Living with excess weight or obesity is already difficult, and if you have been fighting your body weight for a while (or maybe your whole life), the guilt and shame you may have experienced from weight stigma, judgment, or teasing can make you start to question your own ability to understand and manage your relationship with food. Maybe you are struggling to understand what a healthy eating pattern even looks like. Or, you are wondering if you have an eating disorder.

Disordered Eating or Eating Disorder?

While all of us (yes, even your super happy sister who has it “all together”), have engaged in some form or episode of disordered eating. 

“Disordered eating is a phrase used to describe irregular eating patterns such as frequent dieting, rigid rituals, restrictions, or practices around food or eating, or a sense of lack of control around eating,” explains Leah Mandley, LCSW-C, vice president of behavioral health for CoreLife Healthcare. “These behaviors can be distressing, but they do not happen frequently or severely enough to be defined as an eating disorder.” 

However, if the disordered eating patterns are more intense and occur more often, they may meet the criteria for an eating disorder. An eating disorder is a clinically diagnosed mental illness. Eating disorders affect how people consume food, cause negative emotions and perceptions about body size and image, and lead to serious and sometimes life-threatening medical conditions. 

“An eating disorder is incredibly disruptive, even destructive, to families, and the ripple effects of an eating disorder can be life-long,” adds Mandley.

Misperceptions and Stereotypes

We all remember the “after school specials” about the young girl who starves herself, have seen the magazine covers shaming actresses who are “too skinny”, and have heard the stories about the gymnast or dancer who abuses laxatives or vomits to stay thin. 

“These mass media presentations of individuals with eating disorders are not only harmful to those who are suffering, they over-simplify a condition that has many complex and varied environmental, emotional, social, biological, and even genetic causes,” says Mandley. “Moreso, it limits our view of those affected by eating disorders to a limited demographic with a primary motivator of ‘thinness’.”

Nothing could be further from the truth. Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses. 

Understanding Eating Disorders

While anorexia nervosa (self-starvation) and bulimia nervosa (binging and purging) may be the most commonly known, there are other types of eating disorders that are more closely correlated with excess weight and obesity. These are binge eating disorder and night eating disorder. 

Binge eating disorder and night eating disorder are not the same as an occasional episode of overindulgence. 

Consider these examples:

You just realized you mindlessly ate an entire box of Girl Scout cookies while watching Stranger Things. You are disappointed in yourself, and vow to exercise more control next time.

“Sure, it’s not the best for your health or weight loss goals, but occasionally overdoing it is not a sign of an eating disorder,” says Mandley. You may want to talk to your dietitian about some strategies to avoid this temptation, and plan better for your next date with that creepy monster in the upside down. 

Your partner just left to pick up the kids, so while you are alone you quickly sneak eat the bags of chips and candy you had been hiding in the back of the pantry. You bury the empty wrappers deep in the trash and spend the rest of the evening secretly shaming yourself. 

“This might be a bit more serious,” says Mandley. “Hiding food, eating in secret, eating without a sense of control, and feeling intense guilt or shame could be a sign of binge eating disorder, especially if this happens at least once per week over a few months.” Binge eating disorder is closely related to excess weight and obesity, with diagnoses reported in 30% of people in weight control programs, and 50% of people with severe obesity.

Last night, you woke up at 2:00 am, thoughts racing about a big meeting you have the next day. Unable to get back to sleep, you head to the kitchen for a small bowl of cereal while writing in a journal to settle your thoughts. 

Midnight snacks happen. Daily stress or episodic anxiety or worry can keep anyone awake. For some of us, a small snack or glass of “warm milk” (as mom used to recommend) can distract us from our cycling thoughts and be just the thing to help you settle back to sleep. Mandley advises, “If this is happening more often than you would like, you may want to talk to a professional about strategies to improve your sleep habits or manage your stress.”

This morning, you wake up remembering that you had a midnight snack, but when you enter the kitchen you discover that you finished off all of last night’s dinner leftovers. “Ugh, not again,” you think, wondering why this keeps happening. 

This could be a sign of night eating disorder, which is characterized by eating after waking from sleep (or excessive eating after evening meal). You remember the eating episode, but can’t seem to understand the reasons, leaving you feeling distressed. Mandley explains that the night eating does not have another obvious cause, such as changes in your sleep cycle, medications, other mental health or medical conditions. 

Getting Help

If you recognize yourself, or a loved one, in these descriptions of binge eating disorder or night eating disorder, you should speak to a licensed mental health clinician about your observations and concerns. 

“Eating disorders are NOT a sign of a character flaw, and they can be treated. However, detection and intervention from a professional are key,” says Mandley.

Serious medical complications can arise from eating disorders, including weight gain and worsening or increased risk of weight-related health conditions, such as high blood pressure, heart disease, type 2 diabetes, and more. And, mental health conditions are also common with eating disorders, including depression, anxiety, post-traumatic stress disorder, and obsessive compulsive disorder. 

If you suspect you have an eating disorder, or if you are concerned in any way about your eating patterns, working with a registered dietitian and a licensed mental health clinician are the best way to understand and improve your relationship with food. Don’t wait to get the advice and guidance you need to live your healthiest and best life!