Is It Healthy, or Is It a Disguised Disorder?

Jan 27

pst.. today’s post is an adaptation of an exclusive lesson straight from my nutrition course.

Trigger Warning: This article discusses eating disorders and disordered eating behaviors. Please proceed with caution. Do not read if these topics are triggering or distressing to you in any way.

For a lot of people, adopting a healthy eating lifestyle means a commitment to nourishing the body with the best possible nutrients. However, there’s a line, and when the pursuit of a clean diet turns into an obsession, it crosses that line, and it can have unintended consequences.

This obsession often starts early in childhood.

In a large study of 14– and 15-year-olds:

Dieting was the most important predictor of a developing eating disorder.
Those who dieted moderately were 5x more likely to develop an eating disorder.
Those who practiced extreme restriction were 18x more likely to develop an eating disorder.

62.3% of teenage girls and 28.8% of teenage boys report trying to lose weight.
58.6% of girls and 28.2% of boys are actively dieting.
68.4% of girls and 51% of boys exercise with the goal of losing weight or avoiding gaining weight.

Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives.

Girls who diet frequently are 12x more likely to binge than girls who don’t diet.

95% of all dieters will regain their lost weight in 1-5 years.

Eating disorders are associated with some of the highest levels of medical and social disability of any psychiatric disorder.

In the pursuit of health, what does crossing the line look like?

Healthy Eating Behaviors:

Eating when you’re hungry
Stopping when you’re satisfied
Enjoys food and eats a wide variety of food
Doesn’t restrict or limit food out of fear
Food doesn’t produce stress or anxiety
Positive body image
Flexibility and adaptability in food choices
No guilt or anxiety around food choices
No overconsumption or compensatory behaviors
Practices portion control without obsession
Engages in mindful eating practices

Disordered Eating:

Obsessing over weight control
Chronic dieting and restriction
Restricting calories, like skipping meals
Fears and anxiety around food
Compensatory behaviors such as “making up” for a binge by restricting or over-exercising
Extreme preoccupation with body weight or appearance
Rigid food rules that are difficult to maintain or change
Guilt, shame, or anxiety after eating certain foods
Exercise obsession to burn off calories or to compensate for eating

Eating Disorder:

I’m not going to dive deep into all of these (there are more, but these are the “most common” ones) because that’s out of my scope of practice. But if you think you’re struggling with an eating disorder, I highly recommend you visit an eating disorder specialist.

Anorexia Nervosa: Extreme restriction of food, deep fear of gaining weight, distorted body image, and obsession with weight loss, often leading to severe weight loss (but not always).
Bulimia Nervosa: Binge eating large quantities of food followed by purging behaviors (vomiting, laxative use, and excessive exercise) to prevent weight gain.
Binge Eating Disorder (BED): Frequent episodes of binge eating (different than occasionally overeating) without control, often linked to emotional distress, with no compensatory behaviors (purging or exercise).

Being aware of and concerned with the nutritional quality of the food you eat isn’t a problem in and of itself.

It’s when we become so fixated on so-called ‘healthy eating’ that we can damage our own well-being.

The distinction between a simple commitment to healthy eating and disordered eating can be subtle.

However, there are key differences:

Motivation: While those committed to healthy eating do so out of love for their body and the desire to take care of themselves, individuals with disordered eating often eat healthily out of fear or a need for perfection. They derive their self-worth from diet or the way they look and have a persistent concern about the implications of minor dietary infractions.

Flexibility: Someone who eats healthily understands that occasionally indulging doesn't harm overall wellness. Conversely, an individual with disordered eating may experience extreme anxiety if they deviate from their self-imposed dietary rules. They might also spend an excessive amount of time planning meals to maintain control, skipping social plans, and compensating via restriction or excessive exercise.
Social Impact: Many individuals with disordered eating may avoid social events or situations where they don’t have control over the food being served. They may also become highly judgmental of others’ eating habits.

I also want to add, since I get asked often:

Pursuing weight fat loss in and of itself isn’t disordered. You can pursue fat loss by engaging in healthy eating behaviors. The issue is when you pursue fat loss without regard to your health (physical and mental) by engaging in the disordered behaviors I described above. We currently live in a society where a lot of people disguise disordered eating as healthy eating. They’re different.

Motivation, flexibility, and social impact are great ways to check in with yourself. Be honest.

The line between pursuing a healthy diet and becoming obsessed can be blurry.

If you believe you might be struggling with an eating disorder, the most courageous, healthiest, and loving thing you can do is ask for help. Here are some resources you can use:

National Eating Disorders Association (NEDA)