This piece was written by one of our contributors; UK Registered Dietitian – Talia Cecchele.
Disordered eating is on the rise. There are more people than ever with an unhealthy relationship with food as dieting has become the new “normal” in our society. It’s becoming rare to find someone that isn’t talking about weight loss, dieting, going on a detox or being “good” with their eating.
When food rules are created, this then paves the way for disordered eating behaviours, which then have the potential to evolve into an eating disorder.
How common are eating disorders in the UK?
Eating disorders and disordered eating have increased significantly during the pandemic, with hospital admissions for eating disorders having risen by more than 30% across all age groups in the last two years (1). The UK eating disorders charity Beat estimates that approximately 1.25 million people in the UK have a diagnosed eating disorder (2). Eating disorders fall under four main categories:
- anorexia nervosa (AN)
- bulimia nervosa (BN)
- binge eating disorder (BED)
- Other Specified Feeding or Eating Disorder (OSFED), sometimes referred to as Eating Disorders Not Otherwise Specified (EDNOS).
Eating disorder diagnostic criteria look at key areas including dietary
restraint and weight, shape and eating concerns. In reality, the number of people with eating disorders in the UK is likely much higher as many people do not seek help and remain undiagnosed.
What is disordered eating?
Unlike eating disorders which are classified using The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), disordered eating has no official definition. Disordered eating falls on a spectrum of eating behaviours and relationship with food. Generally, it refers to disturbed and abnormal eating behaviours which might include skipping meals, restrictive dieting or having rigid rules around eating e.g. removing a major food group from the diet.
On the flip side, the key components of having a healthy relationship with food are regular eating, diet variety (not cutting out food groups or particular foods unnecessarily), being flexible with food choices and eating with others. Most people will experience some form of disordered eating throughout their lives, and we can only estimate that the number of people in the UK who have disordered eating is high.
Why does someone develop disordered eating?
Relationship with food is complex and there is no one single reason why someone might develop disordered eating or an eating disorder. While it is most common among young women, disordered eating can affect anyone of any age, gender or race. You are more likely to be affected if there is a family history of eating disorders or mental health illness, you have been criticised for your eating or the way you look, there is a pressure to look thin (for example models, athletes or ballet dancers), you have anxiety or low self esteem or have experienced trauma. Environment and social factors, diet culture and increased food availability (and therefore increased dietary choice) can influence someone’s eating habits. We also know that there is a link between social media use and greater body image concerns and disordered eating (3).
What are traits of disordered eating?
Many people with disordered eating will meet criteria for a clinically diagnosed eating disorder, so many of the behaviours will overlap. In general, some warning signs or traits of disordered eating are:
- Restricting the amount of food you eat
- Eating “clean” or regularly engaging in detoxes or fasting
- Spending a lot of time worrying about how you look and what you eat
- Avoiding social events with food
- Counting calories or measuring food obsessively
- Having very strict dietary rules
- Deliberately engaging in behaviours that alter your weight and digestion including vomiting, laxative use, taking diet pills or excessive exercise
- Feeling cold, dizzy and tired all the time
- Digestive issues including IBS type symptoms
- Not allowing others to cook for you or cooking food for others and not eating it
- Losing weight or gaining weight quickly
- Losing your period or having irregular periods
- Overeating without loss of control, eating in the absence of hunger, irregular meal patterns, or continual grazing (4)
Are there any physical or medical risks of engaging in disordered eating?
Many people who engage in disordered eating either minimise their behaviours or do not realise the extent it could impact their physical and mental health. Some people online and diet programs even glorify serious side effects such as diarrhoea, fatigue, headaches and abdominal pain. Disordered eating can pose serious health concerns including risk of obesity, underweight or eating disorders, long-term gastrointestinal issues, osteoporosis, fertility issues, low heart rate and blood pressure and impact on mental health including anxiety and depression. Engaging in disordered eating behaviours serious and help should be sought to overcome it.
How can we make a shift to improve our relationship with food?
With diet culture on the rise, it is firstly important to be aware of how you talk about food and the influence food decisions have on your day-to-day life. Here are some tips to get you started:
- Ditch dietary rules and practice eating regular meals
- Practice food neutrality (not seeing food as good or bad) and try not to label the way you eat as this can turn into another food rule
- Don’t engage in fad diets, detoxes or cleanses. Focus on what you can add to your diet to make it more nourishing
- Don’t cut foods or food groups from your diet. Research tells us that this can increase the risk of overeating or binging on the food later
- It can be helpful to take a break off social media or to unfollow unhelpful accounts which promote fad diets, diet culture or body shaming
- Be kind to yourself and practice body acceptance
- Seek support from a qualified health professional, a registered dietitian or nutritionist, psychologist or counsellor.
What is the treatment for disordered eating?
It is essential to note that if your relationship with food is impacting your life in any way, then that is enough of a reason to seek support. Eating concerns that fall short of an eating disorder diagnosis deserve treatment as there is the risk that it might turn into a more problematic eating disorder. Make an appointment with your GP for a physical health check before making any significant changes to your eating and lifestyle. Standard treatment for disordered eating and eating disorders is to seek support from a psychologist and/or registered dietitian specialising in this area. Speak to your GP to find out about services local to you, or use the Helpfinder service on the Beat website.
(1) BBC. Press release: Eating disorder hospital admissions rise sharply. Available at: https://www.bbc.co.uk/news/uk-50969174
(2) Beat. Statistics for journalists. Available at: https://www.beateatingdisorders.org.uk/media-centre/eating-disorder-statistics
(3) Holland G & Tiggemann M. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image. 2016 June; 17:100-110
(4) Tanofsky-Kraff M & Yanovski S. Eating disorder or disordered eating? Non-normative eating patterns in obese individuals. Obesity. 2004 September, 12(9):1361-1366