Is disordered eating the same as having an eating disorder?

Elizabeth Porter, MD

Psychiatry

Food is nutrition, but it’s also culture, connection and enjoyment. While physicians encourage healthy eating to ensure our bodies get the nutrients we need, trends in wellness and diet culture can often result in disordered eating.

Psychiatrist Elizabeth Porter, MD, discussed the difference between having an eating disorder and disordered eating, as well as how disordered eating affects your health.

What’s the difference between disordered eating and an eating disorder?

“When someone seeks to control what they eat in order to change their body, some of the resulting behaviors would be considered disordered eating,” said Dr. Porter.

Disordered eating behaviors include:

• Restricting calories
• Cutting out certain types of foods or declaring some foods “clean” as opposed to “toxic” or “dirty”
• Compensating for eating certain foods or “eating too much” by exercising heavily, throwing up or using laxatives

When those disordered eating behaviors and patterns begin to cause dysfunction to someone’s body and life, then they become an eating disorder.

Dr. Porter noted that many people have a dysfunctional relationship with food or their body but don’t have an eating disorder. While the two overlap, disordered eating patterns can exist on their own without an eating disorder.

What are the different types of eating disorders?

“Eating disorders fall into three main categories,” said Dr. Porter. “Restrictive eating, compensatory behaviors and sensory issues.”

In restrictive eating disorders, such as anorexia nervosa, people seek to reduce the number of calories or to only allow certain types of foods, usually to lose weight. With compensatory eating disorders like bulimia or orthorexia, the goal is to try to ‘undo’ what they eat by throwing up, using laxatives or exercising excessive amounts to ‘work off’ the calories.

For sensory eating disorders like ARFID (also called Avoidant/Restrictive Food Intake Disorder), the disorder is based in a sensitivity to certain textures. As a result, individuals create a restrictive eating pattern not based around weight loss, but simply around trying to accommodate their sensory issues.

How can disordered eating affect your health?

“On a basic level, our bodies need certain nutrients to build everything that we need to function day to day,” said Dr. Porter. “If we restrict the number of calories we are eating or the types of foods we eat, we may not have enough energy to do all of the things we need our bodies to do.”

This lack of nutritional intake could result in symptoms like mental fogginess, exhaustion and poor immune functioning. Ironically, you may also have trouble sleeping even though you feel exhausted because your body wants you to find food to eat!

If you engage in compensatory behaviors to undo eating, you may upset the balance of salts in your body. Dr. Porter noted that individuals with compensatory eating disorders are at higher risk for seizures and dangerous heart arrythmias.

Eating disorders have the highest mortality rate (risk of dying) of all psychiatric disorders. Receiving treatment may be key to saving your life.

What are some warning signs of disordered eating?

“Any time you hear someone talking about wanting to change the way their body looks, this is a possible warning sign for an eating disorder,” said Dr. Porter. “Again, our bodies are very good at keeping us at our weight set-point and shouldn’t require much intervention from us on a daily basis.”

Weight loss that happens without any change in lifestyle or diet is definitely worth talking to your doctor about, as unexplained weight loss could be caused by other medical conditions.

What should you do if you notice some of these signs in yourself or someone else?

“If someone tells you they are wanting to change their body, ask them how they plan to do so,” said Dr. Porter. “Healthy ways of focusing on nutrition and exercise include talking about increasing what our bodies can do for us and making sure we’re giving them the fuel they need.”

Dr. Ported noted that red flags for unhealthy goals would include focusing on weighing a specific amount or cutting out entire classes of foods (think of people who “aren’t eating carbs” or who suddenly start eating only meat or animal products without eating many, or sometimes any, vegetables or fruits.

Who is at a higher risk for having an eating disorder? Can men have disordered eating?

“The pop culture image of eating disorders seems to always be of a young woman in her teens or twenties,” said Dr. Porter. “While women are one of the higher risk groups, men can also develop eating disorders and may be in other high-risk groups.”

According to the Association of Anorexia Nervosa and Associated Disorders, these groups are at higher risk of developing an eating disorder:

• Women
• People in larger bodies
• Members of the LGBTQ+ community
• Those with diet-related chronic conditions like diabetes or IBS
• People with other psychiatric disorders
• Veterans
• Athletes

Dr. Porter added that women of color with eating disorders are less likely than their white peers to be diagnosed.

While pursuing a healthier diet or more active lifestyle is generally a good thing, there is a blurred line between choosing healthier options and finding yourself falling into disordered eating or exercise patterns.