The saying, “We are what we eat,” seems to be an incomplete statement. Food is essential and the building blocks of the body and mind, although what, when, where, the amount, and how one feels about the food eaten have a powerful impact on health. An individual’s relationship with food and their body determines if they are building good health or contributing to disease.
A healthy eating pattern, adequate physical activity, quality sleep, and positive social connections are essential for optimizing health. It is a well-known fact that unhealthy eating patterns contribute to physical and mental disease, especially when food becomes something to fear or an unhealthy source of comfort.
Eating becomes harmful when there is an unhealthy focus on food, calories and body shape in pursuit of health, social status, or a relationship connection. This mindset stems from believing a certain look or lifestyle is necessary to win others over or create personal success. Any eating pattern that causes negative emotions disrupts the quality of life, or results in poor health outcomes warrants seeking professional help since these behaviors put one at a higher risk of developing a life-threatening eating disorder (ED). The Academy of Nutrition and Dietetics (ANAD) describes disordered eating as a range of irregular eating behaviors that may or may not warrant a diagnosis of a specific eating disorder. The main difference between disordered eating and a diagnosis of an ED is based on the person’s symptoms and habits that meet the criteria defined by the American Psychiatric Association.
According to ANAD, symptoms of disordered eating include:
- Frequent dieting or skipping meals
- Chronic noticeable weight fluctuations
- Anxiety associated with body image, eating, specific foods, or eating around others
- Judging foods and behavior as “good” or “bad”
- Ridged rules and routines surrounding food and exercise
- Compensating for “being bad” by skipping meals, taking laxatives, purging, or excessive exercise
- Preoccupation with food, calories, weight, and body shape that negatively impacts quality of life
- Feeling a loss of control with certain foods
- Binging: eating large amounts of food in a short time frame, especially in secret
- Using supplements or medications for weight loss or body enhancement
Individuals who have signs of disordered eating are at significant risk of developing an ED, as well as obesity, gastrointestinal disturbances, electrolyte imbalances, bone loss, abnormal blood pressure, increased anxiety, depression, and dysfunctional social connections. It’s important to seek professional help if exhibiting any disordered eating behaviors since they can contribute to serious health problems, and lead to an ED diagnosis; a very serious mental illness that can be fatal.
Common Eating Disorders, Signs and Associated Health Risks:
| Diagnosis | Signs | Health Risks |
| Anorexia nervosa 2 types: Restrictive or Binge and Purge | Restrictive eating of very small quantities of select foodsRelentless pursuit of extreme thinness; BMI below 18.5Weighs repeatedly and avoids anything that increases weight, even water Extreme fear of gaining weight or fatBinge and Purge type: episodes of binge-eating followed by immediate purging or laxative use as compensation | High fatality risk compared with other mental disorders due to medical complications associated with starvation Physical symptoms include: Menstruation ceasesDizziness or fainting from dehydrationBrittle hair/nailsCold intoleranceMuscle weakness or wastingConstipationBone loss and stress fracturesHeart arrhythmias, especially those who vomit or use laxativesPoor concentrationIrritability, anxiety, depressionHigh risk of suicide |
| Bulimia Nervosa | Alternate between dieting or eating very low-calorie “safe foods” and binging on “forbidden” high-calorie foods Binging on large amounts of food in a short time period at least weeklyFeeling a loss of control over food Eating beyond fullness causing nausea or extreme discomfortUse of compensatory measures to prevent weight gain; fasting, vomiting, laxative use, excessive exerciseTrips to the bathroom right after mealsPreoccupied with thoughts of weight, food, body shape and body comparisonWeight can be in healthy or above healthy range | Electrolyte imbalances which could lead to cardiac arrhythmias Life-threatening symptoms of Esophageal tears or gastric rupture, due to vomiting Physical symptoms include: Chronic sore throatTooth decay from stomach acidCuts and calluses on knuckles from inducing vomitingHeartburn or reflux due to vomitingDizziness or fainting due to dehydration from purging behaviorsSwelling of salivary gland in cheeks. Large amounts of food disappearing |
| Binge Eating Disorder | Consumes large quantities of food in short periodEats fast with little chewingExperiences loss of control when eatingNo compensatory behaviors to prevent weight gainBinges at least once a weekWeight gainEats secretly because of embarrassmentFeelings of disgust with oneself; extreme guilt | High risk of developing the following: ObesityDiabetesHypertensionCardiovascular diseaseAnxiety and depression |
| Specified Feeding and Eating Disorder | Eating behavior causes personal, social or relational distressBehavior may be similar to other eating disorders, but signs and symptoms do not meet the diagnostic thresholdMay be preoccupied with weight, shape, fear of fatness and weight gain, but not underweight | Health risks may be similar to other ED diagnoses but do not meet frequency or exhibit all behaviors for diagnosis; i.e., “atypical anorexia nervosa” May weight cycle and lose weight quicklyMedical complications can occur based on significant weight loss similar to other diagnoses |
Reference: American Psychiatric Association: https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders
Treatment:
Treatment requires a team of support to address psychological, behavioral, social, nutritional, and other medical complications. The initial primary focus is to correct all nutritional abnormalities, deficiencies, malnutrition, and any heart and gastrointestinal problems, as well as other potentially fatal conditions. The next step is to counter food anxiety, normalizing eating patterns, provide emotional and psychological support to develop a healthy relationship with food and self. Individuals with eating disorders who work with a coordinated medical team can return to healthy eating habits, a positive body image and recover their emotional and psychological health.
Many people are unaware their eating patterns are abnormal or harmful. Working with a Registered Dietitian can help bring insight into creating a healthy eating pattern and relationship with food. The National Eating Disorder Association website (https://www.nationaleatingdisorders.org/) offers an assessment to determine whether to seek professional help and treatment for disordered eating or an eating disorder. The first step in healing is asking for help.
Sandie Lynch, Brook Lane’s staff Dietitian, has been a Registered and Licensed Dietitian for over 34 years. She is a National Board-Certified Lifestyle Medicine Professional by the American College of Lifestyle Medicine. A health and fitness enthusiast, Sandie holds certifications as a Personal Trainer, Fitness Instructor and Wellness and Life Coach. She is the owner of ATP Wellbeing Consultants, providing health, nutrition and fitness services since 2010.
