indicates that cavemen did consume carbohydrate-rich food and, furthermore, the body’s demand of glucose for brain development could not have been met without a diet rich in carbohydrates.

How do we determine what to eat? The human brain is pretty miraculous in that it knows what our bodies require in order to continually rebuild our cells and maintain health. We should not be telling our body what it needs through a predetermined food plan. The brain will provide our bodies with internal cues and signal what we need from our food in order to remain nourished. We are the experts of our own bodies. We know when we are hungry and we know when we are full or satiated. If we truly listen to our bodies, it will guide us to body-supportive eating.

Therefore, normalized or non-disordered eating can be defined as food consumption based on attunement to internal messages around what the body needs. Eating comes naturally and easily when hungry and ceases at a point of fullness. Furthermore, a variety of foods are a necessary part of daily intake. Food should be eaten throughout the day to maintain energy levels as needed with hunger and thirst serving as reminders.

At this point, let’s revisit the topic of disordered eating. Many people actually live with some form of disordered eating. Dieting, restrictive food programs, behaviors, and even guilt or shame about eating can be signs of disordered eating. However, and most importantly, disordered eating does not interfere with daily life. People who are disordered eaters are able to comfortably eat at any restaurant and really have no desire to change their eating habits.

An eating disorder exists when an individual’s disordered eating patterns inhibit normal life functioning.  There is an obsession around food, body image, and other eating disorder thoughts and behaviors. Many eating disorder behaviors exist in disordered eating as well. However, the level of obsession in eating disorders impairs focus, the ability to stay present, sleep, as well as many other aspects of life. The behaviors become out of control to the point where the individual may receive a diagnosis by a professional using the DSM-5 (Diagnostic and Static Manual of Mental Disorders, Fifth Edition). It is serious mental illness. Eating disorders affect 9% of the population.

It is important that someone experiencing an eating disorder seek treatment with a therapist specialized in treating eating disorders. (Many professionals have a certification from iaedp, the International Association of Eating Disorders Professionals). Treatment for eating disorders include a treatment team of professionals required to treat both the mental and physical aspects of the disease. We must eat to live.

If you or a loved one need assistance finding help for an eating disorder you may contact The Alliance for Eating Disorders Awareness at 866.662.1235 or go online for their interactive treatment finder at www.findEDhelp.com.

Joann Hendelman, PhD, RN, CEDS-S, FAED is the Clinical Director of The Alliance for Eating Disorders Awareness. She is also Clinical Director of The Alliance Psychological Services which provides therapy for those who are uninsured or underinsured, those who historically have not had access to care. Dr. Hendelman also trains and supervises Alliance Support Group Facilitators  and groups that are currently held across the country. Dr. Hendelman maintains a private practice in Palm Beach Gardens, Florida.