What are eating disorders and disordered eating?

The Diagnostic and Statistical Manual of Mental Disorders recognises four eating disorders:

• Anorexia Nervosa
• Bulimia Nervosa
• Binge Eating Disorder
• Other Specified Feeding and Eating Disorder (OSFED)

Disordered eating, on the other hand, is characterised by a variety of abnormal but ‘subclinical’ eating behaviours that do not meet the criteria for the formal diagnosis of an eating disorder. This does not mean that it cannot be harmful. Disordered eating includes symptoms and patterns of behaviour common to eating disorders, such as chronic restrained eating, compulsive eating and binge eating with associated loss of control.

Symptoms differ between each eating disorder. Some common symptoms include:

• preoccupation with, or over-evaluation of, weight and size

• preoccupation with, or elimination of, food
• excessive body checking
• binge eating
• food rituals (playing with food, rearranging on plate)
• excessive fear of weight gain
• excessive exercise
• dieting
• purging through vomiting or laxative abuse
• avoidance of social situations involving food
• eating in isolation due to disgust or embarrassment

Research has also linked eating disorders with high rates of depression, anxiety and low self-esteem. People with eating disorders also tend to have elevated rates of personality disorders and substance use. These behaviours and attributes can significantly interfere with a person’s ability to manage day-to-day life.

Eating disorders can have also profound physical impacts. Weight loss and malnutrition caused by Anorexia Nervosa can cause low blood pressure, osteoporosis, muscle wasting, growth retardation and hypothermia. Binge eating and purging disorders such as Bulimia Nervosa can cause esophagitis, enamel erosion, arrhythmias and diarrhea. Eating disorders can also affect cognition, causing deficits in memory, executive functioning, verbal and visuospatial processing.

Eating disorders may be influenced by a number of environmental, genetic, biochemical and personality factors. A history of trauma or abuse, troubled family and personal relationships, feeding difficulties in childhood and bullying based on physical appearance are all risk factors.

Social factors including cultural pressures to achieve certain types of bodies can also be damaging. Media depictions of unrealistic bodies help glorify thinness and reinforce narrow definitions of beauty. These cultural pressures are felt by many people. For some, the pursuit of such idealised bodies plays a role in the development and maintenance of eating disorders. Media which offers ‘thinspiration’ or ‘fitspiration’ can also inadvertently contribute to disordered eating or unhealthy body image.

It is estimated that around one in four people with an eating disorder are male, but the true proportion may be higher. Eating disorders tend to be underdiagnosed in males, perhaps due to stigma, lack of awareness or a reluctance to admit to or address the issue. Excessive exercise, steroid abuse and fixation on muscularity are particularly common among males.

Seed Psychology offers psychological treatment for persons with an eating disorder, or for friends and family who are supporting a loved one with an eating disorder. These sessions aim to identify the psychological aspects that have contributed to the onset and maintenance of an eating disorder.

Through psychotherapeutic techniques, including cognitive restructuring, personal development exercises and relaxation techniques, we will work to reduce feelings of inadequacy, negative body image, shame and guilt and help you to regain your health, wellbeing and quality of life.