Disordered eating vs. eating disorder: What is the difference?

Although these two terms are often used interchangeably, they are not the same. Just as someone can experience a low mood without a diagnosis of major depressive disorder, someone can have disordered eating without a diagnosed eating disorder. So, what is the difference?

Eating disorders

There are 5 main types of eating disorder that are classified in the DSM-5-TR, the most common of which are Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Generally, individuals who meet the criteria for an eating disorder have obsessive thoughts about food, shape and weight, a hyper focus on calories, changes in weight, and a resulting impairment in functioning in all or some aspects of their life. In order to be diagnosed with an eating disorder you must meet the strict criteria outlined in the DSM-5-TR, which takes into account the frequency, duration, specific behaviours, severity, and in the case of Anorexia Nervosa, weight. Eating disorders should always be taken seriously. They can impact every organ in the body and have the highest fatality rate of all mental illnesses. 

Example

Beth is deliberately restricting her calorie intake to just a few hundred calories per day, is extremely fearful of gaining weight and becoming fat, has lost a considerable amount of weight with a BMI of 17, exercises intensely for over an hour most days of the week, does not see the seriousness of her current eating patterns, has withdrawn from friends, and has not had her period in several months. Beth meets the criteria outlined in the DSM-5-TR for Anorexia Nervosa. 

Disordered eating

Disordered eating is a broad term that includes disordered or altered eating habits and relationships with food, however, this is not severe enough to meet the criteria for a specific eating disorder. Disordered eating typically does not include regular deliberate extreme food restriction, purging/laxative use, or binging, and there is not always an intense fear of gaining weight. However, these can occur on a less frequent basis and gradually lead to an eating disorder. Disordered eating is relatively common, and often related to cultural/societal factors, stress, trauma, depression and/or anxiety. 

Disordered eating can include any combination of the following (without meeting the criteria for an eating disorder), and often develops into a habit over time, either intentionally or unintentionally. It encompasses a wide range of thoughts and behaviours surrounding eating and body image, and the severity can vary considerably. Unlike eating disorders, disordered eating is not a medical diagnosis and does not have any sort of classification system. 

• Restricting foods and/or food groups

• Skipping meals

• Eating for comfort

• Loss of control when eating

• Food and/or body image impacting engagement in daily activities and overall quality of life

• Loss of control when eating

• Guilt or shame surrounding food

• Unhealthy weight control behaviors (fasting, diet pills, laxatives, cleanses, purging, etc.) 

• Distorted body image

• Over exercising 

• Chronic dieting

• Inflexible eating patterns

• Significant weight fluctuations

• Anxiety associated with specific foods

• Making up for “bad” foods consumed

• An all-or-nothing approach to healthy eating

• A hyper-focus on eating “clean” or healthy

Example

Jen often leaves for work without eating breakfast. For lunch she grabs quick muffin and coffee at a nearby cafe. She has lunch at her desk and eats while she works. By mid-afternoon Jen usually feels sleepy and grabs another coffee. When she gets home from work she is tired, stressed and hungry. She usually eats the first things she finds in her pantry, standing in her kitchen eating and scrolling social media, often until she is full. She eats dinner most nights, but often doesn’t eat a lot because she is worried about consuming too many calories. Jen is not deliberately skipping meals or binging, but by not eating regular balanced meals earlier in the day, she is throwing off her entire day of eating. This is perpetuated by lack of education and prioritization of healthy meals, eating while distracted, stress, lack of planning, and a busy schedule. Jen does not meet the criteria for an eating disorder, but is demonstrating disordered eating. 

If disordered eating persists, it can easily perpetuate and turn into an eating disorder. For this reason, seeking help at first sign of any disordered eating thoughts or habits is strongly recommended. It is much easier to improve disordered eating than it is to treat an eating disorder. Typically, the treatment for these also looks quite a bit different. 

Treatment options

At Panorama Wellness Group, Christy De Jaegher, works with clients with disordered eating to change the way they view food, establish a pattern of regular eating, address any nutrient deficiencies, develop healthy coping strategies to offset emotional/stress eating, address and modify any unhelpful thinking patterns surrounding food, and reach their specific health and wellness goals in a way that is sustainable. She meets each client where they are at and works with them to develop a roadmap to improve their relationship with food and overall health and wellness. This work is often done in tandem with counselling.

For eating disorders, a more specialized treatment is recommended. There are several inpatient and outpatient eating disorder programs in BC, which are listed on the Government of BC Website, in addition to support groups and other resources. If you suspect you have an eating disorder, it is strongly recommended that you speak to your physician and seek help right away in order to set yourself up for success. 

If you are looking for support with disordered eating, or are unsure of the type of support you require, book a free 15-minute consultation with Christy De Jaegher to discuss your particular concerns in more detail.