Eating disorder dietitians
  • June 9, 2023

How Do I Know If I Have An Eating Disorder? | Imbodi Health Eating Disorder Dietitian Clinic

It can be common to experience thoughts and feelings towards food or your body that are not always positive. However, […]

It can be common to experience thoughts and feelings towards food or your body that are not always positive. However, when these thoughts and feelings become overwhelming and begin to control other parts of your life, you may begin to question if you have an eating disorder.

In this article, our eating disorder dietitian will explore the different types of EDs, common signs symptoms of EDs, treatment options and useful resources.

 

What is an eating disorder?

EDs are a group of serious mental conditions that involve changes in eating behaviours, paired with distressing thoughts and emotions1. 

Often, these conditions exists alongside other mental illnesses including anxiety and depression1. The distressing thoughts and feelings part of an ED can also lead to serious physical health issues.

 

eating disorder dietitian discusses what is an eating disorder

 

There are a number of different eating disorders:

As mentioned, the term ‘eating disorders’ covers a group of conditions that all feature changes to eating behaviours, as well as negative thoughts and feelings about the body and food.

Some of the more commonly occurring or well-known conditions under this umbrella are:

Anorexia nervosa2

  • Very restrictive eating patterns or avoidance of food entirely
  • Frequent weighing
  • May feel they are overweight even when dangerously underweight
  • Distressed by the thought of weight gain

 

Bulimia nervosa2 

  • Recurrent and frequent binge-eating followed by purging
  • Taking laxatives and/or diuretics 
  • Excessive exercise
  • Fasting
  • Forcing themselves to vomit
  • May appear to be a healthy weight/’normal’ body size
  • Feeling out of control around food which leads to eating unusually large amounts

 

Binge eating disorder (BED) 2 

  • Losing control of eating
  • Eating unusually large amounts of food
  • Recurrent and frequent episodes often occur in specific time periods e.g. 2 hours
  • Episodes are not followed by purging
  • Secretive eating behaviours
  • Eating even when already uncomfortably full.
  • Feelings of shame or guilt around eating behaviors
  • Often overweight or obese

 

Avoidant restrictive food intake disorder (ARFID)2 

  • Previously known as ‘selective eating disorder’
  • Do not experience altered or false feelings of body size or fear of weight gain
  • Significant restriction or rules around what foods can be eaten
  • Similar to very picky eating, but occurs to a severe level that prevents healthy body functions
  • May lack interest in food and eating

 

Pica disorder3

  • Eating things that are not food, usually consumed or provide nutrition

 

Other specified feeding or eating disorder (OSFED)4, 5

  • Have symptoms similar to another ED but does not meet full criteria for diagnosis
  • Causes health problems that are as severe as other EDs

 

Common signs and symptoms of eating disorders

There are both physical, mental and emotional signs of eating disorders6.

Some signs and symptoms are more visible or easier to see than others. This is because EDs are mental disorders that involve disruptive and distressing thoughts and feelings surrounding food, eating and/or weight.

The below signs and symptoms are shared between some or many of the conditions under the ED umbrella1, 2, 6:

  • Restrictive or avoidant eating behaviours
  • Anxiety about weight, food and eating
  • Isolation or avoiding social situations
  • Secretly eating or eating in private
  • Dramatic weight change
  • Mood swings or irritability
  • Poor concentration, fatigue or dizziness
  • Brittle hair and nails, dry skin
  • Upset stomach
  • Wearing more loose fitting clothing
  • Feeling cold, even when weather is warm
  • Feeling guilt or shame around eating and food

 

eating disorder dietitians discuss eating disorders

Eating disorders versus disordered eating: what’s the difference?

Unfortunately, the signs and symptoms above are experienced by many people. This does not mean everyone who identifies with a sign on the above list has an eating disorder. 

In these cases, they can indicate disordered eating habits and behaviours. While the terms ‘eating disorder’ and ‘disordered eating’ are often used interchangeably, they do not mean the same thing.

Disordered eating is unhealthy eating habits that may include restriction, dieting, compulsion and skipping meals7.

The signs of disordered eating can look similar to an eating disorder:

  • Fasting or restrictive eating, including skipping meals or eliminating food groups
  • Constant dieting
  • Binge eating
  • Misuse of laxatives, diuretics or diet medication
  • Compensating for eating; forced vomiting, over-exercising etc.

Disordered eating behaviours can increase the risk of developing an ED9.

How is an eating disorder diagnosed?

Before an ED is diagnosed, a doctor may be involved in identifying at-risk behaviours and giving health advice to prevent the disorder from developing.

One of the most common paths to an eating disorder diagnosis is through a doctor like your general practitioner (GP), or psychologist.

Your doctors or psychologist will refer to the diagnosis criteria in the DSM-5 guidelines to conclude an eating disorder diagnosis.  12. This allows them to identify if the individual’s symptoms meet the definition of a specific ED.

Additionally, screening tools like the SCOFF questionnaire may be used by a practitioner as part of this examination10. Other factors considered in the examination may include weight, fatigue, and thoughts and feelings about food and your body13.

It can be difficult for healthcare providers to diagnose an eating disorder. Part of the disorder can include feelings of shame and guilt about food and eating – this leads to secretive behaviours so some individuals may hide their thoughts, feelings and actions.

Sometimes doctors can discuss a person’s behaviours with family and friends of the patient to find out more about their signs and symptoms10.

 

Eating disorder treatment

Treating eating disorders

A team of healthcare professionals may be involved in treating an eating disorder

The specific treatment received depends on the ED being experienced, the individual and their symptoms. Usually, treatment is a mix of psychological treatment, nutritional support and monitoring of health status14

Doctor – can treat physical health impacts that are caused by EDs, prescribe medication and give referrals to specialists.

This may include identifying nutrient deficiencies through blood tests and referring patients to a psychologist or eating disorder dietitian if a referral is needed.

Dietitian – can prescribe diet plans, provide information on food and eating, and nutrition counseling.

An experienced eating disorder dietitian can provide support during treatment and recovery to help patients meet nutritional adequacy and repair their relationship with food. 15.

Psychologist – can use different therapies to help a patient’s mental recovery from an ED14

Ultimately, the therapy and strategies that a psychologist can apply aim to support the patient in shifting their thoughts and feelings about food, eating and their body to a more healthy mindset14, 17.

Psychiatrist – can prescribe medication and may also be able to treat a patient with therapeutic interventions like a psychologist14.

Support from family and friends can also be important during treatment. A patient’s support network can provide emotional support as well as help them stay on track with their strategies, therapies and treatment plan.

Every treatment plan and recovery journey looks different as EDs are a complex group of mental illnesses.

For some individuals, treatment at an inpatient facility or being admitted to a hospital treatment program is more effective14.

BOOK IN A FREE DISCOVERY CALL WITH OUR DIETITIANS

Where can I get help if I suspect I have an eating disorder?

Where to seek help if you are experiencing these signs and symptoms:

If you feel like you identify with any of the signs or symptoms mentioned and would like to seek advice, making an appointment with your doctor is a great place to start.

Eating disorder foundations and helplines are also available for more general information and to talk to someone if you feel like that would help you.

In Australia, the Butterfly Foundation is a national charity that supports individuals impacted by eating disorders18.

Online resources from reputable sites like government bodies and dietitians’ platforms can also provide general advice and be a good starting place.

If making an appointment with a healthcare provider or reaching out to a helpline feels overwhelming, speak with someone you trust like a friend or family member, colleague or peer. 

From there, your support person can help you seek further advice so you do not have to do so on your own.

How can you help someone you suspect may have an eating disorder?

Many ED specific foundations provide resources for the communities that surround someone suffering from an ED.

The Butterfly Foundation website has advice for family, friends and others who are indirectly impacted by EDs. This includes a fact sheet that discusses approaching someone you may be concerned about to talk about the signs and symptoms you may have noticed19

If able, encourage the individual to seek professional help from a healthcare provider and support them as they start their journey to diagnosis, treatment and recovery20.

 

having a support system is important for recovery

 

Summary

Many people struggle with disordered eating habits and eating disorders. Disordered eating habits are often a precursor for an ED, but not always.

The disordered behaviours become an ED when they begin to occur alongside distressing thoughts and feelings about food, eating and the body/body image/size.

As EDs are complex mental health conditions with physical effects, they can be difficult to diagnose.

In most cases, an initial diagnosis or examination can come from a GP and/or doctor.

Treating an ED can look different for each individual that struggles with the condition, but usually involves a team of healthcare professionals including a doctor, psychologist, psychiatrist and eating disorder dietitian.

There are many different therapies and strategies that are used in treatment. The type of treatment received is dependent on the individual, the specific ED they are experiencing and their symptoms.

Support for those suffering with EDs and the people indirectly impacted can be accessed through healthcare providers, government bodies, charities and foundations.

If you struggle with your relationship with food and your body, the Imbodi Health Podcast explores many of these common topics in greater detail. You can listen to the the Imbodi Health Podcast on Apple podcasts and Spotify.

BOOK IN A FREE DISCOVERY CALL WITH OUR DIETITIANS

Written by: Student dietitian Lilee Lunney
Reviewed by: Eating Disorder Dietitian Jade Wrigley

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