The Disordered Eating-Eating Disorder Continuum

TW: Detailed dialogue about consuming problems and disordered consuming behaviors

For some folks, the that means behind the time period consuming dysfunction feels distant and tough to understand. For others, the time period might convey up tough emotions or really feel deeply triggering. 

Research estimates that as many as three in four folks have disordered consuming behaviors. In reality, well being, diet, and health coaches, although well-intended, could also be unknowingly selling problematic consuming behaviors. 

For well being, diet, and health coaches, studying concerning the indicators and signs of consuming problems and figuring out disordered consuming behaviors are important elements of their data toolbox. Learning concerning the disordered consuming to consuming dysfunction continuum not solely helps coaches determine when a shopper could also be exhibiting a few of these behaviors but in addition helps to determine teaching practices which may be fueling disordered consuming. 

This article gives readers with an summary of the variations between consuming problems and disordered consuming behaviors. It additionally introduces the reader to the continuum of disordered consuming, which permits coaches to know how some behaviors can initially appear innocent however might progress towards extra unhealthy consuming behaviors. Finally, it gives coaches with fundamental info on tips on how to spot disordered consuming and help shoppers in in search of the help they want. 


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What Is an Eating Behavior? 

When speaking about people, an consuming habits is how and what an individual tends to eat (or keep away from consuming) along with the ideas and emotions related to that approach of consuming. 

An consuming habits is one component of overall health behaviors. Eating behaviors, like different well being behaviors, end result from a complex process of selections, habits, mental state, social help, historic experiences with discrimination, entry to healthcare, trauma, tradition, financial entry, and a number of other others.

Some examples of consuming behaviors embody:

  • When an individual eats
  • How usually an individual eats
  • The interval between meals and snacks
  • What motivates an individual to eat sure issues
  • Eating roughly of sure meals
  • Combining meals or not
  • How an individual feels about sure meals or elements in meals
  • What an individual eats at completely different occasions of day and 12 months

These are influenced by concepts, data, custom, and emotions related to sure meals.

Before shifting ahead, you will need to acknowledge that the expertise of consuming for people is a posh one. For people, meals is about nourishment as a lot as it’s concerning the expertise of consuming. Other causes that people eat and why, apart from for nourishment, are for pleasure, time availability, useful resource availability, and concepts about what they need to eat and why. 

Healthy and Problematic Eating Behaviors: Spotting the Difference

What Are Healthy Eating Behaviors? 

A wholesome consuming habits is one which helps to fulfill physiological wants (vitamins, water, vitality) along with contributing positively to cultural, emotional, and social wellbeing. For instance, an individual with wholesome consuming behaviors can get pleasure from a chocolate chip cookie with a meal and really feel good or impartial about honoring a craving with none repercussions on their self-image or deliberate actions for the day.

Below are some examples of wholesome consuming behaviors: 

Healthy Eating Behaviors

  • Eating a wide range of meals
  • Eating if you find yourself hungry and stopping if you find yourself full
  • Knowing there are not any “good” or “bad” meals
  • Eating sufficient meals to really feel happy and meet the physique’s wants
  • Eating with out undue guilt, anxiousness, or different adverse emotions
  • Eating recurrently more often than not (having a unfastened sample of consuming all through the week)
  • Eating treats, consolation meals, or enjoyable meals sometimes with out negatively affecting their self-image or feelings

Disordered Eating or Eating Disorder? Definitions and Facts

As a society, we have a tendency to consider consuming behaviors as two experiences on fully reverse, remoted poles; one pole is wholesome consuming behaviors, and on the opposite is unhealthy consuming behaviors that embody consuming problems. 

This thought is flawed in a number of methods, of which we are going to point out just a few. First, it assumes that there’s an goal consuming sample that appears related for everybody. In different phrases, it assumes that there’s one “right” strategy to eat. Second, it doesn’t take into account the progressive nature of behaviors towards and away from consuming problems. Third, it doesn’t take into account that there are a number of diagnosable consuming problems along with disordered consuming behaviors that always fly below the radar. And lastly, it overlooks the overlap between seemingly wholesome meals decisions fueled by deeply unhealthy and unsustainable ideas. 

The Continuum of Disordered Eating

Today’s society is one wherein charges of power ailments rise yearly. Many of these power ailments may be prevented, partially, by way of life, together with weight-reduction plan. Widely out there details about how way of life contributes to well being and illness compounded by unrealistic societal requirements of magnificence and attractiveness has made approach for a rising concern of meals and fatness. 

How does this have an effect on consuming behaviors? According to Temimah Zucker, Licensed Master Social Worker, 

Societal requirements and pressures, in addition to preoccupations with weight reduction and train, might lead people to change/manipulate their meals consumption. For many individuals, this “works.” It doesn’t intervene with their lives; they’re able to discover meals they’re comfy with at any restaurant, and there’s no need to alter.

For others, this manner of consuming is usually a precursor to a full-fledged consuming dysfunction, and in lots of circumstances, it’s exhausting to tell apart when a person is battling disordered consuming versus when an consuming dysfunction is at play.

People can interact in disordered consuming behaviors to a lesser diploma or with much less frequency than is mostly thought of diagnosable as a full-fledged consuming dysfunction. This usually occurs as a result of many disordered consuming behaviors are normalized and even seen as wholesome. 

However, an individual might progress from having disordered consuming behaviors to growing an consuming dysfunction if problematic behaviors will not be recognized early on. 

As Dr. Russel-Mayhew states, “Diagnosable eating disorders are rare, but the behaviors that can lead to them are not.”

The BRIDGE Graph: Building the Relationship between Body Image and Disordered Eating

The graph beneath, based mostly on psychologist Dr. Shelly Russel-Mayhew’s BRIDGE Graph, is a useful gizmo for visualizing the consuming dysfunction continuum because it pertains to physique picture. Each circle brings collectively particular person data, attitudes, and behaviors. The circles overlap, as they aren’t remoted however relatively discovered on a continuum. 

The first circle is physique consciousness and acceptance. It represents when a person has an general acceptance of the physique and understands that look is just one component of who we’re and self-worth isn’t depending on look. 

The second circle is physique preoccupation, which is an over-concern for the physique, significantly round weight and form. An individual may be overly preoccupied with the inner functioning of the physique, feeling that particular person decisions might have a major influence on well being standing or illness danger. 

The third circle is physique paralysis, and that is related to a sense of immobilization or lack of ability to manage how we really feel or care for our our bodies. The particular person turns into fixated on controlling the physique, and it takes extra time and vitality than anything. Daily actions and high quality of life are deeply affected. 


The Relationship Between Body Image and Eating Disorders_V2


Eating Disorders

Eating problems are psychological situations that meet the standards for prognosis. There are 4 consuming dysfunction diagnoses discovered within the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): anorexia nervosa, bulimia nervosa, binge consuming dysfunction, and consuming dysfunction in any other case not specified. Additionally, orthorexia nervosa has been proposed as a fifth prognosis, however extra analysis have to be performed to refine the diagnostic standards. 


The diagnosable sorts of consuming problems are as follows

  • Anorexia nervosa: “An eating disorder in which food intake is so severely limited that a person does not meet minimum weight requirements for height and age. People with anorexia nervosa fear fat, and the perception of their own body size is so distorted that it is difficult for them to recognize the seriousness of their condition.”
  • Bulimia nervosa: “An eating disorder characterized by frequent binge eating episodes, followed by compensatory behaviors such as vomiting, over-exercising, or laxative and/or diuretic use. A person with bulimia is preoccupied with body shape and weight.”
  • Binge consuming dysfunction: Eating monumental quantities of meals in brief intervals of time with no compensatory behaviors. Binges are related to emotions of disgust, disgrace, and lack of management due partially to the frequency and depth of the episodes.
  • Other specified feeding and consuming problems: This is the commonest consuming dysfunction. “OSFED includes warning signs and related medical/psychological conditions that are similar to and sometimes just as severe as those of the other eating disorders.” Clinical examples of OSFED embody atypical anorexia nervosa, bulimia nervosa of low frequency and/or restricted period, binge consuming dysfunction of low frequency and/or restricted period, purging dysfunction, and night time consuming syndrome. 
  • Orthorexia: Not at present within the DSM-5 on account of an absence of consistency for diagnosing standards. A proposed definition of orthorexic behavior is “Persistent fixation on healthy nutrition and avoidance of food considered unhealthy in fear of developing an illness.” 

Disordered Eating

Disordered eating is “when a number of unhealthy behaviors related to eating and exercise coincide. Examples of this include the use of steroids to increase muscle mass, tobacco use for weight loss or control, and occasional binging, purging, or fasting behaviors.”

Disordered consuming behaviors could also be much like a number of the behaviors related to consuming problems however are much less frequent or of much less severity. 

Disordered consuming behaviors may be referred to as problematic consuming behaviors. Problematic eating behaviors are people who trigger bodily, psychological, emotional, non secular, or social misery. For instance, if an individual is consuming their mom’s conventional jerk rooster however feels responsible quickly after as a result of they suppose it’s unhealthy, then it isn’t a wholesome consuming habits. 

Examples of Disordered or Problematic Eating Behaviors

  • Recurring episodes of overeating
  • Recurring episodes of undereating
  • Modifying or needing to change consuming patterns in response to recurring misery relating to physique dimension 
  • Modifying or needing to change consuming patterns in response to recurring misery concerning the healthfulness of an ingredient, meals, or meal
  • Fixating on molding the physique right into a sure physique sort or aesthetic by way of meals, lack of meals, or train
  • Fixating on energy, meals substances, and vitamins
  • Depending on an exterior supply to let you know to wish to eat on account of a recurrent mistrust of your capability to make “the right” meals decisions

When somebody has a problematic consuming habits, their self-worth is intrinsically linked to what they eat, what they don’t eat, how a lot they eat, and the way usually they eat, amongst others. Not adhering to their beliefs results in misery and a poor notion of self-worth. 

Who Is at Risk of Developing Disordered Eating Behaviors?

Every intercourse, gender, race, ethnicity, age, and physique sort can develop an consuming dysfunction and may undertake disordered consuming behaviors. 

Certain teams of individuals could also be extra liable to growing disordered consuming behaviors on account of higher societal expectations associated to their look and physique sort. 

In the West and areas influenced by Western magnificence norms, those that could also be liable to growing disordered consuming behaviors embody: 

  • People in bigger our bodies
  • Men in skinny our bodies
  • Athletes
  • Models and influencers

That being mentioned, everyone seems to be below the affect of unrealistic magnificence norms and the normalization of disordered consuming behaviors. A survey carried out by the University of North Carolina Chapel Hill and SELF Magazine discovered that: 

  • 75 % of girls reported disordered consuming behaviors or signs in line with consuming problems.
  • 53 % of girls who weight-reduction plan are already at a wholesome weight and are nonetheless making an attempt to shed extra pounds.
  • 39 % of girls say considerations about what they eat or weigh intervene with their happiness.
  • 27 % can be “extremely upset” in the event that they gained simply 5 kilos.
  • 13 % smoke to shed extra pounds.

There is an absence of comparable knowledge for males, actually because consuming problems in males are underdiagnosed, under-treated, and misunderstood

What Does It Mean to Have a Good Relationship with Food?

When an individual has a very good relationship with meals, they perceive that meals is for nourishment and for enjoyment and create area to honor each. 

People with good relationships with meals: 

  • Eat sufficient meals in amount and selection to fulfill their physique’s nutrient wants.
  • Don’t have robust emotions towards meals, substances, or meals teams.
  • Eat once they’re hungry, and don’t try and stave off starvation cues with water or gum.
  • Do not do excessive diets.
  • Know when they’re full and customarily respect the purpose of fullness. At the identical time, they don’t really feel responsible when consuming previous the purpose of fullness. 
  • Eat mindfully; they get pleasure from what they’re consuming, admire the qualities of the meals and the socialization happening round meals. 
  • Accept their physique as it’s and really feel grateful for what it’s able to doing. 
  • Are in-tune with the physique’s cues after consuming sure meals.  
  • Exercise primarily for long-term well being.

How to Cultivate a Good Relationship with Food and a Positive Body Image

As a coach, you’ll be able to assist domesticate your shoppers’ constructive relationships with meals and their our bodies by together with quite a few elements into your applications that may assist to stop consuming dysfunction growth. As you’re employed by way of these, it is usually vital to concentrate on potential biases of your individual which may be inadvertently fueling disordered consuming. 

These include: 

  • Self-esteem: Appreciating physique variety and recognizing that outward look is just one component of who you might be as an individual. 
  • Critical considering expertise: Developing the flexibility to identify and critique promoting, advertising and marketing, and social media messages that reinforce unrealistic physique beliefs. 
  • Healthy consuming: Discussing nutrient density, meals group selection, vitality wants, and starvation cues. 
  • Valuing significant meals: Talking about cultural meals, consolation meals, and celebratory meals. 
  • Physical exercise: Learning about really helpful ranges of bodily exercise whereas additionally understanding the hazards of compulsive train. 
  • Respect: Respecting different folks’s our bodies and bodily skills. Discussing that our bodies may be wholesome at any dimension, form, and weight. Recognizing that feedback about different folks’s our bodies, even when they’re meant to be a praise, can set off adverse emotions and behaviors. 
  • Emotional well being: Identifying emotions and studying coping and communication expertise. Identifying how emotions are linked to consuming behaviors and decoupling physique look with adverse emotions. Acknowledging and accepting that makes an attempt to alter the physique won’t resolve the adverse feeling. 
  • Developmental modifications and puberty: Understanding how developmental phases, physique sorts, genetics, surroundings, and trauma can have an effect on physique growth. For younger folks, this implies getting ready them for physique modifications, and for folks, it means encouraging constructive physique picture and never shaming kids for modifications of their physique. 
  • Problem-solving and decision-making expertise: Identifying methods to counteract adverse or contradictory messaging round physique dimension and meals. These could also be promoted by relations, buddies, tradition, and society typically. 

Main Takeaways

Anyone can develop an consuming dysfunction. Disordered consuming behaviors are extraordinarily widespread; as many as three in 4 folks exhibit them. They usually will not be thought of problematic or disordered as a result of they’re normalized and even thought of wholesome. Health coaches, with out realizing it, could also be selling the adoption of problematic consuming behaviors and poor vanity. Examining your individual biases and being ready to restructure your applications and messaging may help to construct an area the place your shoppers domesticate a wholesome relationship with meals and their our bodies. 

As a well being, diet, or health coach, you will need to concentrate on the indicators of disordered consuming, have sources for individuals who might profit from help, and be ready to make referrals when mandatory. 


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