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’s relationships with food.
“If I keep chips in the house, they’d be gone in an hour.”
“I gain weight just looking at a slice of pizza!”
“I eat so well in the morning, but by the time I get home, I eat everything in sight!”
“I just need to lose x amount of weight before my trip.”
Do any of these sound like something you’ve said? If so, I promise you’re not alone. In fact, in the United States, 69-84% of women experience body dissatisfaction, desiring to be a lower weight than they currently are [1], and 45% of women are on a diet. One shocking survey from 2011 a constaté que thirty percent of women studying at British universities would trade au moins one year of their life to achieve their ideal body weight and shape. [2]
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’s a grand total of 75% of American women who struggle with eating, one of our body’s most important needs.
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’s a grand total of 75% of American women who struggle with eating, one of our body’s most important needs.
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.
What is disordered eating?
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.
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.
Even if someone does not meet the criteria for an eating disorder diagnosis, disordered eating behaviors often cause anxiety and impact a person’s relationship with food, exercise, and/or their body. For this reason, I will use the term “disordered eating” to refer to all behaviors, regardless of severity. Anyone struggling with their relationship with food, exercise, or body deserves support.
How does disordered eating develop?
Disordered eating is influenced by biological, psychological, and social factors, 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.
- Biological factors: family history, history of dieting, Type 1 diabetes, parental substance use disorder, parental eating disorder history
- Psychological: low self-esteem, negative body image, perfectionism, psychological conditions such as depression, anxiety, OCD, PTSD, and substance use
- Social/Environmental: cultural norms, drive for the “ideal body,” weight stigma, fat shaming, family environment, discrimination, trauma, abuse, neglect
What are the impacts of disordered eating?
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.
Disordered eating can lead to eating disorders
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 “breaks the rules” 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.
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 “breaks the rules” 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.
Disordered eating can contribute to a variety of metabolic symptoms
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—body 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].
This effect can contribute to “weight cycling,” 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].
Weight cycling is poignantly illustrated in the Biggest Loser study, which followed 14 of the show’s contestants for six years. Cette étude found that, compared to baseline (before they started the season), the participants’ 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 cet article.
Disordered eating can impact hormonal health, and vice versa
Caloric restriction leaves the body with depleted energy stores, and can impact santé hormonale, leading to symptoms such as osteopenia or osteoporosis, amenorrhea, fertility changes, gastrointestinal issues, depression and/or anxiety, fatigue, and poor sleep quality. This Article sur la féminité naturelle underlines the importance of adequate caloric consumption in hormonal balance.
Not only does disordered eating impact hormone health, but hormone fluctuations and imbalances can also trigger disordered eating. The reproductive hormones, progesterone and estrogen, are both hugely impactful to our reproductive function, but they also have systemic physiological and psychological effects. 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 “feel-good hormones” dopamine and serotonin, and inhibiting ghrelin, our hunger hormone.
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.
In addition to their influence on appetite regulation, progesterone and estrogen levels also impact glucose metabolism and insulin sensitivity, leading to fluctuations in blood sugar and weight [5]. These changes throughout the menstrual cycle may be associé with emotional eating patterns [6].
A note on special diets for hormone balance, endometriosis, PCOS, etc.
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. They are also effective at en augmentation overall health promotion, metabolic and cognitive health, as well as chronic disease prevention and management [7].
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 “special diet,” many of which were inconsistent with evidence-based practices for PCOS. Additionally, only a quarter of women 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 [9,10].
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.
How a healthy relationship with food is possible
At this point, you might be thinking, “Oh my gosh, this sounds like me,” or “These behaviors all seem normal.” 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.
Explore “intuitive eating” (with help)
Developed by registered dietitians Evelyn Tribole and Elyse Resch, Intuitive Eating is an evidence-based non-diet approach to nutrition 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].
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 “food police,” how to move away from guilt and shame, how to enjoy food again; and how to respect your body and health in the process.
However, as this brilliant viral Instagram post by Yates Nutrition 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.
Shift the focus from weight to health behaviors
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 “How many calories did I just burn?”
Dieting, especially in the female population, can lead to many undesired health outcomes. Our healthcare system’s emphasis on weight loss as a means to cure conditions has the potential to be futile and even harmful.
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 [11].
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.
Finding support
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.
If you are interested in learning more yourself, or are concerned for a loved one, the National Eating Disorder Association (NEDA) 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 who offer education and support on their Instagram platforms.
Résultat
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’t have to be how you live your life. Non-disordered eating, sometimes referred to as “normal” eating, 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’re hungry and when you’re full. It is flexible.
If you believe you could benefit from an improved relationship with food, there are people to help. You don’t have to go through it alone.
Références
- Runfola, C.D., Von Holle, A., Trace, S.E., Brownley, K.A., Hofmeier, S.M., Gagne, D.A. and Bulik, C.M. (2013), Body Dissatisfaction in Women Across the Lifespan: Results of the UNC-SELF and Gender and Body Image (GABI) Studies. Eur. Eat. Disorders Rev., 21: 52-59. https://doi.org/10.1002/erv.2201
- University of the West of England. (2011, May 26). Thirty percent of women would trade at least one year of their life to achieve their ideal body weight and shape, UK study finds. ScienceDaily. Retrieved February 18, 2026 from www.sciencedaily.com/releases/2011/04/110404110812.htm
- Tribole, E., & Resch, E. (2020). Intuitive eating: A revolutionary anti-diet approach (4th ed.). St. Martin’s Essentials.
- Fothergill E, Guo J, Howard L, Kerns JC, Knuth ND, Brychta R, Chen KY, Skarulis MC, Walter M, Walter PJ, Hall KD. Persistent metabolic adaptation 6 years after “The Biggest Loser” competition. Obesity (Silver Spring). 2016 Aug;24(8):1612-9. doi: 10.1002/oby.21538. Epub 2016 May 2. PMID: 27136388; PMCID: PMC4989512.
- Jesús Miguel Escalante Pulido, Melchor Alpizar Salazar. Changes in Insulin Sensitivity, Secretion and Glucose Effectiveness During Menstrual Cycle, Archives of Medical Research, Volume 30, Issue 1, 1999, Pages 19-22, ISSN 0188-4409, https://doi.org/10.1016/S0188-0128(98)00008-6.
- Klump KL, Keel PK, Racine SE, Burt SA, Neale M, Sisk CL, Boker S, Hu JY. The interactive effects of estrogen and progesterone on changes in emotional eating across the menstrual cycle. J Abnorm Psychol. 2013 Feb;122(1):131-7. doi: 10.1037/a0029524. Epub 2012 Aug 13. Erratum in: J Abnorm Psychol. 2013 Feb;122(1):137. Burt, Alexandra S [corrected to Burt, S Alexandra]. PMID: 22889242; PMCID: PMC3570621.
- Yu X, Pu H, Voss M. Overview of anti-inflammatory diets and their promising effects on non-communicable diseases. Br J Nutr. 2024 Oct 14;132(7):898-918. doi: 10.1017/S0007114524001405. Epub 2024 Oct 16. PMID: 39411832; PMCID: PMC11576095.
- Cowan S, Grassi A, Monahan Couch L, Jeanes Y, Lim S, Pirotta S, Harris J, McGirr C, Moran L. Evidence-Based Lifestyle Guidelines and Self-Management Strategies Utilized by Women with Polycystic Ovary Syndrome. Nutrients. 2023 Jan 22;15(3):589. doi: 10.3390/nu15030589. PMID: 36771296; PMCID: PMC9919009.
- Başar Gökcen, B., Akdevelioğlu, Y., Canan, S., & Bozkurt, N. (2020). Increased risk of eating disorders in women with polycystic ovary syndrome: a case-control study. Endocrinologie gynécologique, 36(9), 764–767. https://doi.org/10.1080/09513590.2020.1744554
- Infertility and eating disorders. Stewart, Donna E. et al. American Journal of Obstetrics & Gynecology, Volume 163, Issue 4, 1196 – 1199
- Gaesser GA, Angadi SS. Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience. 2021 Sep 20;24(10):102995. doi: 10.1016/j.isci.2021.102995. PMID: 34755078; PMCID: PMC8560549.
