What is disordered eating that is common in children?

People have been more mindful of what they consume in recent years. Some people keep track of their calorie intake, while others may be cutting back. Although these situations may appear normal to us, the medical profession has voiced concern that they might be symptoms of disordered eating. One in five children and adolescents worldwide show symptoms of disordered eating, according to a new study that also called attention to the problem. That amounts to 22.36 per cent of children and teenagers who have eating disorders, with girls experiencing the condition more frequently than boys (30 per cent).

Disordered eating is described as food behaviours that may or may not warrant a diagnosis of a specific eating disorder. It can include having strict rules around how much to eat, what to eat, the amount a person exercises vis-à-vis exercise. Psychologist Margo Maine, PhD, author of Pursuing Perfection: Eating Disorders, Body Myths and Women at Midlife and Beyond, explains disordered eating as the extent to which you move away from listening to what your body is telling you to eat to nourish and care for yourself, both physically and emotionally.

Instead, she explains that one starts eating according to external food and exercise rules — some may not even realise they are following or rebelling against — sometimes to the point where the way you eat (or don’t eat) gets in the way of your life. Chelsea Levy, an Intuitive Eating counsellor and weight-inclusive dietician in New York City, told Healthline in a report, “On one end is healthy eating, or just regular old eating, and then all the way on the other side of extreme or unhealthy behaviours would be an eating disorder. Disordered eating would be somewhere in between.”

A hallmark of disordered eating specifically is that many times, it starts from a desire to be “healthier” that slowly becomes more rigid in nature. An individual engaging in disordered eating behaviours may become obsessed with “clean eating” and use extreme language to describe certain foods, such as “toxic” or “poisonous.” While disordered eating may sound similar to an eating disorder, there is a difference between the two. People with disordered eating do not necessarily meet the diagnostic criteria for an eating disorder — such as anorexia or bulimia. They also may not have the same intense fear of gaining weight that is characteristic of eating disorders.

The term “disordered eating” is a descriptive phrase, not a diagnosis. It is said that eating disorders are considered more severe, and a person who has an eating disorder will engage in disordered habits more often with greater impact on their health. However, that’s not to say that disordered eating isn’t a serious issue. Most healthcare professionals in the US are of the opinion that disordered eating can be (but aren’t always) a precursor to an eating disorder.

Disordered eating can affect anyone — and this means anyone. A 2020 report by the Harvard TH Chan School of Public Health suggested that people of colour are half as likely to be diagnosed with or receive treatment for an eating disorder than white people. Another 2019 study in the Journal of Adolescent Health found that 60 per cent of college students, who identify as members of the LGBTQ community reported engaging in disordered eating behaviours.

Disordered eating like eating disorders are rooted primarily in body image concerns, which are often influenced by fatphobia— the fear or hatred of fatness. The notion that food is the fuel of our body has gradually stopped and today our eating is dictated by 7,000 “diet” rules. The multi-billion dollar weight loss industry, the media and social media influences alike encourage food behaviours and products meant to keep weights low and waistlines small, despite evidence increasingly suggesting that weight loss diets do more harm than good for many people. The normalisation and celebration of these behaviours is one reason disordered eating endures.

Mental health disorders such as anxiety, depression, or obsessive-compulsive disorder (OCD) could also attribute to disordered eating. Health experts noted that stress or life-altering changes could also trigger the onset of disordered eating. Moreover, trauma could make people more vulnerable to disordered eating. The COVID-19 pandemic also attributed to the rise in cases of disordered eating. “Isolation and anxiety intensified significantly during this time, leading people to struggle with disordered eating thoughts and behaviours,” said Dr Jillian Lampert to Medical News Today.

One must recognise that disordered eating is a step away from normal or natural eating habits. “Disordered eating is anything that disrupts a harmonious, body-connected eating experience,” says Anna Sweeney, owner of Whole Life Nutrition Counselling in the US, where she helps people recover from eating disorders and disordered eating. Experts note that many who suffer from disordered eating patterns minimise the issue and this could exacerbate the harm from it.

Restricting the kind of food one consumes could prevent the body from getting the nutrients it needs to function properly. Disordered eating could also lead to bone damage; if someone isn’t getting adequate amounts of key nutrients, such as calcium and vitamin D, their bones may become weak and brittle. More worrying consequences include a greater risk of obesity, low heart rate and blood pressure, increased anxiety, depression and social isolation.

“Disordered eating can take away and limit someone’s quality of life as they fill your brain with thoughts about food and your body,” therapist Jennifer Rollin, founder of The Eating Disorder Center in Rockville, Maryland, said to CNN, adding that the behaviours often keep you from other things you value in your life. “Freedom is possible, and you deserve to live a full life — not one that is consumed with food, exercise and weight.”

There are steps to manage one’s behaviour and develop a healthier relationship with food. First off, people must steer clear of fad diets and focus on eating in moderation and avoid labelling foods as inherently “good” or “bad”. Secondly try body neutrality. Body neutrality involves practicing accepting your body and focusing on caring for your body with adequate food, rest, water, and care. Learn to appreciate your body can help improve body image and combat disordered eating behaviours.

If these methods fail, opt for professional help. Look for a therapist who specialises in eating disorders. Another option would be to work with a dietician who isn’t focused on weight loss. The bottom line is that disordered eating is becoming more normal. We need to take action now to successfully navigate our way back to a healthy relationship with food.