What is disordered eating?
Disordered eating refers to a pattern of abnormal eating behaviors like impulsive eating, purging, restricting food intake, and using potentially harmful and ineffective methods to manage body weight. These behaviors are influenced by various biological, psychological, and social factors and are often associated with negative body image and distorted attitudes toward food.
Although disordered eating behaviors are less frequent or severe compared to those needed for the diagnosis of an eating disorder, they can still have significant effects on body weight and overall health.[1]
What are the main signs and symptoms of disordered eating?
Disordered eating behaviors may include frequent dieting, anxiety related to specific foods or meal skipping, chronic weight fluctuations, rigid rituals and routines surrounding food and exercise, and feelings of guilt and shame associated with eating.
Individuals with disordered eating are often preoccupied by distorted thoughts about food, weight, and body image. They may also experience a loss of control around food and engage in compulsive eating habits. In an attempt to compensate for consuming what they perceive as "bad foods," they may resort to using exercise, food restriction, fasting, or purging.[1]
How is disordered eating diagnosed?
Diagnostic tools used for eating disorders can also be used to identify disordered eating behaviors, but because disordered eating doesn’t meet the clinical diagnostic criteria, it doesn’t receive a diagnosis. Different health providers can play a role in identifying these behaviors with questionnaires about a person’s dietary history, nutrient intake, and eating habits.[1]
What are some of the main medical treatments for disordered eating?
Most interventions for disordered eating are still in the experimental stages and are not considered medical treatments, but telephone-provided cognitive behavioral therapy reduced disordered eating in a small study of participants who had undergone bariatric surgery.[2]
Are there any other treatments for disordered eating?
Intuitive eating, cognitive dissonance-based group treatment, mindfulness, and yoga have all been studied for preventing or reducing disordered eating behaviors, with varying efficacy. Intuitive eating and cognitive dissonance-based interventions appear to be the most effective ways to prevent or reduce disordered eating behaviors.[3][4][5]
Mindfulness shows some promise for reducing certain disordered eating behaviors in adults, but it may not be appropriate for adolescents.[6][7] Based on the limited amount of research, yoga can lead to a more positive mood, but it doesn’t appear to improve risk factors for disordered eating.[8]
Other interventions aimed at improving body image — such as body appreciation and education on social media usage — may also help to prevent disordered eating behaviors.[5][9]
What causes disordered eating?
Disordered eating behaviors can be triggered by a variety of situations, including stressful life events like divorce, the death of a loved one, childhood trauma, or the diagnosis of a serious illness or injury. The behaviors can sometimes be a way to regain a sense of control after experiencing a major life change. Dieting and using nutrition trackers to lose weight can also lead to the development of disordered eating behaviors.[10][11][12][1]
Other risk factors include perfectionism, negative self-image, being teased or bullied as a child, problematic social media use, and tracking body weight, all of which can contribute to body comparison and dissatisfaction.[13][7]
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Frequently asked questions
Disordered eating refers to a pattern of abnormal eating behaviors like impulsive eating, purging, restricting food intake, and using potentially harmful and ineffective methods to manage body weight. These behaviors are influenced by various biological, psychological, and social factors and are often associated with negative body image and distorted attitudes toward food.
Although disordered eating behaviors are less frequent or severe compared to those needed for the diagnosis of an eating disorder, they can still have significant effects on body weight and overall health.[1]
Normal eating generally involves following a well-balanced diet that provides sufficient nutrients and calories to support the body's requirements while maintaining a flexible mindset towards food. A flexible approach includes all foods without guilt, shame, anxiety, or labeling any food as “good” or “bad.” Normal eating is adaptable and varies based on factors such as hunger, schedule, proximity to food, and emotions but doesn’t lead to preoccupation or excessive weight fluctuations. [1]
Disordered eating behaviors may include frequent dieting, anxiety related to specific foods or meal skipping, chronic weight fluctuations, rigid rituals and routines surrounding food and exercise, and feelings of guilt and shame associated with eating.
Individuals with disordered eating are often preoccupied by distorted thoughts about food, weight, and body image. They may also experience a loss of control around food and engage in compulsive eating habits. In an attempt to compensate for consuming what they perceive as "bad foods," they may resort to using exercise, food restriction, fasting, or purging.[1]
Diagnostic tools used for eating disorders can also be used to identify disordered eating behaviors, but because disordered eating doesn’t meet the clinical diagnostic criteria, it doesn’t receive a diagnosis. Different health providers can play a role in identifying these behaviors with questionnaires about a person’s dietary history, nutrient intake, and eating habits.[1]
Most interventions for disordered eating are still in the experimental stages and are not considered medical treatments, but telephone-provided cognitive behavioral therapy reduced disordered eating in a small study of participants who had undergone bariatric surgery.[2]
Intuitive eating, cognitive dissonance-based group treatment, mindfulness, and yoga have all been studied for preventing or reducing disordered eating behaviors, with varying efficacy. Intuitive eating and cognitive dissonance-based interventions appear to be the most effective ways to prevent or reduce disordered eating behaviors.[3][4][5]
Mindfulness shows some promise for reducing certain disordered eating behaviors in adults, but it may not be appropriate for adolescents.[6][7] Based on the limited amount of research, yoga can lead to a more positive mood, but it doesn’t appear to improve risk factors for disordered eating.[8]
Other interventions aimed at improving body image — such as body appreciation and education on social media usage — may also help to prevent disordered eating behaviors.[5][9]
Most treatments for disordered eating work by addressing the underlying internalized weight stigma, body image disturbances, and rigid food rules.
Dissonance-based treatments include verbal, written, and behavioral activities that work by highlighting the costs of pursuing the thin ideal and engaging in disordered eating behaviors and emphasizing their conflict with the participant’s values.[4][5]
Mindfulness practices involve noticing and responding to hunger and fullness cues, rather than following external rules about what or how much to eat, and may also reduce disordered eating behaviors by improving emotional regulation skills. Intuitive eating integrates mindful eating with other practices that address body image concerns and strict food rules, similar to dissonance-based treatments.[3][6]
Interventions that encourage body appreciation and self-compassion may also reduce or prevent eating pathology by addressing the underlying body image concerns that create a drive for a specific physique. Education programs that focus on social media use can help adolescents understand the ways that social media can negatively affect body image and potentially reduce their susceptibility to problematic content such as photoshopped pictures that depict unrealistic beauty standards.[5][9]
Disordered eating behaviors can be triggered by a variety of situations, including stressful life events like divorce, the death of a loved one, childhood trauma, or the diagnosis of a serious illness or injury. The behaviors can sometimes be a way to regain a sense of control after experiencing a major life change. Dieting and using nutrition trackers to lose weight can also lead to the development of disordered eating behaviors.[10][11][12][1]
Other risk factors include perfectionism, negative self-image, being teased or bullied as a child, problematic social media use, and tracking body weight, all of which can contribute to body comparison and dissatisfaction.[13][7]
It is possible to use nutrition trackers without developing disordered eating behaviors.[14] However, there is a positive correlation between nutrition tracking and eating pathology, and participants in some observational studies have reported that use of a nutrition tracker contributed to their eating disorder. Most research suggests that it’s the reason for using the tracker — not simply the tracking itself — that links nutrient tracking to eating pathologies.[11][12][7]
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References
- ^Pereira et alDisordered Eating: Identifying, Treating, Preventing, and Differentiating It From Eating DisordersDiabetes Spectrum.(2007)
- ^Sockalingam S, Leung SE, Ma C, Hawa R, Wnuk S, Dash S, Jackson T, Cassin SEThe Impact of Telephone-Based Cognitive Behavioral Therapy on Mental Health Distress and Disordered Eating Among Bariatric Surgery Patients During COVID-19: Preliminary Results from a Multisite Randomized Controlled Trial.Obes Surg.(2022-Jun)
- ^Katcher JA, Suminski RR, Pacanowski CRImpact of an Intuitive Eating Intervention on Disordered Eating Risk Factors in Female-Identifying Undergraduates: A Randomized Waitlist-Controlled Trial.Int J Environ Res Public Health.(2022-Sep-23)
- ^Atkinson MJ, Diedrichs PCExamining the efficacy of video-based microinterventions for improving risk and protective factors for disordered eating among young adult women.Int J Eat Disord.(2021-May)
- ^Wilksch SM, O'Shea A, Taylor CB, Wilfley D, Jacobi C, Wade TDOnline prevention of disordered eating in at-risk young-adult women: a two-country pragmatic randomized controlled trial.Psychol Med.(2018-Sep)
- ^Osborne EL, Ainsworth B, Chadwick P, Atkinson MJThe role of emotion regulation in the relationship between mindfulness and risk factors for disordered eating: A longitudinal mediation analysis.Int J Eat Disord.(2023-Feb)
- ^Omiwole M, Richardson C, Huniewicz P, Dettmer E, Paslakis GReview of Mindfulness-Related Interventions to Modify Eating Behaviors in Adolescents.Nutrients.(2019-Dec-02)
- ^Pacanowski CR, Diers L, Crosby RD, Mackenzie M, Neumark-Sztainer DYoga's impact on risk and protective factors for disordered eating: a pilot prevention trial.Eat Disord.(2020)
- ^Baceviciene M, Jankauskiene RAssociations between Body Appreciation and Disordered Eating in a Large Sample of Adolescents.Nutrients.(2020-Mar-12)
- ^Froreich FV, Vartanian LR, Grisham JR, Pinkus RTThe psychological effects of blind and open weighing in women with a high drive for thinness: A mixed method inquiry.Body Image.(2021-Dec)
- ^Courtney C Simpson, Suzanne E MazzeoCalorie Counting and Fitness Tracking Technology: Associations With Eating Disorder SymptomatologyEat Behav.(2017 Aug)
- ^Levinson CA, Fewell L, Brosof LCMy Fitness Pal calorie tracker usage in the eating disorders.Eat Behav.(2017-Dec)
- ^Francisco-Javier Hinojo-Lucena, Inmaculada Aznar-Díaz, María-Pilar Cáceres-Reche, Juan-Manuel Trujillo-Torres, José-María Romero-RodríguezProblematic Internet Use as a Predictor of Eating Disorders in Students: A Systematic Review and Meta-Analysis StudyNutrients.(2019 Sep 9)
- ^Samantha L Hahn, Niko Kaciroti, Daniel Eisenberg, Heidi M Weeks, Katherine W Bauer, Kendrin R SonnevilleIntroducing Dietary Self-Monitoring to Undergraduate Women via a Calorie Counting App Has No Effect on Mental Health or Health Behaviors: Results From a Randomized Controlled TrialJ Acad Nutr Diet.(2021 Aug 19)