As a registered dietitian who has primarily worked with individuals with disordered eating, I have seen countless examples of how our culture surrounding nutrition and diet has harmed people\u2019s relationships with food. <\/p>\n\n\n\n
\u201cIf I keep chips in the house, they\u2019d be gone in an hour.\u201d<\/p>\n\n\n\n
\u201cI gain weight just looking at a slice of pizza!\u201d<\/p>\n\n\n\n
\u201cI eat so well in the morning, but by the time I get home, I eat everything in sight!\u201d<\/p>\n\n\n\n
\u201cI just need to lose x<\/em> amount of weight before my trip.\u201d<\/p>\n\n\n\n Do any of these sound like something you\u2019ve said? If so, I promise you\u2019re not alone. In fact, in the United States, 69-84%<\/a> of women experience body dissatisfaction, desiring to be a lower weight than they currently are [1], and 45% of women are on a diet<\/a>. One shocking survey from 2011<\/a> found that thirty percent<\/em> of women studying at British universities would trade at least <\/em>one year of their life to achieve their ideal body weight and shape. [2]\n\n\n\n With all that, is it surprising that 65% of American women ages 25-45 engage in some form of disordered eating, while an additional 10% suffer from a diagnosable eating disorder<\/a>? That\u2019s a grand total of 75% of American women who struggle with eating, one of our body\u2019s most important needs. <\/p>\n\n\n\n With all that, is it surprising that 65% of American women ages 25-45 engage in some form of disordered eating, while an additional 10% suffer from a diagnosable eating disorder? That\u2019s a grand total of 75% of American women who struggle with eating, one of our body\u2019s most important needs. <\/p><\/blockquote><\/figure>\n\n\n\n This mindset of feeling out of control over your body and the food you eat has very much become the norm in our society. These thoughts and feelings may seem harmless and ordinary, but they often stem from other factors and can lead to health effects that can not only be harmful, but potentially fatal, to your overall health.<\/p>\n\n\n\n Disordered eating exists on a spectrum of concerning eating patterns and attitudes toward food, exercise, and appearance. It can include behaviors such as: dieting, rigid food rules, emotional eating, feelings of shame around foods and\/or skipping exercise, skipping meals, eliminating food groups, food preoccupation, and anxiety around body image as it relates to food and exercise. Although these patterns can range in severity, someone engaging in disordered eating does not necessarily meet the criteria for a diagnosable eating disorder<\/a>. <\/p>\n\n\n\n Eating disorders, on the other hand, have specific diagnostic criteria as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and mostly commonly include anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), avoidant restrictive food intake disorder (ARFID), and other specified feeding and eating disorders (OSFED). The criteria include engaging in some disordered eating pattern for a specific frequency and\/or length of time, along with other specific criteria.<\/p>\n\n\n\n Even if someone does not meet the criteria for an eating disorder diagnosis, disordered eating behaviors often cause anxiety and impact a person\u2019s relationship with food, exercise, and\/or their body. For this reason, I will use the term \u201cdisordered eating\u201d to refer to all behaviors, regardless of severity. Anyone struggling with their relationship with food, exercise, or body deserves support.<\/p>\n\n\n\n Disordered eating is influenced by biological, psychological, and social factors<\/a>, some of which are listed below. Many disordered eating behaviors, such as dieting, are often used as a means of control, especially when various events, genetic predispositions, or diagnoses can make one feel out of control.<\/p>\n\n\n\n It is important, before moving forward, to note that often, individuals who technically meet the criteria for a diagnosable eating disorder never get diagnosed. Because most disordered eating behaviors are so normalized in our society, it can be difficult to identify these behaviors in someone else, let alone yourself. Being able to recognize concerning behaviors around food can go a long way in getting yourself or someone else the help needed.<\/p>\n\n\n\n Disordered eating behaviors, most especially dieting, are strong predictors for the development and management of an eating disorder. Dieting or caloric restriction precipitates both physical and psychological feelings of deprivation. After a period of time, the dieter often \u201cbreaks the rules\u201d and overeats, which often leads to feelings of guilt or shame. Those feelings often prompt another diet, starting the cycle again<\/a>. This diet cycle illustrates how a dieting behavior can lead to and maintain an eating disorder.<\/p>\n\n\n\n Disordered eating behaviors, most especially dieting, are strong predictors for the development and management of an eating disorder. Dieting or caloric restriction precipitates both physical and psychological feelings of deprivation. After a period of time, the dieter often \u201cbreaks the rules\u201d and overeats, which often leads to feelings of guilt or shame. Those feelings often prompt another diet, starting the cycle again. This diet cycle illustrates how a dieting behavior can lead to and maintain an eating disorder.<\/p><\/blockquote><\/figure>\n\n\n\n When someone undergoes a diet for the purposes of weight loss without the supervision of a doctor, the body becomes very efficient at using the calories it does consume. Our bodies experience a diet in the same way they experience famine\u2014body systems slow in order to maintain the vital energy to perform essential functions throughout the day. The result is a slowed metabolism, lower muscle mass, higher body fat percentage, and more difficulty losing weight [3].<\/p>\n\n\n\n This effect can contribute to \u201cweight cycling,\u201d a phenomenon in which an attempt to lose weight is followed by an increase in weight. This can lead to cardiovascular disease, inflammation, high blood pressure, insulin resistance, and higher body weight [3].<\/p>\n\n\n\n Weight cycling is poignantly illustrated in the Biggest Loser <\/em>study, which followed 14 of the show\u2019s contestants for six years. This study<\/a> found that, compared to baseline (before they started the season), the participants\u2019 metabolism was significantly slowed, their muscle mass was lower, and most of the weight they lost was regained [4]. The results of this study are also summarized in this article<\/a>.<\/p>\n\n\n\n Caloric restriction leaves the body with depleted energy stores, and can impact hormonal health<\/a>, leading to symptoms such as osteopenia or osteoporosis, amenorrhea, fertility changes, gastrointestinal issues, depression and\/or anxiety, fatigue, and poor sleep quality. This Natural Womanhood article<\/a> underlines the importance of adequate caloric consumption in hormonal balance.<\/p>\n\n\n\n Not only does disordered eating impact hormone health, but hormone fluctuations and imbalances can also trigger disordered eating<\/a>. The reproductive hormones, progesterone and estrogen, are both hugely impactful to our reproductive function, but they also have systemic physiological and psychological effects<\/a>. Estradiol is the dominant hormone in the follicular phase and is responsible for the development and release of the egg. It is also responsible for inhibiting food consumption by increasing the \u201cfeel-good hormones\u201d dopamine and serotonin, and inhibiting ghrelin, our hunger hormone. <\/p>\n\n\n\n In the luteal phase, progesterone is the dominant hormone and is responsible for preparing the body to maintain a pregnancy. In the presence of estradiol, it also contributes to an increased metabolic rate, decreased satiety, and decreased dopamine and serotonin, all of which can lead to increased hunger and food cravings<\/a>.<\/p>\n\n\n\n In addition to their influence on appetite regulation, progesterone and estrogen levels also impact<\/a> glucose metabolism and insulin sensitivity, leading to fluctuations in blood sugar and weight [5]. These changes throughout the menstrual cycle may be associated<\/a> with emotional eating patterns [6].<\/p>\n\n\n\n Often, an anti-inflammatory diet or gluten-\/dairy-\/sugar-free diet is recommended to women struggling with hormone imbalance, and these diets may prove to be beneficial for women struggling with this issue<\/a>. They are also effective at increasing<\/a> overall health promotion, metabolic and cognitive health, as well as chronic disease prevention and management [7].<\/p>\n\n\n\n The challenge, however, lies in where individuals get their nutrition advice, how knowledgeable those sources are, and how effective that individual is at implementing changes in their lifestyle. One study showed that 57% of a population of women with PCOS implemented a \u201cspecial diet,\u201d many of which were inconsistent with evidence-based practices for PCOS. Additionally, only a quarter of women<\/a> sought advice from a healthcare professional [8]. This is an example of why many women with hormone imbalances, such as PCOS and infertility, struggle with disordered eating moreso than healthy women [9<\/a>,10<\/a>].<\/p>\n\n\n\n It is crucial to assess how following any nutritional recommendation will impact your individual physical and mental health. If you already struggle with disordered eating patterns, avoiding entire food groups could be damaging. If you are struggling with hormone imbalance and your relationship to food, it is important to find a healthcare team with whom you feel comfortable disclosing this information to receive the best possible advice and care.<\/p>\n\n\n\n At this point, you might be thinking, \u201cOh my gosh, this sounds like me,\u201d or \u201cThese behaviors all seem normal.\u201d And you are not alone. It can be difficult to recognize the impact these thoughts and attitudes have had in your life. If this is how you feel, it could be useful to sit down and assess your relationship with food. Do you engage in any of the behaviors discussed in this article? If so, you may consider searching for a mental health therapist or dietitian who could support you. Your primary care physician or other trusted healthcare professional may also be able to connect you with resources in your area.<\/p>\n\n\n\n Developed by registered dietitians Evelyn Tribole and Elyse Resch, Intuitive Eating is an evidence-based non-diet approach to nutrition<\/a> that is weight-neutral and honors both physical and mental health. It is proven to be effective at lowering fat levels in the blood, decreasing the overall risk for heart disease, improving blood sugar control, and decreasing disordered eating behaviors, independent of weight loss [3].<\/p>\n\n\n\n The model is comprised of ten principles that start with how to reject the diet mentality; work through recognizing hunger and fullness cues, how to recognize and respond to your internal \u201cfood police,\u201d how to move away from guilt and shame, how to enjoy food again; and how to respect your body and health in the process. <\/p>\n\n\n\n However, as this brilliant viral Instagram post by Yates Nutrition<\/a> shows, positive, effective “intuitive eating” can be difficult to achieve when your inner voice has been dominated by years of “dieting, tracking, bingeing, emotional eating, and… food obsession,” so it’s recommended that you undertake this approach with the help of someone who can help you recognize your triggers, and unlearn your harmful feelings and thought patterns towards food. <\/p>\n\n\n\n What if you could eat food for its health benefits and enjoyment rather than for how it will impact your weight? What if you could go for a run without thinking \u201cHow many calories did I just burn?\u201d<\/p>\n\n\n\n Dieting, especially in the female population, can lead to many undesired health outcomes. Our healthcare system\u2019s emphasis on weight loss as a means to cure conditions has the potential to be futile and even harmful. <\/p>\n\n\n\n If weight loss is a primary goal in your health journey, consider shifting the focus of your diet or exercise changes from weight loss to that of health – feeling better throughout the day; having more energy; feeling better in your body; or experiencing less undesirable symptoms. It may greatly benefit not only your mental health, but also your physical health<\/a> [11].<\/p>\n\n\n\n If weight loss is a primary goal in your health journey, consider shifting the focus of your diet or exercise changes from weight loss to that of health – feeling better throughout the day; having more energy; feeling better in your body; or experiencing less undesirable symptoms. <\/p><\/blockquote><\/figure>\n\n\n\n Whether you suffer from disordered eating or an eating disorder, there are professionals who can support you. Mental health therapists and eating disorder informed registered dietitians are trained to work through these sensitive topics in a compassionate, comprehensive manner. It can also be helpful to find a trusted friend or relative to confide in.<\/p>\n\n\n\n If you are interested in learning more yourself, or are concerned for a loved one, the National Eating Disorder Association (NEDA)<\/a> offers education and tools, as well as where to find support in your area. This article also offers a comprehensive list of inclusive eating disorder therapists, dietitians, and advocates<\/a> who offer education and support on their Instagram platforms.<\/p>\n\n\n\n Disordered eating runs rampant in our society as a result of a weight- and image-focused culture. Our food culture also promotes instant gratification, which can make the pursuit of mindful and intuitive eating seem futile. But this doesn\u2019t have to be how you live your life. Non-disordered eating, sometimes referred to as \u201cnormal\u201d eating<\/a>, should not be stressful and is not tied to an ideal weight or body. It is choosing food because you enjoy it, and not feeling guilt. It is eating enough food, and sometimes overeating, but not punishing yourself when you do. It is eating to give your body nutrition, while not overly restricting yourself from food that is not as nutritious. It is trusting your body to tell you when you\u2019re hungry and when you\u2019re full. It is flexible.<\/p>\n\n\n\n If you believe you could benefit from an improved relationship with food, there are people to help. You don\u2019t have to go through it alone.<\/p>\n\n\n\n References<\/strong><\/p>\n\n\n\nWhat is disordered eating?<\/span><\/h2>\n\n\n\n
How does disordered eating develop?<\/span><\/h3>\n\n\n\n
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What are the impacts of disordered eating?<\/span><\/h2>\n\n\n\n
Disordered eating can lead to eating disorders<\/span><\/h3>\n\n\n\n
Disordered eating can contribute to a variety of metabolic symptoms<\/span><\/h3>\n\n\n\n
Disordered eating can impact hormonal health, and vice versa<\/span><\/h3>\n\n\n\n
A note on special diets for hormone balance, endometriosis, PCOS, etc.<\/span><\/h3>\n\n\n\n
How a healthy relationship with food is possible<\/span><\/h2>\n\n\n\n
Explore “intuitive eating” (with help)<\/span><\/h3>\n\n\n\n
Shift the focus from weight to health behaviors<\/span><\/h3>\n\n\n\n
Finding support<\/span><\/h3>\n\n\n\n
Bottom line<\/span><\/h2>\n\n\n\n
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