Disordered Eating Vs. Eating Disorders: Understanding the Differences

Key Differences Between  Disordered Eating & Eating Disorders

What Are Eating Disorders?

Eating disorders are serious mental illnesses that refer to distorted relationships with food, exercise, and body image. People with eating disorders feel anxious about eating, and they tend to experience great shame and frustration over their eating habits. Many of them experience poor body image, and some have symptoms of body dysmorphia. There are several types of eating disorders, all of which have different behaviors and treatments.

The most common eating disorders include:

• Anorexia nervosa: Anorexia nervosa refers to an excessive restriction of calorie intake coupled with an intense fear of weight gain.
• Bulimia nervosa: Bulimia nervosa refers to patterns of binging with compensatory purging (self-induced vomiting, laxative abuse, fasting, compulsive exercise) behaviors.
• Avoidant/restrictive food intake disorder (ARFID): ARFID refers to heightened food avoidance/pickiness that is not due to an inherent desire to restrict eating.
• Binge-eating disorder: Binge-eating disorder refers to patterns of binging without compensatory behaviors. Research shows that binge eating disorder is the most common eating disorder.
• Pica: Pica refers to compulsive patterns of eating non-food items.
• Other specified feeding or eating disorder (OSFED): OSFED refers to a general eating disorder classification for having eating disorder symptoms that do not meet the full criteria for an eating disorder.¹

Eating Disorder Symptoms

Eating disorder symptoms tend to be consistent, compulsive, and chronic. They are both emotional and physical. In all cases, they occur on a spectrum, impacting people of all ages and body types. It is not necessarily possible to know whether someone has an eating disorder simply by looking at them.

Signs of an eating disorder include:

• Weight loss
• Weight gain
• Tooth decay
• Feelings of shame, guilt, or anxiety after eating
• Secretive behavior around food
• Excessive exercise
• Poor body image/self-deprecating talk about the body
• Gastrointestinal distress
• Malnutrition
• Academic/school problems
• Relationship issues

Possible Causes of Eating Disorders

There is not a single cause of an eating disorder. Instead, researchers propose that several factors likely influence someone’s likelihood of developing an eating disorder. Genetics, environment, societal expectations, and other co-occurring mental health conditions may all play a role.

Causes of an eating disorder may include:

• Family history of eating disorders: Many people with eating disorders have first-degree relatives with current or past histories of eating disorders.²
• Childhood trauma: Research suggests that many people with eating disorders have a history of childhood trauma. One study found that around 30% have a history of childhood sexual abuse.³
• History of dieting: Chronic dieting can lead to eating disorders, particularly if the dieting starts earlier in life.
• Weight-related bullying: Being bullied over size and weight may lead to an eating disorder.
• Societal messaging: Living in a society where thinness is coveted, and thinspo is common on social media can trigger eating disorders.
• Low self-esteem: Low self-esteem, which can be a symptom of depression or anxiety, may also cause or exacerbate eating disorders.

What Is Disordered Eating?

Someone with disordered eating tends to be preoccupied with their weight and may also be hyperfocused on nutrition and exercise.⁴ Disordered eating is not an actual diagnosis, but the symptoms can certainly affect a person’s daily routine and emotional well-being. Chronic disordered eating behaviors change how people interact/behave with food, engage with exercise, interact with others, and perceive their bodies.

Symptoms of Disordered Eating

Disordered eating represents a complex global problem, and it affects people of all ages and demographics. Some people have habits of disordered eating that ebb and flow based on their emotional states. Others engage in disordered eating to lose weight or achieve a certain fitness goal.

Signs of disordered eating include:

• Obsessive calorie counting: This often looks like being overly preoccupied with calories and/or feeling anxious when eating too many calories (or when the calories are unknown).
• Avoiding certain food groups: Unless there is a medical reason, cutting out entire food groups often represents a symptom of disordered eating.
• Abusing laxatives: This looks like taking laxatives as a means of “getting rid” of food.
• Excessive eating in a short amount of time: Binge eating refers to eating an abnormally large amount of food in a short amount of time, and it’s often done secretly and shamefully.
• Fasting: Fasting looks like avoiding food for extended periods of time, and it is often a weight loss method.
• Compulsive exercise: This consists of having an unhealthy relationship with exercise, which may include exercising too much or too intensely or feeling excessive distress when missing a workout.

Causes of Disordered Eating

It’s estimated that 9% of people worldwide have eating disorders,  but significantly more people exhibit disordered eating symptoms.⁵ In modern society, many parts of disordered eating are considered socially acceptable, making the problem even more complicated. Diet culture, in particular, plays a vital role in shaping disordered eating patterns. It’s very easy for people to develop an unhealthy relationship with food and their bodies.

Possible causes of disordered eating include:

• Stress: Both chronic and acute stress may cause or exacerbate disordered eating symptoms, particularly if someone struggles with body image.
• Dieting: Research shows that frequent dieting attempts are associated with persistent disordered eating habits.⁶
• Peer pressure: People may be more likely to engage in disordered eating when their friends or family engage in such habits.
• Mental health issues: Depression, anxiety, Attention-deficit/hyperactivity disorder (ADHD), and Obsessive-compulsive disorder (OCD) symptoms may correlate with disordered eating habits.

Differences Between Disordered Eating & Eating Disorders

Disordered eating symptoms share similarities with eating disorders. People with eating disorders have chronic disordered eating habits, but not everyone with disordered eating would be diagnosed with an eating disorder. Disordered eating can lead to eating disorders, which refer to severe, pervasive, and frequent patterns of food disturbances.

Differences between disordered eating and eating disorders include:

Physical Consequences

Both disordered eating and eating disorders can coincide with physical consequences, including weight fluctuations, heart rate changes, fatigue, hair loss, and more. However, the physical consequences of eating disorders are more severe and, in some cases, can be fatal.

Another difference is that when an individual with disordered eating begins to see physical consequences, they may stop their behaviors. However, someone with an eating disorder may continue to struggle despite these issues.

Psychological Consequences

Both disordered eating and eating disorders come with numerous psychological consequences, including low self-esteem, obsessive thinking, guilt and shame, and relationship disturbances. However, the severity of these psychological consequences tends to be more intense for those with eating disorders.

Frequency of Behaviors

Eating disorders are diagnosed based on a specific set of criteria. For example, someone with bulimia, on average, binges and engages in compensatory behaviors at least once a week for three months. Someone with disordered eating habits may engage in certain behaviors infrequently or only in response to specific stressors.

Severity of Behaviors

Disordered eating behaviors are abnormal, but they do not meet the full criteria for an eating disorder diagnosis. For example, someone with disordered eating may focus on cutting calories to lose weight (even becoming obsessive about weighing themselves), but this may not be as severe as someone intentionally restricting their intake and trying to lose as much weight as possible.

How Is an Eating Disorder Diagnosed?

Medical providers make a diagnosis of eating disorders after thoroughly assessing an individual and evaluating their past and current symptoms. A diagnosis can happen within a single visit, although it sometimes may take more time to rule out other possible medical or psychological conditions.

Tests used to diagnose an eating disorder include:

• Using the DSM-5: The DSM-5 lists all the criteria for each eating disorder, and mental health professionals use these criteria to establish a working diagnosis.
• Physical exam: A physical exam does not test for an eating disorder, but it can help rule out other potential medical issues coinciding with or causing disordered eating habits.
• Blood tests: Like a physical exam, blood tests can also provide data about someone’s health and offer important information about other potential conditions.
• Biopsychosocial assessment: A biopsychosocial assessment is generally conducted at the onset of therapy and evaluates a person’s physical, mental, and psychological well-being.

Can Disordered Eating Be Diagnosed?

Disordered eating can’t be diagnosed as a mental health disorder. However, in some cases, disordered eating falls under OSFED. That said, regardless of whether or not someone has a diagnosis, disordered eating can become a serious problem. If left untreated, it may cause significant distress to someone’s life. Symptoms can also progress into an eating disorder.

How to Identify Eating Disorders Vs. Disordered Eating

Disordered eating and eating disorder symptoms closely overlap, and it isn’t always easy to distinguish which behaviors meet the criteria for an eating disorder. Furthermore, disordered eating is serious and should not be overlooked. In most cases, it’s important to evaluate how much the eating patterns hurt the individual. An eating disorder comes with a higher level of impairment (i.e., relationship problems, work-related issues, health consequences).

Can Disordered Eating Become an Eating Disorder?

Disordered eating can become an eating disorder. Someone may be at a higher risk of developing an eating disorder if they have a history of trauma or a co-occurring mental illness like depression or anxiety. Disordered eating can also progress into an eating disorder due to frequent dieting cycles and/or obsessions about physical appearance.

When Does Disordered Eating Become an Eating Disorder?

For some people, disordered eating mindsets can slowly or quickly spiral into an eating disorder. But, for other people, symptoms never progress that far. Research shows that teenage girls and young women are at the highest risk of developing an eating disorder, but nobody is fully immune. The longer someone engages in disordered eating – and the more they become entrenched in such habits – the more likely they are to develop an eating disorder.

Disordered eating may be indicative of an eating disorder if:

• Problematic eating behaviors progress into skipping meals and excessive fasting
• Frequent exercising turns into obsessive physical activity
• Frequent dieting results in unhealthy weight management tactics
• Fixation on food or exercise impacts relationships, work, or school
• Problematic eating behaviors persist despite physical or psychological health consequences

How to Prevent Disordered Eating From Becoming an Eating Disorder

There is no guaranteed way to “prevent” an eating disorder from emerging. However, if you recognize that you have disordered eating habits, it’s important to be aware of the risk of developing an eating disorder. It’s important to be honest and seek support if you’re struggling.

Here are some tips for how to prevent disordered eating from becoming an eating disorder:

• Surround yourself with body-positive people: Embrace having relationships with a diverse range of people of different body sizes and shapes. Focus on what you value about each person (rather than how they look).
• Consider mindful eating: Practicing mindful eating can help you better attune to your hunger and satiety cues. This can help you maintain a healthy relationship with food.
• Engage in healthy coping skills: Stress is inevitable, but implementing preventative coping skills for eating disorders can help you manage difficult moments. Write down skills that can be helpful to you to reference during challenging times.
• Try to separate yourself from diet culture: Diet culture can be toxic and may perpetuate harmful messages about food, eating, and body image. It may be helpful to focus more on nourishing your body rather than subscribing to rigid beliefs.
• Seek professional support: If you’re finding it difficult to untangle yourself from disordered eating, consider finding a therapist or counselor who specializes in disordered eating and eating disorders. A therapist can support you in understanding your triggers and guide you in making necessary and desired changes.

How Is Treatment Different for Disordered Eating Vs. Eating Disorders

Disordered eating behaviors are treated using a combination of therapy, medication, nutritional counseling, and psychiatry. Because eating disorders can be more serious and urgent, your doctor or therapist may suggest a higher level of care, including hospitalization or residential treatment. This depends on the severity and type of symptoms.

For both eating disorders and disordered eating, treatment tends to focus on building a healthier relationship with food. This can include eating a more structured and/or varied diet. It may also include developing the ability to eat mindfully and intuitively. Therapists also tend to focus on healing underlying trauma or mental health issues that led to the disordered eating or eating disorder.

Therapy Options

An eating disorder therapist provides support, guidance, and necessary referrals for someone experiencing an eating disorder. While therapy for eating disorders has been extensively researched, there isn’t a single therapy method that’s been consistently proven to be the most effective. Instead, the right approach will be different depending on the individual’s needs and way of thinking. Finding the right approach may take a trial-and-error process.

Therapy options for eating disorders and disordered eating include:

• Enhanced cognitive behavioral therapy (CBT-E): CBT-E is an extension of CBT, but it’s designed for disordered eating or eating disorders, and it includes interventions rooted in psychoeducation, self-monitoring, homework, and cognitive restructuring.
• Dialectical behavior therapy (DBT): DBT for disordered eating and eating disorders helps strengthen skills in interpersonal effectiveness, emotion regulation, distress tolerance, and mindfulness.
• Family-based treatment (FBT): FBT, or the Maudsley approach, can be helpful for children, teenagers, and young adults, as it includes the family in disordered eating or eating disorder treatment.
• Eating disorder group therapy and support groups: Eating disorder group therapy and support groups provide a space where an individual is surrounded by people who are struggling with the same issues. This can help a person feel understood and supported, as well as be held accountable for healing in a non-judgmental way.
• Trauma-informed therapy: Because people with eating disorders often have trauma histories, trauma-informed therapy often represents an essential part of any treatment.
• Interpersonal therapy: Interpersonal therapy focuses on improving interpersonal difficulties in someone’s life, which can strengthen self-esteem and reduce/eliminate eating disorder symptoms.

Medications

Some people benefit from taking psychiatric medication for comorbid conditions of depression, bipolar disorder, or anxiety. The FDA has approved fluoxetine (Prozac) and lisdexamfetamine (Vyvanse) for bulimia and binge eating disorder. Topiramate (Topamax) is also a popular medication for binge eating disorder. There are currently no FDA-approved medications for anorexia, ARFID, or pica.

Hospitalization/Inpatient Treatment

In severe cases, hospitalization for an eating disorder may be necessary to stabilize a person’s health. People who are seriously dehydrated or malnourished often need this option before seeking psychological care. Inpatient treatment refers to 24/7 monitoring and supervision, and these lengths of stay can range anywhere from a few days to several months based on someone’s symptoms. After completing an episode of care, people generally benefit from intensive outpatient treatment, followed by regular therapy.

How to Cope With Disordered Eating & Eating Disorders

Disordered eating and eating disorders can be stressful and frustrating, and recovery is rarely a linear process. Many people experience several setbacks throughout their journey. However, it’s possible to get better, heal, and live a more meaningful, enjoyable life. Adopting healthy coping mechanisms is important for managing stress and staying on track in recovery.

Here are five tips for coping with eating disorders and disordered eating:

1. Mindfulness: Mindfulness refers to staying in the present moment and being attuned to the here and now. Engaging in mindful eating is often recommended in eating disorder treatment.
2. Meditation: Meditation is a form of applied mindfulness that encourages you to focus on your breath or a guided script. Doing this can help you feel less stressed and more confident.
3. Journaling: Journaling is a great way to release feelings and understand your own behavioral patterns better.
4. Building a strong support network: Eating disorders can thrive in isolation, so having a sense of community can be invaluable for your well-being.
5. Practicing self-compassion: Try to be forgiving and kind to yourself through this journey. When you make mistakes, aim to learn from them gently.

When to Seek Professional Support

It can be very challenging to recover from disordered eating or an eating disorder on your own. Professional help offers you a safe, structured space for healing. You can start your search by looking through an online therapist directory and searching for a provider with experience and certification in treating disordered eating and eating disorders. There are also many online therapy options if you prefer to begin treatment from the comfort of your own home. It is important to note that individuals with more severe eating disorders will not qualify for remote care.