And how to treat it
We had a question today about “disordered eating” that perhaps was not addressed in our eating disorder training. My first thought was, what specific “disordered” does this mean? And who has the right to define someone’s eating as “disordered?” A lot of people eat oddly and that includes me, I have a small appetite and prefer to eat very small meals very often. If you see me eat a single meal you would be convinced I’m weird. I also have a lot of foods I don’t like, or, don’t even think of as “food” like icing on cakes. But I don’t have an eating disorder. So whose judgement is it that eating is “disordered”? There are lots of ways of having disordered eating. Lets take a few examples
Eating randomly
Eating because the food is there, not with real hunger
Not eating because you are depressed
Eating mindlessly
Eating badly (a lot of junk food because it tastes nice)
Having a lot of food dislikes that is common with neurodivergence.
Not eating because you are convinced they’re trying to poison you
So there are lots of ways people have “disordered eating” that doesn’t quite capture a fully blown eating disorder, and so, there are huge swathes of people who don’t “eat normally” – but does it matter?
There are many more people with an eating disorder than can be described as anorexic, bulimic or a binge eater. Some people just pick at food. Some people with anorexia are not thin. To have an eating disorder SPECIFICALLY means you have shape and weight concerns that lead to many kinds of behaviour that harm your health to a greater or lesser extent, and that makes you miserable, fixated, and probably makes other people miserable too.
Our training seeks to heal a person’s relationship with food, no matter what kind of “disordered type of eating” they have. And there are differences between someone with anorexia and the people who do not.
The only question we ask is. “does eating rule your life?” In my case, even though you might think my eating is “disordered” the answer is no, not at all. If the answer is yes, I don’t really care what label we will stick on the person such as “bulimic” or “orthorexic” or “weird”.
In summary, there are many different ways to be a human and there are many different ways to relate to food. If the answer to the question “does eating rule your life” is YES, then the person has an eating disorder of varying severity and it is up to the therapist to decide how critical this severity is.
So you might ask, how will I treat someone with “disordered eating” who doesn’t have a full blown eating disorder? And this bit is for trained health professionals.
If someone doesn’t have a “full blown eating disorder” then you have to find out….
What they are doing that makes you call them “disordered”. Clearly that person is not able to take care of themselves healthfully with food. If they have weight concerns/anxieties then you can “label” the person a “FEDNEC” case (eating disorder without classification) and treat them exactly the same way as you would treat someone with binge eating styles of eating, starting with assessment and then discovering and explaining all the things that are driving their behaviour; such as unhelpful habits, lifestyle, stinking thinking and low self worth. Then, you assess their motivation to change, and then, proceed with behavioural styles of therapy, before going into cognitive and emotional aspects of treatment including work on self worth and body image. And this may need you to work with a person who knows how to treat what else might be amiss, such as trauma.