The Disordered Eating Spectrum

I’m going to go out on a limb and guess that you’ve heard of Anorexia Nervosa, Bulimia Nervosa, or Binge Eating Disorder. You likely even know someone who has struggled with one of these conditions as around 28.8 million Americans will suffer from an eating disorder in their lifetime (1).

To be diagnosed with an eating disorder one would need to be assessed by a mental health professional, someone such as a psychiatrist, psychologist, or your primary care practitioner (PCP). Your insurance company will use this diagnosis if you seek treatment to determine how much they will cover of said treatment.

What most people, insurance companies, and even many health professionals don’t realize is that each of these eating disorders are not separate from the other. Eating disorders (and disordered eating – unhealthy eating behaviors that may not meet the diagnostic criteria of a full-blow eating disorder) occur on a spectrum rather than their own individual bubbles.

Disordered eating occurs on a spectrum.

On one end of the spectrum you’ll find restrictive and dieting eating habits. This might look like cutting your calories or using a calorie counting app, going on a weight loss diet, replacing a meal with a low-calorie meal replacement shake, cutting out particular foods from your diet, and generally having a mindset of “good” and “bad” (healthy/unhealthy, clean/unclean, etc.) foods.

On the other end of the spectrum you’ll find binge eating and compensatory behaviors. Compensatory behaviors are associated with Bulimia Nervosa. Your mind may initially think of purging/intentional vomiting, but there are many other behaviors that fall into this category. These can include but are not limited to over-exercising and abusing laxatives. Often compensatory behaviors will follow a food binge.

Individuals who find themselves on the restrictive/dieting end of the spectrum are being driven to the bingeing/compensatory behavior end of the spectrum physiologically.

Some signs that your body is physically trying to persuade you to binge are food preoccupation (frequent thoughts about food), dreaming about eating, and subjective bingeing.

An objective binge is when someone eats an “unusually large amount of food in one sitting.” Food binges are characterized by feelings of being out of control, guilt, and shame. A subjective binge is when someone eats a food on their “bad” food list and feels out of control, guilty, and shameful. The psychological feeling is similar between an objective and subjective binge. An individual may feel very shocked at their behavior and appalled that they ate a forbidden food, but this is simply their body’s survival mechanism when food is scarce.

After an individual binges (either objectively or subjectively), they are pressured by their own beliefs about food/health/weight, and possibly the beliefs of others and society, to “get back on the bandwagon” with their diet. And thus the vicious cycle of disordered eating continues.

You might say, “Well, I’ve been restricting for x amount of time and I haven’t binged. This will never happen to me.” And I could tell you that I've heard that many, many times before. What I can also tell you is that this is the body’s natural response to restriction - to seek out more food.

There is no calculation or specified timeline as to when a binge will occur. Some individuals restrict their intake and end up bingeing a month later. Some individuals restrict their intake for years before experiencing a binge. I can also tell you that most individuals who binge, did not expect it to happen. It was scary and felt out of control. To prevent binge eating, one must stop the restricting/dieting behaviors.

The only way out of this vicious cycle: eliminate the restrictive/dieting behavior.

And thus, that is the only way out of this vicious cycle: to eliminate the restrictive/dieting behavior. Luckily, you don't have to do the work alone. For information on getting help with disordered eating, please contact me via the contact form on my homepage or visit the National Eating Disorders Association website.

1. The Social and Economic Cost of Eating Disorders in the United States of America by the Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED) and the Academy for Eating Disorders.

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