From the Guidelines
Disordered eating is a spectrum of unhealthy eating behaviors that do not meet the clinical criteria for diagnosed eating disorders, but can still significantly impact physical and mental health, and should be addressed with a comprehensive treatment plan that incorporates medical, psychiatric, psychological, and nutritional expertise. Disordered eating refers to irregular eating behaviors that don't meet the clinical criteria for diagnosed eating disorders but still involve unhealthy relationships with food, body image, and weight. These behaviors include restrictive eating, compulsive eating, skipping meals regularly, rigid food rules, emotional eating, and using exercise to compensate for food intake. Unlike clinically diagnosed eating disorders such as anorexia nervosa or bulimia nervosa, disordered eating exists on a spectrum of severity but can still significantly impact physical and mental health. It often stems from societal pressures about body image, diet culture, stress, trauma, or attempts to control aspects of life. Disordered eating can lead to nutritional deficiencies, metabolic issues, digestive problems, and psychological distress. It may also progress to a full eating disorder if left unaddressed.
Key Characteristics of Disordered Eating
- Restrictive eating
- Compulsive eating
- Skipping meals regularly
- Rigid food rules
- Emotional eating
- Using exercise to compensate for food intake According to the American Psychiatric Association practice guideline for the treatment of patients with eating disorders 1, patients with an eating disorder should have a documented, comprehensive, culturally appropriate, and person-centered treatment plan that incorporates medical, psychiatric, psychological, and nutritional expertise. Treatment typically involves working with healthcare professionals including therapists, dietitians, and doctors to develop healthier eating patterns and address underlying psychological factors. Cognitive behavioral therapy and intuitive eating approaches are commonly used interventions to help individuals rebuild their relationship with food and body image. The American Academy of Pediatrics also recommends that physicians be aware of several complications that can occur in outpatient settings, and that treatment should be individualized, with goal weights based on age, height, stage of puberty, premorbid weight, and previous growth charts 1.
From the Research
Definition of Disordered Eating
Disordered eating refers to a range of abnormal eating habits that can have serious psychological and physical consequences 2. It is characterized by disturbed attitudes towards weight, body shape, and eating, and can take many forms, including:
- Restrictive eating patterns
- Binge eating
- Purging behaviors
- Excessive exercise
Types of Eating Disorders
There are several recognized types of eating disorders, including:
- Anorexia nervosa
- Bulimia nervosa
- Binge eating disorder
- Avoidant-restrictive food intake disorder
- Pica
- Rumination disorder 2
Treatment of Eating Disorders
Eating disorders can be treated using a variety of approaches, including:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Family-based treatment (FBT)
- Medications such as fluoxetine and fluvoxamine
- Combination therapies, such as CBT plus medication 3, 4, 5, 6
Effectiveness of Treatments
Research has shown that CBT and FBT can be effective in treating eating disorders, particularly in adolescents 3, 6. CBT has been shown to be superior to medication alone in reducing binge eating and improving cognitive features and psychological distress 4, 5. FBT has been shown to be effective in facilitating weight gain in underweight adolescents 6. DBT has also been proposed as a potentially effective treatment for eating disorders, although more research is needed to fully establish its efficacy 3.