Nutrition Articles

Recognizing Eating Disorders and Getting Help

It's Not Just about Food and Weight

Full-fledged eating disorders are abnormal, disordered patterns of eating that become out-of-control. All types of eating disorders represent serious and immediate threats to the health, well-being, and happiness of the individuals caught up in them.

For practical purposes, it’s less important to know the clinical criteria that doctors use to diagnose these disorders than it is to simply recognize the typical behaviors and thoughts that people tend to exhibit. Many people start slipping into these patterns well before they meet the formal requirements for diagnosis. Likewise, a basic understanding of how people use these “disordered” behaviors and thought patterns to solve the problems they are experiencing in daily life can point the way to finding better solutions. This will help individuals and their loved ones figure out if professional help is needed.

Common Signs & Behaviors
The following behaviors can be signs of an active eating disorder:
  • Refusal to maintain a minimum, healthy weight and adequate nutrition. This is usually due to intense fear of gaining weight, not losing weight, or becoming fat.
  • A distorted body image. You see yourself as fat even when you are underweight or at normal, healthy weight. Your weight, shape and appearance are primary factors for determining your self-worth and self-image.
  • Severely restricting food intake. This may also include a rigid unwillingness to eat certain types of food due to their caloric contents, such as sweets and fats.
  • Eating large quantities of food twice per week (or more). "Large quantities" are obviously more food than most people would eat under similar circumstances. These binges usually occur within a short time (two hours or less) and are accompanied by out-of-control feelings and an inability to stop oneself.
  • Purging behaviors. This includes self-induced vomiting, taking laxatives, enemas, or diuretics, and/or exercising excessively. The purpose of "purging" is to eliminate calories eaten, to get “bad” foods out of the body, to prevent weight gain, and/or to reduce strong feelings of guilt, anxiety or shame.
  • Overeating frequently. This may involve several of the following factors: eating much faster than normal; eating until you are uncomfortably full; eating large amounts when you know you aren’t really hungry; eating alone out of embarrassment or hiding your eating from others; and feeling depressed, guilty, or disgusted with yourself because of your eating.
As you can see, the differences between dieting and anorexia nervosa, and between overeating and binge eating disorder, can get pretty hazy. What starts out as “normal” can easily cross the line and become disordered, especially when you are focused primarily on weight and calories, instead of healthy eating and exercising. Recognizing problems as early as possible is one key to getting them under control.

Underneath the Surface
Many people with clinical eating disorders have certain genetic or biochemical susceptibilities to strong emotions, or histories of emotional, physical, or sexual abuse that further amplify the intensity of feelings and short-circuit the development of normal emotional-management skills. There is also strong evidence that disordered eating can be “passed down” from generation to generation within families.

Although biology and genes play significant roles in eating disorders, it's a mistake to think that people develop eating disorders because there is something wrong with them. People turn to these behaviors because, to them, they solve an important problem or accomplish some necessary purpose. And even when the “solution” starts causing serious problems of its own, people may consciously or unconsciously stick to their disordered eating patterns until they can come up with some alternative way of meeting the original need.

It’s a lot easier to find a way to meet that need when you have some idea of what that original purpose or problem might be. So, let’s take a brief look at some of the most common problems and needs that, according to people who have successfully struggled with their own eating disorders, got them headed down the road to trouble in the first place:
  • “There’s nothing special or interesting about me. I thought that if I could make myself the thinnest person in my school, people would notice me.”
  • “My boyfriend dumped me for a skinnier girl. I hated my fat body and was determined not to let it ruin my life.”
  • “I was so puny that I was embarrassed to take a shower at school. I spent hours at the gym every day trying to put on some muscle.”
  • “The idea of dating and sexuality was too much for me to handle. Who needed all that worry about whether I’d get asked out at all or get dumped? I got fat so people would find me unattractive and undesirable, and leave me alone.”
  • “Nothing I did was ever good enough for anyone. I knew I could be very good at controlling what I ate, and exercising like a fiend, and that made me feel good.”
  • “If I didn’t have my food problems to worry and feel bad about, I don’t think I would feel anything at all. I’m empty inside.”
  • “I knew I didn’t have what it took to succeed at anything. As long as I was fat, I figured people wouldn’t expect much from me. I didn’t have to expect much from myself either, or try for anything that made me nervous. My fat was my shield.”
  • “I just couldn’t handle my feelings. When I felt bad, eating was the only thing that made the feelings go away. After I ate, I felt even worse—until I discovered that purging made the guilt and anxiety go away, and let me get back to business as usual again.”
  • “I was angry all the time, and I felt bad about that. I ate whatever I wanted, whenever I wanted it, because I deserved it. And if that made me fat and miserable, that was fine, because I deserved that, too.”

The common theme in all these statements (and many others) is that disordered eating almost always starts out as an effort to manage feelings, thoughts, and worries that aren’t really about food and eating. Most often, they are about basic human needs like fitting in, being valued and wanted for who you are, having control over your own life, and having the power to influence how other people see and treat you.

When these problems grow larger and persistent enough to pave the way for the development of disordered eating (or a full-blown eating disorder), it is because other factors have also conspired to make this the “path of least resistance.” It is not because the individual is stupid, defective, or incompetent.

Getting Help When You Need It
The good news is that recovering from an eating disorder is possible. You can find much better ways to deal with your original concerns or needs; you can learn the skills you need to manage difficult feelings and “thought storms” without turning to overeating or not eating. There are also effective treatments (like good nutrition and medication) for many of the biochemical problems involved.

It’s not impossible to do all or most of this on your own. There’s plenty of good information and support available from books and websites, and there are good self-help programs available.

But doing it on your own is not the easiest or fastest way, and often it's not enough. You can’t hang a picture straight on a wall when you’re right up against the wall yourself. You need someone with a different perspective to tell you when one side is higher or lower than it should to be. That’s not a reflection on you—it’s just a fact of life. The same can be true when it comes to seeing your own behaviors and attitudes clearly enough to start changing them.

These days, there are many counselors, dietitians and doctors who know a lot about disordered eating. These helpful professionals won’t pass judgment on you, but they can help you sort things out so that your decisions will help you get what you really want for yourself. If you find yourself having a hard time changing your behavior (or wanting to change), even though it is causing you problems, ask for some help.

The following online resource will help you find help in your area:

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Member Comments

  • I think people with eating disorders should seek some qualified help.Self help is wonderful in many instances but not in the case of eating disorders.
  • Great article. Sadly, those with eating disorders seem to suffer alone. Guilt & shame overtake them. We had friends and a family member with eating problems. It's hard to deal with them. 8 they don't want help or deny they have a problem, your hands are tied..
  • Thank you! I wish I had seen this earlier. I guess this was posted a while ago. I probably was not ready to see it when it first came out.

    I was afraid to be found out as a fraud. If people found out I wasn't as together as they believed I thought bad things would happen. I was afraid to ask for help or admit when I did not know something. Thank god I have learned.

    Change is hard, but abusing my body was worse. I needed my behaviors to get truly out of control before I could see the harm I was doing to myself. Only then was I ready to examine what led me there.

    I think this article was eye opening. I, personally don't have an eating disorder, but I work with people who do. Being supportive and having empathy for them is the type of article I was hoping this would be.would love any feedback from those struggling on how to be supportive.
  • I believe my excess weight is genetic. My Mother was obese and I never saw her overeat.
  • Having an ED on this website definitely makes it tough to recover - large parts of of this online community are centered around ideas of control and calorie counting, which are definitely triggers for me! It's tough to want to be a healthy person, who thinks about and eats healthily while having a demon in your mind all of the time (which is what it feels like). More articles about EDs, please!
  • I wanted to comment on this article because I have been through so many ED's over the years. i used to binge and purge and I have fought and failed with emotional over eating and being over weight my whole entire life. I was sexually abused when I was younger and raped as an adult. I have sought out help over the years from professionals. I am fully aware of my ED issues and have been looking for help from someone for the physiological portion of these problems. I have talked to the doctor and have talked to my fair share of nutritionists who all say the same thing that I just need will power. It urks me that the author here thinks it is so easy for someone like myself to find help with ED. I have been to several therapists trying to get a handle of how to control my ED's and so far they have not helped and do not even understand anything about ED's. I went to OA which for me personally was a total crock. It was neither helpful and the people did not really listen. i have looked for other support groups that are not based on the "12 step" programs and have not had any luck. Maybe it is because of where I live at the moment in Northwest WA 2 hours North of Seattle. Anyway, I had to put my 2 cents in because I have been trying to get help and had no luck. I am trying to face my issues and learning what makes my ED's worse. Unfortunately my husband is a BIG trigger which explains why I packed back on the weight after we got together. I ended up having to get out of the Navy because I had put on so much weight after we got together. Anyway, that is a whole other story.
  • This is the first time I've ever had a problem with a Spark People Article. The author may be a behavioral expert, but he is not a clinical psychologist. Asserting that people with eating disorders can do most or all of the recovery on their own is seriously irresponsible. Do you really want the liability of someone with AN or BN NOT seeking medical treatment because you've stated they can heal without help? I love Spark People but I'm seriously disappointed by this one.
    AS someone that was diagnosed with BED, Non-purging Bulimia, and Exercise Anorexia & Bulimia (both as I used both types depending on the situation) I can attest for what the damages are. I was a member a long time ago from SP and to make a point to another comment, SP and using it with a focus on numbers is what makes my EDs the worst they had ever been. It got so bad that I was having issues with organ damage and would vomit just walking to my mailbox because of being so overly exhausted and malnourished.

    I will say that apparently SP has started to recognize the obsessive behaviors of the many members over the years that cross the line(s). Instead of seeing articles that focus on "pushing past the fears and the scale that doesn't budge" I am seeing articles that address questionable and risky behaviors. KUDOS to SP as it was most definitely needed. I have to say that SP giving many, many new options for a plan including not having a weight loss goal, having non-scale related trackers and tickers, articles, and support is fabulous! I am hoping that I can now use SP in a responsible fashion to help me work towards my goals in a non-scale related way and push past the fears and negative self-dialogue that helped to facilitate my EDs.

    I have new goals now and want to take things super slow without a focus on the scale or tape measures. It's one of the first steps in getting to where I want to be without triggering (I hope) obsessive and unhealthy behaviors.
    What I would have liked to read in this article is how being a Sparkpeople member affects these disorders. Is it wise or unwise to be at SP if one has anorexia, bulimia or BED? Can visiting a site like this hamper healing, or help accelerate it?
  • Great article. Thank you
  • I am an unusual case in that I believe I am underdosed in my medication as a newly-diagnosed Type 2 diabetic. I believe I have possibly a cross between "carborexia" and a kind of wasting disease brought on (and possibly encouraged) by my treatment. Having lost over 40 pounds in rapid order while on Spark, and even starting at maintenance levels.

    I now have Broadcast Basic Cable TV (i.e., minimal TV reception in my neck of the woods) and feel heavy enough only watching Kelly Ripa on the Kelly and Michael show.

    My exercise levels are far from compulsive, and my mind still functions well. And I'd never, ever wanted to be skinny. I believe in Health at Every Size and I will believe it to my death.
  • i'm hesitant to claim i actually have a binging disorder, but this (and other things) are definitely making me more aware of the possibility. i was able to overcome it with relative ease, so i don't know how serious of a disorder it could be, but it's definitely unnatural when i binge - it's not just 'omg i love food', its 'there is a hole and only food will fill it; i'm stuffed and physically ill but still eating because there's still something wrong'. and it would last days or weeks. im becoming much more aware of my emotions and their hold over my eating. the possibility of having an actual eating disorder - or at least identifying strongly with some of the symptoms - is really an eye-opener in terms of how dangerous that kind of behavior really is.
  • Thank you for this article! I am in my 40's and while I have realized for quite some time that I use food to cope, I am just beginning to truly acknowledge the psychological issues at the root. I am also just beginning to open my eyes to the help available for someone like me. From the outside, people say I am strong, reserved, fearless, etc. Sounds great, right? They have no idea how weak, scared, and depressed I feel - - I walk around wearing a mask to hide my problems because I don't want people to notice. This article and others like it give me the validation that I am not alone and that there is help. Thanks again.
    Thank you for this article, from the bottom of my heart. As a teenager, I’d always felt there was so much wrong with me, and I turned to disordered eating as a coping mechanism that has followed me into my fifties. To read that “people turn to these behaviors because, to them, they solve an important problem or accomplish some necessary purpose,” and that “it is not because the individual is stupid, defective, or incompetent,” was such a relief! I may have already known this intellectually, but the compassion woven into this article had me “get it” on another level entirely. Bless you for writing it!

About The Author

Dean Anderson Dean Anderson
Dean Anderson has master's degrees in human services (behavioral psychology/stress management) and liberal studies. His interest in healthy living began at the age of 50 when he confronted his own morbid obesity and health issues. He joined SparkPeople and lost 150 pounds and regained his health. Dean has earned a personal training certification from ACE and received training as a lifestyle and weight management consultant. See all of Dean's articles.