Deciphering Disordered Eating

Disordered eating spans a spectrum of unhealthy relationships with food. From overeating to not eating enough, it is often difficult for the average person to recognise because of many factors, from deep-rooted cultural traditions to contemporary views to the normalising of instant gratification.

With that in mind, this article breaks down the complex topic so that you can begin to understand what disordered eating comprises—and perhaps increase awareness about it in your community.

The two ends of the spectrum

On one end of the spectrum, someone eats uncontrollably or binge eats—eating a lot of food and often feeling a loss of control once they give in to the desire.

On the opposing end, someone may scrutinise their food intake excessively—and is likely driven by an intense fear of weight gain or their natural inclination to control just about everything in life. When it comes to food, this perfectionist behaviour may manifest as obsessing over calories or even avoiding specific food groups altogether for various reasons.

While describing these behaviours on a spectrum helps to make this complex topic easier to understand, it is also possible for the same person to have two seemingly opposing behaviours simultaneously.  

Examples of disorders that affect eating habits

Body dysmorphic disorder

For example, someone suffering from body dysmorphic disorder obsesses over their perceived defects in appearance. They may want to achieve a more athletic and muscular body. In pursuit of it, they may go through cycles of binge eating to gain weight (i.e., bulk up) and drastically reduce their food intake to get lean after. Now, whether trying to gain or lose weight, they're likely to be consumed by the need to track their food intake.

The scenario described above is also known as muscle dysmorphia—the extreme pursuit of muscularity, a variant of body dysmorphic disorder. And while it is commonly associated with physique sports (e.g., bodybuilding and physique competitions), it can affect someone who may simply be trying to 'get fitter'.

Before we continue, it is important to caveat that being more particular about your diet or leading a more active lifestyle or pursuing sports more seriously than the average person does not mean you have a disordered relationship with food. Many people make the conscious choice to modify their diet in pursuit of certain goals that they deem important, and they should be allowed to without judgement. Ultimately, it is about being able to pursue goals while maintaining a positive relationship with food and being happy.

Anorexia and bulimia nervosa

These are possibly the two most infamous disorders. To help you understand the differences between these two disorders, we've summarised what a person with either disorder typically does so that you may recognise them.

Anorexia

• A person suffering from anorexia will refuse to eat or eat an extremely inadequate amount of food

Bulimia

• Someone who has bulimia may eat but will purge themselves (i.e., vomiting, using laxatives or diuretics, fasting, or exercising excessively)

How someone may develop an eating disorder

We’ve talked about the what, and now it’s time to look at the why. Negative relationships with food often stem from unrealistic sociocultural pressures. Bombarded with imagery and ideas of what a 'healthy' and 'fit' person should look like—with little context, understanding of the personality's training, resources at their disposal, editing capabilities and motives—the average person interested in leading a more active lifestyle can quickly tumble down a rabbit hole of fads and unhealthy obsessions.

What about athletes?

The short answer is ‘yes’ even athletic people can develop eating disorders. While their peers may put them on a pedestal as examples of health and physical fitness, athletes have to face the judgement of competition and their expectations.

It is not uncommon for athletes competing in sports with weight classes (e.g., martial arts) or where having a smaller or aesthetic physique is advantageous (e.g., diving or gymnastics) to develop eating disorders.

From chasing a sport-specific 'look' to equating less weight with being faster—athletes are just as vulnerable as the average person.

How disordered eating can disguise itself as healthy eating

Like a wolf in sheep's clothing, disordered eating can hide in plain sight and pass off as healthy eating. Opting for more healthful habits, like a diet with more vegetables and whole foods, understanding food labels, and having a meal routine are accepted as healthful lifestyle choices and habits. However, as with most things, there can be too much of a good thing.

'Clean eating' or being fixated on eating only food perceived (or advertised) as clean is a behaviour or mindset that's disordered eating masquerading as healthy eating. Coupled with trends like intermittent fasting, which may work for some, but add unnecessary rigidity to another person's schedule, these purported healthy habits can lead to overthinking what and when to eat and be anxiety-inducing.

Disordered eating's warning signs and what you can do

Here are some common signs that someone suffering from disordered eating may exhibit

• Drastic weight loss or gain
• Obsession with body shape, size, or weight
• Obsession with food, calories, or nutrition labels
• Frequent skipping of meals or extreme dietary rules
• Engaging in excessive exercise to 'burn' food intake
• Feeling guilt or shame after eating
• Withdrawing from or avoiding social situations involving food

Do you experience or know someone showing one or more of these signs? We strongly encourage you to seek professional help.

Learn more about Singapore General Hospital's Eating Disorder Programme or Singhealth's Patient Care for Eating Disorders.