Disordered eating refers to a wide range of abnormal eating behaviours, many of which are shared with diagnosed eating disorders. The main thing differentiating disordered eating from an eating disorder is the level of severity and frequency of behaviours.
Disordered eating can have a negative impact on a person’s emotional, social and physical wellbeing. It may lead to fatigue, malnutrition or poor concentration. It can affect someone’s social life (when socializing is restricted due to anxiety around food/eating), and can lead to anxiety and depression.
Disordered eating behaviours and attitudes include:
Binge eating
Dieting
Skipping meals regularly
Self-induced vomiting
Obsessive calorie counting
Self-worth based on body shape and weight
Misusing laxatives or diuretics
Fasting or chronic restrained eating
What is considered “normal” in terms of quantities and types of food consumed varies considerably from person to person. “Normal eating” refers to the attitude a person holds in their relationship with food, rather than the type or amount of food they eat.
It is normal to:
Eat more on some days, less on others
Eat some foods just because they taste good
Have a positive attitude towards food
Not label foods with judgement words such as “good”, “bad”, “clean”
Over-eat occasionally
Under-eat occasionally
Crave certain foods at times
Treat food and eating as one small part of a balanced life
Why are disordered eating and dieting dangerous?
Dieting is one of the most common forms of disordered eating. Research shows that dieting is a commonality among people with eating disorders.
Severely restricting the amount of food you eat can be a very dangerous practice. When the body is starved of food it responds by reducing the rate at which it burns energy (the metabolic rate), this can result in overeating and binge eating behaviours that can lead to weight gain and obesity.
Feelings of guilt and failure are common in people who engage in disordered eating. These feelings can arise as a result of binge eating, ‘breaking’ a diet or weight gain. A person with disordered eating behaviours may isolate themselves for fear of socializing in situations where people will be eating. This can contribute to low self-esteem and significant emotional impairment.
What are the risks associated with disordered eating and dieting?
The risks associated with disordered eating are severe. People with disordered eating may experience:
A clinical eating disorder (Anorexia Nervosa, Bulimia Nervosa, Binge Eating or Other Specified Feeding and Eating Disorders (OSFED))
Weight gain
Osteoporosis – a condition that leads to bones becoming fragile and easily fractured
Fatigue and poor sleep quality
Constipation and/or diarrhea
Headaches
Muscle cramps
Types of Therapies for Disordered Eating
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that focuses on negative patterns of thinking as well as beliefs that contribute to these thought patterns. CBT teaches participants skills that allow them to identify problematic beliefs as well as healthy ways to cope with emotions. CBT has been shown to effectively help those who may be struggling with eating disorders or mood disorders and decrease destructive behaviors. In relation to eating disorders, CBT may include educational components and the development of a meal plan, as well as addressing various facets, such as familial, psychological, and societal factors.
Family approaches
Family approaches are most common when adolescents, young adults and children are suffering from an eating disorder.
Family approaches will involve the whole family or support network of the person with the eating disorder during treatment. The aim of a family approach is to treat the person with the eating disorder, while also supporting and educating the entire family about how to provide appropriate care. Focus can also be placed on strengthening family relationships and improving the family dynamic.
Self-help approaches
Self-help approaches are carried out by the person who is suffering from the eating disorder and often involves forms of Cognitive Behavioural Therapy (CBT).
Self-help treatments can be useful, however, they are most effective when combined with other treatment approaches that are provided by professionals and clinicians. Patients who only adopt self-help approaches and ignore or reject other forms of medical treatment may not recover from their eating disorder and may also be at high risk of recurrence or relapse.
Nutritional management
Nutritional management approaches are provided by a dietitian or nutritionist during treatment. They can also sometimes be provided by a GP. This approach has been designed to ensure that the person with the eating disorder is receiving the right level of vitamins and minerals throughout the treatment process and to help develop normal and beneficial eating habits and behaviours.
The Stages of Change model is a guide to understanding recovery.
There are generally five stages of change that a person with an eating disorder may go through. Everyone is different and some people may pass back and forth between these stages, especially in cases where relapse is common.
This model seeks to understand a person’s motivation towards achieving change and recovery. From a care perspective, it can also be used to understand how to approach and care for someone with an eating disorder.
Stage 1: Pre-Contemplation
In the Pre-Contemplation stage, a person with an eating disorder will most likely be in denial that there is a problem.
While others around them may have noticed some of the warning signs, the person with the disorder will have little or no awareness of the problems associated with their disordered eating. Instead, they may be focused on controlling their eating patterns.
A person with an eating disorder in this stage may not be willing to change or disclose their behaviour and may be hostile, angry or frustrated when approached. This is because the person’s eating disorder is currently serving as a way to control or avoid strong and unpleasant emotions. The person may be unwilling or afraid to let go of these behaviours.
Stage 2: Contemplation
A person with an eating disorder in the Contemplation stage will have an awareness of their problems. They may be considering the benefits of changing some of their behaviour.
However, their attitude may also fluctuate between wanting to change and wanting to maintain their disordered eating habits. This can be difficult and confusing, both for the person with the eating disorder and for their loved ones.
Stage 3: Preparation and Determination
In this stage, the person with the eating disorder has decided they want to change their behaviour and is preparing to make these changes in order to recover. This can be a very stressful and anxious time for the person with the disorder, as well as for others who are supporting them. In most cases, help from a doctor, clinician or eating disorder professional is necessary.
Stage 4: Action
A person with an eating disorder in the Action stage will be taking the first steps towards recovery and is focused on completing the recovery process. They require strong support and encouragement to get through this stage. The person can move backwards and forwards in their development during this stage and relapse can be common.
Stage 5: Maintenance
In the Maintenance stage, a person with an eating disorder will have changed their behaviour and may be focusing on maintaining their new, healthier habits. They are also learning to live without the eating disorder.
This stage takes time and ongoing commitment, both from the person with the disorder and his/her support network. It is still possible for a person with an eating disorder to relapse at this stage. However, full recovery from relapses and recurrences is also entirely possible.
Changing our behavior is never easy but when it involves something that is essential to our well-being it can be a significant challenge. Finding a strong support network can be useful when making such large scale changes. Change is possible. It takes time and some difficult work, but it can be done.
References
http://www.eatingdisorders.org.au/eating-disorders/disordered-eating-a-dieting
http://www.nedc.com.au/disordered-eating
https://www.eatingdisorderhope.com/treatment-for-eating-disorders/types-of-treatments
http://www.nedc.com.au/treatment-approaches
http://www.nedc.com.au/stages-of-change