Lose It!: When Healthy Eating Becomes Disordered: Signs and How to Get Help

Changing your eating habits can be an important, positive step toward better health. However, if you feel like your relationship with food is affecting your mental health or quality of life, you might be at risk for disordered eating. Although it’s not a clinical diagnosis, disordered eating is a serious problem that, when left unaddressed, may lead to an eating disorder, according to the National Eating Disorders Association (NEDA).

Disordered eating encompasses a spectrum of problematic eating behaviors and attitudes toward food and body image, per NEDA. Although these behaviors and thought patterns can significantly affect a person’s well-being, they aren’t always easy to spot, says Cherie Miller, a licensed professional counselor supervisor and clinical director at Nourished Soul Center for Healing in Southlake, Texas.

“It can be hard for someone to recognize when their eating habits have become too restrictive or disordered because, unfortunately, a lot of disordered eating habits are considered healthy in our culture,” Miller explains. “Thanks to diet culture, things like chronic dieting or rules around certain foods are pretty normal. Society tends to praise things like dieting for weight loss and ‘clean’ eating instead of recognizing how problematic it can be for [many] people. This is especially true for people with larger bodies because society expects and pressures them to always be trying to lose weight.”

Here’s a look at how disordered eating compares to eating disorders, how to identify disordered eating patterns, and ways to cope.

The Difference Between Disordered Eating and Eating Disorders

Research suggests roughly 9 percent of Americans will have an eating disorder such as anorexia nervosa, bulimia nervosa, binge eating disorder (BED), or other specified feeding and eating disorder (OSFED) in their lifetime. Moreover, a systematic review and meta-analysis of 32 studies involving 63,181 participants found that 22 percent of children and teens exhibited disordered eating behaviors.

Another research review found a similar prevalence rate among university students globally, and studies indicate that rates of eating disorders and disordered eating have recently risen. Although all demographics can experience disordered eating, research suggests women and people with larger bodies tend to be more vulnerable.

People with disordered eating exhibit one or more signs of an eating disorder — such as food restriction, purging, or withdrawing from social situations involving food — but don’t meet the criteria for an eating disorder, according to NEDA. Those criteria are outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the guidebook healthcare providers use to diagnose mental illnesses.

The main difference is that in folks who have disordered eating, problematic thoughts and behaviors tend to occur less frequently and persistently than in those with eating disorders, per NEDA. People with disordered eating may also not meet the psychological criteria for eating disorders, which are complex mental illnesses, according to the organization. Still, research indicates that disordered eating, sometimes called “subthreshold” eating disorders, can have a similar effect on people’s health and quality of life.

5 Signs of Disordered vs. Healthy Eating

Healthy eating may look different for everyone, but it’s generally flexible and balanced, focusing on nourishing the body and honoring hunger and fullness cues without rigid rules or guilt, Miller explains.

“I think it’s about listening to your body and meeting your body’s needs without overthinking or judgment,” says Miller. “It looks like sometimes eating a salad and other times enjoying ice cream with friends.”

There’s nothing wrong with wanting to eat healthier. However, Miller says if you’re on a restrictive diet that isn’t medically necessary and is interfering with your life, you may have a problem. “How we eat shouldn’t hurt our physical or mental health,” she says. “It’s important to remember the mental health part because we often focus exclusively on trying to improve our physical health, even if it comes at the expense of our emotional well-being.”

Below, experts outline some of the more common disordered eating signs and offer tips to address them.

1. Eliminating Certain Foods or Entire Food Groups

Cutting out specific foods can sometimes be appropriate for certain health conditions, ethical reasons, or cultural or religious traditions, but outside of those contexts, it may signal disordered eating, Miller says. “If you’re restricting food groups (such as carbs, fats, or sugars), it’s important to be honest with yourself about why you’re doing that and if it’s actually necessary for a medical reason,” she says. “Food choices based on fear, shame, guilt, or anxiety are usually not coming from a healthy place.”

This rigidity often stems from fears rooted in diet myths, not balanced nutrition principles, says Supatra Tovar, a clinical psychologist and registered dietitian in Pasadena, California. The body needs a variety of foods to function optimally, and taking an all-or-nothing approach to more indulgent foods, like sugary treats, may not only be unsustainable but also promote negative feelings around eating.

“Gradually reintroduce small portions of these foods, paying attention to how they make you feel physically and emotionally,” Dr. Tovar suggests. “Try reframing these foods as ‘nourishing’ rather than harmful and work on understanding their genuine, science-backed role in a balanced diet.”

2. Experiencing Guilt Around Eating ‘Bad’ Foods

People with disordered eating often feel intense shame or guilt when eating foods that don’t align with their perceptions of being “good” or “healthy,” which can contribute to anxiety, says Kelsey Latimer, PhD, RN, a clinical psychologist and eating disorder specialist in Stuart, Florida. “Food is just food and should never determine whether we are ‘good enough’ or ‘strong’ or ‘controlled,’” she says. “Assigning those labels to food can be really dangerous.”

Shame and guilt often also accompany disordered eating behaviors like binge eating, according to the Mayo Clinic. Many factors can raise the risk of binge eating (and binge eating disorder), including food insecurity. A recent systematic review and meta-analysis found people who had experienced food insecurity were roughly 1.7 times more likely to develop binge eating disorder than those who had not.

Instead of labeling foods as “good” or “bad,” try thinking of them as “sometimes” foods, suggests Cynthia Hawver, a clinical psychologist and eating disorder specialist in Scranton, Pennsylvania. Practice eating one “sometimes” food, even if it’s just a small amount, and allow yourself to enjoy it without judgment, she suggests. “Remind yourself that nothing bad will happen from eating one cupcake. Eat it slowly and focus on the taste,” Dr. Hawver says. “Remind yourself you are not going to lose total control by having an indulgence. You’ll begin to unlearn the guilt attached to ‘unhealthy’ foods.”

Although including all kinds of foods, including so-called “trigger” foods, in your diet is typically recommended, in certain instances this may not be the right approach, such as for people with certain eating disorders who are not currently in treatment.

3. Having Strict Rituals Around Food

“Adhering to precise rituals, like eating only at certain times or needing a specific setting, can start as an effort to maintain control, but may signal underlying anxiety or obsession,” Tovar says.

She recommends gently challenging your need for strict routines. “For example, if you always eat lunch at noon, try eating at 12:30 on occasion,” she suggests. “Notice if any anxiety arises and explore its source. Remind yourself that flexibility can promote a healthier relationship with food.”

4. Getting Anxious About Eating Around Others

When eating becomes challenging for people, Dr. Latimer says they tend to withdraw from social events involving food, such as parties or brunch with friends. Often, that’s because the inability to control the situation — including what type of food is served — can cause anxiety, she explains. Research indicates that in the long term, this may contribute to issues such as social isolation and loneliness.

Hawver recommends taking some deep breaths and trying to visualize the event going well, and then reminding yourself that food is only part of the occasion. Again, she says adjusting this behavior incrementally is helpful, starting with small goals like enjoying a few bites of food at a party.

“Try to focus on the company and conversation more than the food. If [you are] going to a restaurant, then look at the menu online and pick in advance something you will order,” Hawver suggests. “This will take away the stress of having to choose in the moment and allow you to focus on your guests. Remember that people are not really concerned about or scrutinizing your food choices… Focus on the social connection rather than the food.”

5. Constantly Thinking About Food and Body Image

When you’re making changes to your eating habits and lifestyle to support your goal of weight loss, it’s only natural that you’ll spend some time thinking about your meals for the day, how you’ll make time for exercise, and researching restaurant menus to see what might fit into your calorie budget for the day. But this can shift from a balanced and healthy approach to an unhealthy focus on food and your appearance.

A preoccupation with food, weight, or body image is another sign to watch for. “Spending excessive mental energy on these topics can crowd out other important parts of life and make it hard to focus on anything else,” says Miller. Research suggests 20 to 40 percent of women and 10 to 30 percent of men are dissatisfied with their bodies.

If you’re stuck in this pattern, Miller recommends building or strengthening a sense of identity and self-esteem outside of your appearance. “It’s important to detach whether you see yourself as a good or worthy person from what you eat or weigh,” she says. She suggests getting involved in activities that emphasize your passions and nonphysical qualities, like a new hobby or volunteering. She says it may also help to explore and focus on your values.

“When we drill it down, being thin and attractive is not an actual value for most of us. No one on their deathbed says to themselves, ‘I really wish I had lost that last 5 pounds.’ To find your real values, list the qualities or activities that bring you a deep sense of joy, energy, or purpose,” Miller says. “If you’re feeling stuck, you can look up a list of values online and circle all the ones that resonate with you. Once you know your core values, work on bringing them into your daily life. Shifting your focus to living out your values instead of trying to look a certain way creates time and energy for building a more fulfilling life.”

Additionally, it can be helpful to unfollow and disengage with people and social media content that reinforces diet culture or negative body image, says Latimer, which research supports. Instead, Latimer recommends prioritizing people and content that make you feel valued and supported for who you are, not what you look like.

Treatment for Disordered Eating

Disordered eating and eating disorders are treatable, and the sooner you reach out for help, the better, Hawver says, aligning with research. “I always tell clients that just because you don’t meet the DSM-V criteria does not mean you do not have eating issues. I have found that I have the most success in treating patients in outpatient [settings] who seek treatment before they have the full diagnosis for anorexia nervosa or bulimia nervosa.”

Seek help if your eating habits are beginning to affect your mental or physical health, social life, or ability to function, Tovar says. “Feeling persistent anxiety around food, struggling with self-worth tied to eating behaviors, or facing physical consequences (like fatigue, digestive issues, or menstrual irregularities) are key indicators.” Even if you’re not at that stage, you might want to reach out to a counselor for help cultivating a more balanced approach to food.

Treatment for disordered eating and eating disorders usually involves working with a multidisciplinary team with expertise in this area, Latimer says, aligning with NEDA. Therapists can provide individual, group, and family therapy to help people identify and overcome the root of their disorder and establish effective long-term coping strategies. Meanwhile, a physician can care for any health complications, and a registered dietitian can help with nutritional counseling.

“Disordered eating is not about the food. It is about something deeper, often a sense of not being good enough and the promise that a body change will instantly lift one’s mood and life. The desire to feel better is real and deserves space in exploration,” Latimer says. “A therapist can assist you, but they must have eating disorder experience to understand this delicate issue.”

If you need help connecting with a therapist or would like supplemental support, the following organizations may be able to help:

• National Eating Disorders Association (NEDA)
• Eating Disorder Foundation
• National Alliance for Eating Disorders
• Eating Disorders Resource Center (EDRC)
• National Association of Anorexia Nervosa and Associated Disorders (ANAD)
• Project HEAL

The Wrap-Up

Signs of disordered eating versus healthy eating can be difficult to spot, in part because many problematic patterns have been normalized. But doing so is crucial to prevent an eating disorder or recognize and treat an emerging one. Reach out to a counselor, doctor, or helpline for support if you think your relationship to food may be unhealthy.

Editorial Resources and Fact-Checking

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