Eating Disorders vs Disordered Eating - What's the Difference? Thoughts from a Berwyn Pennsylvania Registered Dietitian

By: Rachel Dodson RD. LDN.

When discussing concerns related to eating habits and body image, terms like "eating disorder" and "disordered eating" are often used interchangeably. However, while they might seem similar, there are key differences between the two. Understanding the differences can be essential for discovering the right path to support, healing, and recovery.

Defining an Eating Disorder

The American Psychological Association defines an eating disorder as, “any disorder characterized primarily by a pathological disturbance of attitudes and behaviors related to food, including anorexia nervosa, bulimia nervosa, binge-eating disorder, and ARFID.” An eating disorder severely impacts a person's physical health, emotional well-being, and overall functioning. Both genetic and environmental factors contribute to the development of eating disorders. An eating disorder often requires professional treatment such as therapy, medical intervention, and nutrition counseling. Eating disorders are best treated with a team which may include an individual therapist, a registered dietitian nutritionist, a primary care doctor, a psychiatrist, and a family therapist, who are willing to collaborate.  

Specific diagnostic criteria for each of the major eating disorders is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) including, anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, and other specified feeding and eating disorders (which include purging disorder, night eating syndrome, “atypical” anorexia,  and bulimia and binge eating disorder “of low frequency or limited duration.”

A brief description on each: (partial but not the full DSM-5 criteria - see also https://www.mccallumplace.com/admissions/dsm-5-diagnostic-criteria/)  

• Anorexia nervosa: restriction of energy intake leading to significantly low body weight in the context of age, sex, developmental trajectory and physical health; intense fear of gaining weight; disturbances in the way in which one’s body weight or shape is experienced 

• Bulimia nervosa: binge eating and recurrent inappropriate compensatory behaviors 

• Binge eating disorder: recurrent episodes of binge eating characterized by both eating in a discrete period of time, an amount of food that is larger than most people would eat during a similar period of time and under similar circumstances; a sense of lack of control over eating during the episode 

• Avoidant restrictive food intake disorder: an eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one or more of: significant weight loss, significant nutritional deficiency, dependence on enteral feeding or oral nutritional supplements, and/or marked interference with psychological function; no evidence of a disturbance in the way in which one’s body weight or shape is experienced  

• Other specified feeding and eating disorders:

  • Purging disorder: recurrent purging behavior to influence weight or shape in the absence of binge eating 

  • Night eating syndrome: recurrent episodes of night eating as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal

  • Atypical anorexia nervosa: all of the criteria for anorexia nervosa are met except that despite significant weight loss the individual’s weight is within or above the normal range 

  • Bulimia / binge eating disorder of low frequency and/or limited duration: all of the criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory behaviors occur occur on average less than once a week and/or for less than 3 months / all of the criteria for BED are met excerpt that the binge eating occurs on average less than once a week and.or for less than 3 months

    
    

Defining Disordered Eating

Disordered eating refers to a pattern of unhealthy eating behaviors that may not meet the full criteria for an eating disorder diagnosis. It typically involves problematic or irregular eating habits representing unhealthy attitudes and behaviors surrounding food but do not meet the frequency, duration and/or psychological criteria for a diagnosable eating disorder. 

Not all disordered eating develops into a diagnosable eating disorder, however, disordered eating is a risk factor in the development of an eating disorder. Therefore, early intervention is key in order to improve treatment outcomes.

Disordered eating behaviors may include, but are not limited to: 

• Dieting

• Obsessive calorie counting 

• Frequently skipping meals

• Restricting food intake/eliminating specific foods or food groups

• Binge eating

• Excessive use of diuretics, laxatives, and weight loss medications

• Use of compensatory behaviors (purging, excessive exercising)

Disordered eating can still have negative effects on one's physical and mental health, leading to nutrient imbalances, poor self-esteem, and unhealthy relationships with food.

Key Differences Between Eating Disorders and Disordered Eating

The severity, treatment needs, and the presence of a diagnosis or not can all be factors in distinguishing the difference between disordered eating and an eating disorder. Understanding the difference between eating disorders and disordered eating is important in helping individuals seek the right kind of help at the right time. If someone is experiencing disordered eating, early intervention could prevent the behaviors from escalating into a full eating disorder. Sadly in our diet saturated culture, disordered eating may not always be recognized by others or even the individual themselves as a problem, due to how socially acceptable some disordered behaviors have become.

Both eating disorders and disordered eating are serious issues that deserve attention and care. While eating disorders are more severe, diagnosable conditions that require intensive treatment, disordered eating is a broad term that describes unhealthy eating patterns that might not meet diagnostic criteria but still need intervention. If you or someone you know is struggling with any of these issues, our team at Recovered and Restored would be honored to help you in your journey! 

By understanding the key differences between eating disorders and disordered eating, individuals can better advocate for themselves and others, ensuring that the necessary support and treatment are accessible and tailored to each person's needs. Healing is possible! Reach out for help today!!

References and other helpful resources: 

• https://www.mccallumplace.com/admissions/dsm-5-diagnostic-criteria/

• https://staging.nationaleatingdisorders.org/what-is-the-difference-between-disordered-eating-and-eating-disorders/

• https://www.eatingrecoverycenter.com/resources/disordered-eating-vs-eating-disorders

• https://www.apa.org/topics/eating-disorders 

• Academy of nutrition and dietetics pocket guide to Eating Disorders

Other Mental Health Services Offered in PA, NJ, DE, SC, MD, CT, VT, and FL

We offer a wide variety of services related to eating disorder recovery including trauma therapy!  We offer Weekly Support Groups, Nutrition Services,  and Family and Parent Therapy as well as Coaching, all tailored to meet the specific needs of the individual. We offer our services for Anorexia, Bulimia, Binge Eating, and Orthorexia as well as Maternal Mental Health, and eating disorder therapy for athletes online in New Jersey, Delaware, South Carolina, Maryland, Florida, Vermont, and Connecticut! We are here to offer our support and understanding in a safe and non-judgmental environment.

We have immediate openings right now for eating disorder therapy in:

Delaware, New Jersey, Florida, Maryland South Carolina, Connecticut, Vermont, and Pennsylvania.

And recovery coaching worldwide.

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Recovered and Restored is an eating disorder therapy center founded by Gabrielle Morreale, LPC. We specialize in helping teens and young women heal from eating disorders such as anorexia, bulimia, orthorexia, and binge eating disorder and treat disordered eating, anxiety, depression, and PTSD. We provide eating disorder therapy in the towns of Horsham, Upper Gwynedd, Lower Gwynedd, North Wales, Lansdale, Hatfield, Blue Bell, Doylestown, and nearby towns with eating disorder therapy. Also providing virtual eating disorder therapy in New Jersey, Delaware, and Florida. Some towns served virtually but are not limited to Pittsburg, Lancaster, Harrisburg, Center City, Cherry Hill, Haddonfield, Mount Laurel, Cape May, Avalon, Brick, Dover, New Castle, Bethany Beach, Marydel, and Oceanview