Recently I had the pleasure to interview Alexandra Venger, a Registered Dietitian who is currently working with an NGO in Tanzania to reduce childhood malnutrition. Considering her strong background in nutrition and her experience seeing patients that struggle with disordered eating, I was thankful for the opportunity to have her explain the differences between eating disorders and disordered eating. Ms. Venger defines these two terms for us and describes how to recognize them, as well as what to do if we believe we might be dealing with one or the other.
Alexandra Venger, Registered Dietitian
Can you tell us a little bit about your professional background?
I am a Registered Dietitian from Toronto currently working abroad in Tanzania with an NGO to increase the access and quality of health services to residents in Kigoma Region. My work currently focuses on reducing childhood malnutrition through improved healthcare services and community outreach. I am a relatively new dietitian, having graduated from Western University in 2015 (go Mustangs!). Before my current placement I was working as a Registered Dietitian at a weight loss clinic and at a gym in addition to being a personal trainer. In both of these settings, a large part of my job was promoting client-centred weight loss (meaning it was their goal, not mine!). Although as dietitians it is our responsibility to provide client-centred care (and not impose judgement), it is important, I think, to note this since we will be talking about disordered eating.
How would you define disordered eating versus an eating disorder?
It’s very interesting that you mention disordered eating before an eating disorder since the latter is more well known. But let me start with eating disorders. An eating disorder is that which can be diagnosed using national guidelines (to whichever respective regions). The most common eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder, which may be classified as a mental health disorder. These eating disorders have specific diagnosis criteria such as having a binge eating episode at least once a month for three consecutive months. Disordered eating, on the other hand, encompasses broader characteristics of problematic eating habits such as restrictive eating, preoccupation with food and weight loss, and those which do not warrant an official diagnosis (i.e. binge eating less than a week and/or fewer than three months). While only one may be officially classified as a disorder, that which negatively impacts health and may be life-threatening, the other (disordered eating) addresses those habits which present differently in individuals and continue to pose negative health risks.
How are the two related?
The two are related in that they both may pose a life-threatening risk to those living with the condition and may negatively impact their quality of life. The difference is that one is narrower in its screening process (eating disorders) and may exclude those individuals who may require treatment outside of an official diagnosis.
How common would you say one is versus the other?
Disordered eating is more common than an eating disorder since it encompasses broader symptoms and characteristics. In Canada, eating disorders may affect about 10% of Canadians, or 1 in 10 people. Women are often more largely impacted by anorexia nervosa and bulimia nervosa for a variety of reasons including genetics, social pressures, culture, and among others, while both men and women are often equally impacted by a binge eating disorder.
How can I know whether I have an eating disorder or am engaging in disordered eating?
If you can answer yes to any of the following statements, the best thing to do is to talk to your doctor:
- I’m always thinking about food, dieting and my weight
- I often avoid food even when I am hungry
- I feel guilty and ashamed after I eat
- I often feel out of control when I eat
- I feel better when I don’t eat
- I will never be happy unless I reach my ideal weight
- I rarely/never get my menstrual period
- I often try to “get rid” of food by purging
- I experience physical signs that my body isn’t getting enough nutrients, such as hair loss, dry skin, dizziness or lack of energy
When should I seek help from a dietician, and when should I seek help from a mental health professional?
If you suspect you may have an eating disorder or disordered eating habits and wish to get help, it would be best to speak to your doctor as they would have all the information needed to guide you to the appropriate treatment. Treatment may include inpatient programs geared towards those in critical life-threatening conditions, psychotherapy, medication, nutritional counselling, support groups, and others. Given the complicated nature of eating disorders and disordered eating habits, one or a combination of treatments may provide the best outcomes. Deciding on which treatment to engage in, however, is specific to the individual with guidance from their doctor.
What steps can I take to improve my relationship with food?
Seek professional help. Self-diagnosing an eating disorder or disordered eating habits may be problematic and not offer the best course of treatment. Intensive behavioural counselling may be required under the guidance of a trained professional. In addition to seeking professional help, steps to improve your relationship with food may include being mindful of your overall habits and influences potentially motivating your behaviours. For example, pervasive social media marketing campaigns, cultural norms, peer pressures promoting an ideal body type, preference for specific diets including fads, and idealizing a certain lifestyle may promote a negative self-view leading to behaviours to achieve the desired norm, even if these motivations are external to your inherent qualities. If you find yourself becoming, for lack of a better term, victim to these negative influences, consider taking steps to reduce their impact on your life or how you may perceive them. For example, challenging norms promoting “x” body types in place of all body types, unfollowing certain social media profiles (such as those promoting “fitspo”, “clean-eating”, “gym goals” or any other restrictive or limiting views), and setting boundaries with family and friends favouring your well-being. This may mean identifying and reducing self-deprecating culprits, such as a family member who may constantly make negative remarks about your weight or eating habits, or friends who may inadvertently promote body shame by complimenting recent weight loss. Being mindful of the many factors contributing to your eating habits and relationship with food is challenging, however with the right help and direction, improvements are very possible.
Edited by Natasha Cheong & Emily Deibert