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Eating Disorders

Differences Between Eating Disorders and Disordered Eating

Eating disorders and disordered eating have important distinctions.

Key points

  • Eating disorders are considered a mental illness.
  • Eating disorders often have co-occurring anxiety and depression as well as a strong thread of perfectionism.
  • Disordered eating is a risk factor and warning sign for an eating disorder.
  • For best-practice treatment, find a specialist who is trained in eating disorders or disordered eating.
Wallace Bent / Unsplash
Wallace Bent / Unsplash

Chances are, you’ve heard the terms eating disorders and disordered eating—but do you know what both concepts mean?

In today’s blog post, I want to dive into the differences between eating disorders and disordered eating, as well as the motivation behind and treatment for both issues.

Eating disorders versus disordered eating

The main difference between an eating disorder and disordered eating is that an eating disorder meets the frequency threshold and cluster of symptoms in the DSM 5 (the Diagnostic and Statistical Manual of Mental Disorders, a professional reference book published by the American Psychiatric Association), which means that eating disorders are considered a mental illness. Like many mental illnesses, they are very connected to our physical health.

In recent years, neuroscience has shown us that when our body is threatened by low weight or poor nutrition, we become more obsessive and anxious. Given this connection, we now recognize eating disorders as a brain disorder, more closely related to obsessive-compulsive disorder (OCD). The level of inflammation in our brain or the type of bacteria in our gut can change our mood and our cravings significantly, so we can’t separate the body from the mind in these disorders.

We also recognize that many “loss of control” eating disorders, like bulimia and binge eating disorder, have a likeness to an addiction. The tricky thing here is that abstinence from certain foods is not the answer, as it actually provokes more loss of control due to our body’s food insecurity sensitivity. Food is survival to the body. This is why restrictive dieting often contributes to the development of eating disorders from a purely scientific level, not to mention the psychosocial facilitation.

Not all disordered eating has a drive for thinness, but this is a thread that runs through all eating disorders.

Even loss-of-control eating disorders have a mindset of restricting particular foods in order to look a certain way despite the end result of engaging in the very opposite behavior. Eating disorders often have co-occurring anxiety and depression, as well as a strong thread of perfectionism. When they do not meet their own expectations, individuals engage in self-loathing and low self-esteem. I learned early on in my career working with those who overeat or binge that not everyone who eats more than they would have liked feels bad about it. This is what separates those who are disordered and those who just eat more than they would have liked. Their bodies or their eating behaviors don’t define who they are.

There is much controversy about “clean eating” and whether it’s disordered eating or just a good habit. For many, health is important, and food intake does contribute to our health. Someone who has heart disease or diabetes or is preventing progression into the disease may limit or avoid certain foods. Are these individuals disordered? What about those with food sensitivities or allergies?

The key here is obsession. Does obsession lead to poor health in the name of health? Does it interrupt daily functioning and socialization? Not everyone becomes obsessive to the point of dysfunction. Oftentimes, the difference is whether the individual has the propensity for an obsessive-compulsive anxiety disorder or other mental illness driving the behavior, such as depression and low self-esteem.

It’s also important to understand that disordered eating is a risk factor for an eating disorder.

Keep in mind that all behavioral disorders meet a need: They make people feel better on some level, so they repeat it. Many individuals don’t intend to get caught in the vicious cycle of repetition. The reward may even change or drift over time. This is why dabbling in disordered eating behaviors is so dangerous for young people.

While disordered eating can make one’s life miserable (like yo-yo dieting), it doesn’t always turn into an eating disorder, which is a mental illness. Even so, since these disorders are body-based, symptom behaviors can turn into a mental illness, especially when someone has the propensity for such disorders (i.e., a family history or other mental health conditions).

Remember that eating disorders are serious and lethal illnesses.

Find a specialist who is trained in these disorders, as not everyone understands what to look for and how to respond with best-practice treatment. Know that eating disorders are treatable and that people do recover.

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More from Kari Anderson DBH, LPC, CEDS-S
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