Dealing with Adult Eating Disorders

By:    Medically Reviewed: Tom Iarocci, MD   Published: August 13, 2014

Learning “intuitive eating” may help millions of U.S. women and men overcome disordered eating and orthorexia, or “healthy eating” taken to extremes.

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Clinical eating disorders like anorexia and bulimia are serious mental illnesses that can also have very serious risks to physical health.

In fact, anorexia may be the most fatal mental disorder, period. But there is a lot of gray area when it comes to what’s commonly called “disordered eating” (as opposed to clinical, more acute eating disorders).

“You’ll see some of the same signs and symptoms, but, generally, people who are dealing with disordered eating and body image issues are still able to function and still have some control over their behaviors,” says clinical psychologist Stacey Rosenfeld, PhD, author of “Does Every Woman have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight” (June 2014).  

“In people with true eating disorders, the disease controls them,” says Rosenfeld. On the other hand, the term “orthorexia nervosa” was coined as a label for people whose fixation on healthy eating has turned into an unhealthy obsession. Many who suffer with it refuse foods that contain added salt or artificial colors, preservatives, fat or any sugar.

 

Body Image and Disordered Eating  

According to the National Eating Disorders Association, about 20 million women in the U.S. (and roughly 10 million men) suffer from a clinically significant eating disorder at some point in their lives. But that number is miniscule in comparison to how many people cope with less serious, but still harmful, issues with disordered eating and body image.

“The majority of adult women have some sort of unhealthy relationship with food or their bodies, which I believe interferes with their quality of life,” says Rosenfeld.

And the fact that it is so common that it seems normal, may be one of the reasons that few people seek treatment — or even think that they have a problem with their relationship to food or their bodies.

Disordered eating often looks similar to some supposedly healthy behaviors, like trying to lose weight, cutting out certain food groups or doing juice cleanses. “When someone becomes obsessive about their diet plan or extremely rigid in what they can and cannot eat, that may be a warning sign,” says Rosenfeld.

Some of the signs and symptoms of disordered eating include pathological dieting, weighing yourself more than once a day, obsessively checking your body in the mirror, fasting, and using extra-long workouts to compensate for eating too much.

These exact behaviors — when taken to even greater extremes — can cross over into clinical eating disorder territory.

In addition to the mental strain of constantly worrying about food and your body, this type of behavior has the potential to make you unhealthy. You might not be getting enough calories, nutrients, or vitamins, which may cause things ranging from fatigue to hair loss and fertility problems.

 

How “Intuitive Eating” Helps

When your attitudes about eating are disordered, food is on your brain a lot. Maybe even all the time. “But it’s not supposed to be,” says Rosenfeld. “It’s supposed to be as simple as thinking about food when you’re hungry, eating till you’re full, then stopping.”

That is the premise behind intuitive eating. The goal is to return your focus to the biology of hunger instead of eating out of emotion.

Many adult women, particularly those who suffer from disordered eating, have long since tuned out their body’s own hunger cues. But intuitive eating is what babies and very young children naturally do. It can be a scary notion for those accustomed to setting rigid rules around food, but that’s how our bodies are supposed to function.

Critics might argue that intuitive eating could lead to obesity or wait loss failure in some individuals. But if your doctor says you are not overweight, you’re not overweight. The point here is a healthy approach to food from the get-go. “Listen to your body and feed it a variety of nourishing, satisfying foods,” suggests Rosenfeld. “Stop trying to lose weight, eat when you’re actually physically hungry, and stop when you feel full.”

Next Steps

  • Raising children to have healthy attitudes toward food and their bodies can be challenging, especially for those dealing with disordered eating and body image issues themselves. Forty to sixty percent of elementary school girls are already concerned about weight and body shape.
  • As a parent, teacher or caregiver you can help encourage a healthier approach, starting with modeling good behavior instead of letting your child see you obsess over your food and how you look.
  • Family caregivers should be conscious, when talking about food, to do so in terms of how it nourishes the body, not focusing inappropriately on calories or on labeling foods as being either “good” or “bad.” Help your loved one adhere to any clinical nutritional needs, and your end game should be about good health, not a particular body shape.

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sources
  • Rosenfeld, S., PhD, clinical psychologist and author of “Does Every Woman have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight (Siena Moon Books, June 2014). http://www.staceyrosenfeld.com.  Interviewed May 2014.
  • Arcelus J, Mitchell AJ, Wales J, Nielsen S. “Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.” Archives of general psychiatry. Jul 2011;68(7):724-731. Accessed May 2014.
  • National Eating Disorders Association, “Get the Facts on Eating Disorders.” http://www.nationaleatingdisorders.org/get-facts-eating-disorders.
  • Accessed May 2014.
  • National Eating Disorders Association, “Orthorexia Nervosa” 2013. http://www.nationaleatingdisorders.org/orthorexia-nervosa. Accessed May 2014.
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