Unfortunately, society and the school systems typically fail to properly educate on the topic of Eating Disorders. As a society, we are terribly misinformed and under-informed. Health classes typically breeze over the topic in a 40-minute period, if that, or in 5 textbook pages that are glanced over. Furthermore, most health classes explain different Eating Disorders in language that is very misleading. I hear so many of my clients complain about the frustrations they’ve felt when their health teacher teaches that people who have Anorexia simply starve themselves and don’t eat anything at all. This is, in fact, untrue. If a person doesn’t eat for any significant period of time, they will die. If people with Anorexia never eat, how is it possible that they may be struggling with this disorder for years, and still be alive? Now, why does this matter? It matters because our adolescents and young adults are so susceptible to eating and body issues, and if our teachers are explaining these disorders without giving due diligence to the topic, our young people then come to believe that they don’t have a problem, when they do. The consequences then become them continuing to struggle, not reaching out, and getting to a place much further along in their Eating Disorder, simply because they thought they didn’t have a problem, because they were educated in such a way to believe they did not. Now, I want to make it clear that I am not blaming the school systems or our teachers for the misinformation or not spending enough time on this. I simply would like to put this information out there in a simplified, yet straight-forward way. I’ll give a small snapshot of each disorder so that it can begin to correct the misconceptions we have been taught in our society:
-Anorexia Nervosa: This is marked by the intense fear of gaining weight. A person will severely restrict their food intake to a caloric intake that is below what really is necessary for the body to function optimally. Many times, this will lead to a significant drop in weight in a small window of time. However, it is important to note that you do not need to be underweight to have Anorexia. This is one of the biggest barriers to seeking treatment that many people have since they feel they are not classified as being underweight, therefore they must not have a problem.
-Bulimia Nervosa: In Bulimia, there may be periods of time where the person restricts their intake. The difference from Anorexia is that there will also be episodes of binging and purging. Purging may be done through various methods including inducing vomiting, using laxatives or over-exercising. The person with Bulimia also struggles with body image issues and fear gaining weight.
-Binge-Eating Disorder (BED): BED has 2 clear differences from the other disorders;
1: There are episodes of binge-eating, however the person does not purge and;
2: There is not a body image component. However, this does not mean that the person may not feel shame about their body, it means that they are not engaging in an act to ruthlessly avoid gaining weight such as restricting or purging.
Typically, Binge-Eaters will have episodes of binging that they will describe as mechanistic, numbing or out-of-control.
-Orthorexia: Although this one has yet to make its way into the DSM-5 as an official diagnosis, it is something that still is problematic that is hiding under the disguise of “healthy eating.” We are living in a society that is all about eating better, eating “cleaner,” and some people take this to an extreme. How does one know if it’s just a person trying to pursue a healthier lifestyle versus Orthorexia? The answer lies within their flexibility, or lack thereof. If they are never, or very rarely, willing to have a food item that may not be considered “healthy” or “clean,” they may have Orthorexia. When there is such a rigidity around healthy eating, it begins to become unhealthy. If you can never allow yourself to have regular ice cream or a meal at a normal restaurant, the quest for healthy eating may have gone too far. There’s nothing wrong with trying to pursue a healthier lifestyle, but healthy also requires flexibility. In this disorder, body image issues tend not to be the focus.
-Avoidant-Restrictive Food Intake Disorder (ARFID): This feeding disorder looks a bit different than the rest. It is sort of the catch-all for Eating/Feeding issues that don’t have it’s own diagnoses. Some examples of how it may present itself in a person are as follows;
1: Someone can’t eat anything green because they have an aversion to the color. The aversion may have developed from a time they got sick from having a food that was green in the past. Or;
2: Someone undereats out of fear that if they eat too much, they will get sick.
While these examples are not all-inclusive, the important piece to take away is that there is some reason that the person is unable to eat all foods in a normal, healthy way, for a reason that is unrelated to body image.
-Body Dysmorphic Disorder: This one can be very tricky to understand, even for the person experiencing it. The textbook definition is a “preoccupation with a defect or a part of your body that is either slight or imagined.” For example, someone may be convinced that they have one eye that is smaller than the other, however, no one else is able to see this. The “defect” is either very slight or even imagined. As an outsider looking in, it can be difficult and frustrating to understand. What is important to remember is that that preoccupation is that person’s truth. In the example given, this person’s truth is that one eye is smaller than the other, and trying to convince them otherwise is going to be about as difficult a task as convincing me that the sky is green.
It is important to note that while these are listed as distinct disorders or issues, they typically do not look as clear cut in actuality. People may and typically will range in their problematic eating behaviors throughout their lives, if not dealt with. It is rare that you find someone who is so close to the textbook definition of solely one disorder.
One note I want to make perfectly clear is that not falling into one of these categories does NOT mean that you aren’t struggling enough to get help. You do not have to feel you have a diagnosis to need treatment. You do not have to be underweight to need treatment. You do not have to feel out-of-control to need treatment. You may feel that you struggle with eating or body image issues and find that it is interfering with your quality of life. If you feel you are struggling, treatment could be beneficial for you.
Thank you for reading, I hope this post offers some clarity and understanding! Please let me know if you have any questions, concerns or comments either by leaving a comment or messaging me privately!
I wish you wellness on your journey to finding your State of Balance!
Binge And Restrict Cycle
Eating Disorder Specialist
Healthy Self Vs. Eating Disorder