We all need food to live. Eating and drinking is also a deeply social activity, whether that means sitting down at the dinner table for a cherished family meal or grabbing a quick bite and glass of wine after work with friends. When a person’s relationship with food is disrupted by intrusive body image concerns or anxieties, they may develop a pattern of disordered eating: a pattern of restrictive or compulsive behaviors around food and drink. If left untreated, disordered eating can lead to serious physical and mental health complications.
The earlier someone is able to recognize their disordered eating and seek treatment, the likelier they are to recover—both physically and psychologically. Here are some common signs and symptoms of disordered eating.
Preoccupation with food, calories, or weight gain: It’s completely normal to think about the food we eat, but food shouldn’t be the guiding preoccupation of our daily lives or a source of distress. Calorie tracking, measuring daily food intake, or weighing oneself multiple times per day can all be indications of disordered eating.
Feeling like you have to “earn” food: Ascribing a moral value to how much you do or don’t eat can be a sign of disordered eating. While it isn’t necessarily harmful to be aware of the nutritional values in the food you eat, thinking of your food intake as a rigid allotment of calories and/or macronutrient values (e.g. carbohydrates) that need to be limited or “earned” is a restrictive behavior associated with disordered eating.
Overcompensating with exercise: Compulsive exercising — sometimes even to the point of injury — is strongly linked to disordered eating.
Having trouble eating in front of others: Anxiety around eating in public may reflect a fear of how disordered eating behaviors will be perceived by others. This anxiety might even manifest in physical symptoms like trouble swallowing, stomach pain, nausea and a racing heart.
Fixation on dieting: Dieting in and of itself is one of the most common disordered eating patterns. Popular diets often prescribe too little food and/or restrict eating from certain food groups. Even modest dietary restriction has been found to push the body and brain into a state of semi-starvation, which can create heightened anxiety around food. This anxiety can lead to more dieting.
Lack of enjoyment or anxiety around eating: Food-related anxiety, or a general inability to enjoy eating, is a common indication of disordered eating. Starvation alters your brain chemistry, specifically affecting the neurotransmitters responsible for mood and memory. Disruptions in serotonin and dopamine have been found to physiologically perpetuate food-related anxiety.
Prioritizing calorie count over food value: Thinking of food strictly in terms of calories instead of their overall nutritional value can lead people to habitually prioritize low-calorie, low-nutrient foods. Repeatedly choosing low-calorie foods over higher calorie, nutritionally substantial foods (like opting for a pair of rice cakes at lunch instead of a hearty sandwich) can cause fatigue, reduced cognitive function, and a whole host of malnutrition-related health problems.
Disordered eating vs. eating disorders
The National Eating Disorder Association characterizes eating disorders as “serious but treatable mental and physical illnesses” that can affect anyone. They are influenced by psychological, biological, and social factors—including societal pressure to maintain a specific body image. Eating disorders, like anorexia and bulimia nervosa, are specific diagnoses determined by a medical professional.
Disordered eating, on the other hand, is more of a descriptive term that can encompass a wide array of behaviors and traits. A person with disordered eating will likely show symptoms associated with one or more eating disorder diagnoses, but these food-related behaviors may or may not culminate in a specific eating disorder diagnosis. The behaviors may be triggered by societal body image pressure, a traumatic life event or any number of circumstantial factors.
Despite its distinction from specific eating disorder diagnoses, disordered eating can interfere tremendously with a person’s day-to-day quality of life. Disordered eating can also cause significant health complications, including those associated with specific eating disorders.
Seeking help
It can feel scary to seek help for an eating disorder or disordered eating patterns. But the negative consequences of untreated disordered eating are significant.
In addition to changes in the brain that affect a person’s enjoyment of life, ongoing starvation or semi-starvation can create problems in the cardiovascular and endocrine systems. Low blood pressure and cardiac arrhythmia are common in anorexia patients in particular, thus increasing the risk of heart failure. Malnutrition and/or starvation can lead to menstrual irregularity.
Then there are the repercussions of specific nutritional deficits. For example, not consuming enough of certain vitamins and minerals over time can cause bone loss and premature osteoporosis. Diminished estrogen levels further heighten the risk of osteoporosis.
Recent studies have also found a strong correlation between eating disorders and severely reduced immune function. Eating disorder patients were found to present a significantly elevated risk of developing opportunistic infections that require hospitalization.
If you’re interested in getting help for disordered eating but not sure where to begin, you can start by talking to your primary care doctor or even seeing an urgent care provider for a check-up. You might also consider finding an eating disorder therapist who will help you get to the psychological root causes of your disordered eating patterns, and can act as an emotional support in your road to recovery.