What is Meant by a Continuum of Disordered Eating?
Disordered eating refers to a range of unhealthy eating behaviours and weight related practices that negatively impact an individual's overall well being. These behaviours could include chronic dieting, restricting intake, binge eating, self-induced vomiting, laxative use or over exercising. Individuals with disordered eating also struggle with body image issues and feelings of ineffectiveness and low self esteem. Disordered eating occurs in a significant percentage of the population, affects both females and males and can begin at a young age and continue into adult life.

The term Eating Disorders refers to extreme disordered eating that occurs for a certain duration, frequency and meets specific criteria for a diagnosis of one of the following:
Anorexia Nervosa (AN) Anorexia Nervosa (AN) is characterised by drastic weight loss and refusal to maintain a normal body weight by engaging in extreme restriction. The individual does not recognize their weight loss, has an extreme fear of gaining weight and even when emaciated will still insist they are too fat or that some part of their body is too big. Excessive exercise and other purging methods (laxatives, enemas, vomiting) may be used. For some there can be periods of binge eating. Individuals with anorexia may pick at food, cut it into small pieces, eat in ritualistic ways or hide or throw food out. They also tend to focus on watching food shows, collecting recipes and cooking for others but refusing to eat what they have made. Bulimia Nervosa (BN) Bulimia Nervosa (BN) is characterized by periods of dieting to try and control eating that is followed by episodes of out of control eating called binge eating. Afterwards, individuals feel guilty about their consumption and are worried about weight gain so they engage in purging behaviors (vomiting, laxatives or taking diuretics) or over- exercising. Binge eating and purging behaviors occur at least once a week. Bulimia can be less noticeable than anorexia as individuals don’t necessarily loose weight. Further a person with bulimia can be of an average weight but their body can still be in a state of semi-starvation. Binge Eating Disorder (BED) Binge Eating Disorder (BED) is characterised by eating a large amount of food in a short period of time. The binge eating occurs at least once a week. The individual often eats alone because they are embarrassed about their eating and often report feeling depressed and guilty about their eating. Unlike Bulimia the person does not engage in purging behaviours or excessive exercise. Individuals with Binge Eating Disorder often have higher weights and some struggle with obesity. Other Specified Feeding or Eating Disorders This is a new title that was previously known as Eating Disorders Not Otherwise Specified, or EDNOS. This category refers to situations when the person has many but not ALL of the specific criteria for AN, BN or BED. This category represents 50-70% of those with an eating disorder. Who Can Have These Struggles? Disordered eating and eating disorders can affect people of any age, sex, race, socioeconomic class or sexual orientation. As well, eating disorders can be present in persons of varying weights and shape. Nine out of every 10 individuals with anorexia or bulimia are females. However for Binge Eating Disorder, there is a more even ratio between females and males. Overall though, males with eating disorders are under reported. What Causes Eating Disorders? We do not know for sure what causes eating disorders. We do however know that they are complex illnesses that involve the interaction of a number of variables. These variables include genetic and biological factors, personality, mental health and social environment. More and more research is also showing that there is a strong genetic factor to the risk of developing an eating disorder. As well, dieting can be a precursor to disordered eating and when other factors are present it can lead to a full eating disorder.

The reasons for an eating disorder developing can be different for each individual person. For some individuals it’s about trying to deal with other problems and difficult emotions (e.g., anxiety, anger, depression). For others, it’s related to struggles with identify, confidence, voicing their thoughts and feelings or having greater control over their lives.
Risk Factors Certain factors and events might increase the risk of developing an eating disorder. Some of these factors may include:
  • Being female. Eating disorders occur in more females than males and are more common during the teens and early 20's, but can occur across a broad age range. Note: reports of males with eating disorders are under reported.
  • Having a parent or sibling who has had an eating disorder
  • Having depression, anxiety or an obsessive-compulsive disorder
  • Being perfectionist; having poor body image; low self esteem
  • Struggling with changes and life transitions (e.g., puberty, moving, relationship break up, starting post-secondary education or a new job)
  • Having difficulties identifying & expressing emotions; difficulties managing stress
  • Problems in the family; but families do NOT cause eating disorders
  • Trauma or abuse history
  • Easily pressured and influenced by peers, media and the dieting industry
  • Involvement with activities that focus on weight and size (e.g., ballet, modeling, gymnastics, running, figure skating and wrestling)
Warning Signs There are numerous behavioural, psychological and medical signs that someone may have an eating disorder or disordered eating. Please go to my Resource Page for links to find detailed information on this topic. Some common signs to watch for are:
  • Changes in eating habits; aversion to previously enjoyed foods; counting calories or fat grams; dieting; excuses to not eat; avoiding meal times; obsessive thinking about food; preoccupation with cooking; trying to control food choices for the household; binge eating or emotional eating; eating in secrecy
  • Fluctuations with weight; gains or losses
  • Poor body image; making negative comments about self; obsessional thinking about weight; repeatedly weighing or checking self in mirror
  • Over exercising; vomiting, using diet pills, laxatives or misusing diuretics
  • Mood changes and increased anxiety; withdrawing socially; self harming behaviours
  • Feeling tired, dizzy, muscle cramping, headaches, retaining water; sleep issues, irregular or loss of menstruation, sore throat, swollen glands, blood in vomit, loss of hair, brittle nails & stress fractures
Is Recovery Possible? Yes, progressive treatment professionals believe that full recovery is possible with the right treatment. Recovery, however does not happen oven night. The best path to recovery is early intervention and consistent efforts at restoring normal weights, nutritional needs and addressing emotional/psychological issues. Full recovery means not just stopping the behaviours but also stopping the obsessing about food and weight and learning self acceptance. It also means learning healthy ways to cope with difficult feelings and situations and discovering how to listen to your body and feelings.