Disordered Eating

Disordered eating is a classification (within DSM-IV-TR, used in the health-care field) to describe a wide range of irregular eating behaviors that do not warrant a diagnosis of a specific eating disorder such as anorexia nervosa or bulimia nervosa. Affected people may be diagnosed with an eating disorder not otherwise specified. A change in eating patterns can also be caused by other mental disorders (e.g. clinical depression), or by factors that are generally considered to be unrelated to mental disorders (e.g. extreme homesickness).

Some people consider disordered-eating patterns that are not the result of a specific eating disorder to be less serious than symptoms of disorders such as anorexia nervosa. Others note that individual cases may involve serious problems with food and body image. Additionally, certain types of disordered eating can include symptoms from both classic cases of anorexia and bulimia, making disordered eating just as dangerous.

Some counselors specialize in disordered-eating patterns. The recognition that some people have eating problems that do not fit into the scope of specific eating disorders makes it possible for a larger proportion of people who have eating problems to receive help.

Disordered eating affects the lives of up to 5 million adults and their families in the United States (Hewitt et al., 2001). Problematic eating behaviour may emerge during childhood or adolescence and persist into mid and late-adulthood, or first emerge during mid-life. (Berry & Marcus, 2000; Chavez & Insel, 2007; Fairburn et al., 2003; Streigel-Moore & Bulik, 2007). Disordered eating behaviors are associated with a number of harmful behavioral, physical, and psychological consequences, including poorer dietary quality, weight gain and obesity onset, depressive symptoms, and the onset of eating disorders. Thus, it is important to identify strategies for the prevention of disordered eating behaviors.

The prevalence of disordered eating and eating disorders has steadily risen over the past 50 years (Steiner & Lock, 1998). Researchers have found evidence that disordered eating patterns, such as excessive dieting, fasting, and binging, can lead to serious eating disorders, such as Anorexia Nervosa and Bulimia Nervosa (Neumark-Sztainer et al., 2006). In order to be diagnosed with an eating disorder, as opposed to disordered eating, individuals must meet a list of specific criteria, as laid out in DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders 4th Edition). Those who do not meet all of the criteria for either Anorexia Nervosa or Bulimia Nervosa are considered ‘‘eating disorder not otherwise specified’’ (American Psychological Association, 1994). This category is also referred to as partial syndrome, subfrequency, atypical, or subthreshold disorders. When individuals do not meet the criteria for EDNOS but still manifest partial symptoms, disordered eating behavior is the appropriate category. In response to the high prevalence rates of EDNOS, many researchers have proposed the idea that dieting and eating disorders may represent different points along a continuum of eating pathology referred to as the Continuum Theory (Cohen & Petrie, 2005; Tylka & Subich, 1999).

Disturbed eating attitudes describe a person’s belief that cultural standards for attractiveness, body image, and social acceptance are closely tied to one’s ability to control diet and weight gain. Weight concerns (such as fear of weight gain, worry over weight and body shape, diet history, and perceived fatness) and body image, in particular, appear to be significantly related to the onset of eating problems and eating disorders during adolescence. (Tyrka et al., 2003). This constellation of physical and psychological factors, linked to early eating problems and distorted beliefs, signifies a considerable risk pattern for the development of persistent and possibly severe eating problems. (Jacobi et al., 2004; Striegel-Moore & Bulik, 2007).The desire to appear thin may be responsible for the near epidemic rates of referral of young people with eating disorders, especially bulimia, since the mid-1970s throughout Western society.

The results of research findings have suggested that there is a distinct relationship between body dissatisfaction and the onset and maintenance of eating pathology. It is concluded that there is evidence that perceived pressure to be thin, internalization of the thin sociocultural ideal and elevated body mass, increase risk for body dissatisfaction and that this, mediated by increases in dieting, increases risk of eating pathology. (Stice & Shaw, 2002).

Online sources of information and referral include the following list of web sites: Academy for Eating Disorders: www.aedweb.org National Eating Disorders Association: www.nationaleatingdisorders.org American Dietetic Association: www.eatright.org National Institute of Mental Health: www.nimh.nih.gov/publicat/eatingdisorders.cfm Society for Adolescent Medicine: www.adolescenthealth.org