How Do You Get an Eating Disorder: Defining Disordered Eating

Despite increased awareness about eating disorders in recent years, most people feel totally unprepared when faced with an eating disorder in their child or loved one. No one expects to come face to face with the disorder and many physicians are still unaware of the intricacies of treatment because so little information has been disseminated. Further, the disease can be baffling because of what appears to be a sudden onset of the disease and the rapid physical and emotional decline of the person afflicted with the eating disorder. In other cases, the decline is more gradual and increasing health complications finally bring attention to the disorder. In addition, when food or caloric restriction is occurring (either through reduced intake or extreme exercise), people suffering from eating disorders can become irrational, confused and either emotionally volatile or emotionally collapsed because there is not enough glucose in the brain for normal thought and emotional responses to occur. The end result is that attempts by loved ones to reason with or to talk logically about the disorder are often met with staunch resistance, leaving loved ones frustrated or anxious or angry because they feel increasingly helpless, as normal avenues of problem solving repeatedly fail.If you or your loved one is struggling with an eating disorder, you may be searching for answers to help you determine the logical next step in seeking treatment and moving toward recovery. This article and the ones that follow are intended to provide answers to the most frequently asked questions regarding eating disorders as a first step in understanding the disorder and finding needed resources.To define disordered eating, it is helpful to remember that, as with any type of behavior, a wide variety of eating behaviors will fall in the normal range. For example, even if a person has peculiar tastes or is considered to be a “picky eater,” this does not mean he/she has an eating disorder. Changes in diet, even a somewhat restricted diet, refusal of particular foods or a sudden increase in exercise does not necessarily signal a potential eating disorder, as the individual may simply be attempting to make positive lifestyle changes. Most people will not be able to maintain drastic changes in lifestyle, eating or exercise routines for a prolonged period of time, such that typical excesses tend to self-correct fairly quickly (e.g., new year’s resolutions). What you are looking for, then, are significant changes or behavioral and emotional extremes when it comes to the person’s emotional relationship with food, their bodies or social situations involving food consumption.So, what should you look for? The types of changes that may indeed be warning signs of a developing eating disorder include behaviors such as:1. Guilt: Feeling extremely guilty when eating or after eating and/or defining self-worth based on food consumption or body appearance.
2. Coping: Using food consumption and drastic weight control measures in an attempt to cope with life stressors.
3. Comparisons: Constant comparisons (generally negative) between personal eating habits and the eating habits of others.
4. Food Rituals: The development of food rituals (e.g., eating very slowly or cutting food up in tiny pieces that are simply shifted around on the plate).
5. Food Restriction: A drastic reduction in food intake leading to significant weight loss, often accompanied by attempts to hide the weight loss (e.g., dressing in baggy clothes).
6. Food Rejection: A sudden rejection of entire classes of foods (e.g., meat, fatty foods, dairy, sugary foods, high carb foods) or an intense focus on “healthy foods” such that the types of food consumed become very restricted.
7. Binging: Frequent binges in which a large amount of food is consumed in a short period of time.
8. Compensatory Behaviors: Self-induced vomiting (purging), laxative use or abuse of medications (e.g., insulin) or other substances in order to avoid hunger or to empty the stomach or intestines in an attempt to control caloric intake.
9. Over-Exercising: Sudden increase or obsession with exercising, usually for extended periods of time and despite injuries or pain.
10. Secrecy: Secrecy regarding food intake (e.g., refusal to eat meals with the family or eat in front of others).
11. Body Image Distortions: Drastic shifts in body image (e.g., development of body-hatred or intense focus on one particular body part such as thighs or stomach or a distorted image of the body).
12. Emotional Changes: Increased emotional dysregulation (e.g., rapid mood changes uncharacteristic of the patient or significant emotional upset over minor issues), depression or flattened affect that accompanies changes in eating behavior.
13. Cognitive Changes: Increased hostility, argumentativeness, confusion or irrational behavior that accompanies changes in eating behavior.
14. Social Behavior: Changes in social behavior (e.g., loss of interest in friends, social activities/hobbies or isolating from others) based on negative perceptions of weight or appearance or blaming weight and appearance issues for perceived social problems.If you or your loved one is experiencing any of these symptoms, it is important to seek an immediate evaluation by a professional to determine the reasons for the changes and to rule out the presence of an eating disorder. Research indicates that the sooner an eating disorder is diagnosed and treated, the quicker the recovery. Once eating disorders are fully integrated and entrained into a person’s manner of perceiving food, their manner of perceiving their body and their manner of using food, weight control and over-exercise or other compensatory measures to cope with life stressors, the more difficult it is to recover and the more prolonged the course of the illness will be. For more information, see the next article in this series: “How Do You Get An Eating Disorder: Types of Disordered Eating.”