Problematic eating habits and patterns are present in both eating disorders and disordered eating - but these are not the same thing, says integrative counsellor and psychology of eating coach Jo Lloyd, from our Salisbury rooms...
Disordered eating refers to a range of eating behaviours often with a distorted mindset around eating, food, weight, body shape and appearance. Such behaviours might include restricting food, dieting, fasting, binge eating, purging, skipping meals, use of laxatives and other weight loss medications (such as the booming industry for GLP-1 agonists such as Ozempic and Wegovy).
At this point you might be wondering therefore what an eating disorder is, imagining that it might include some of the behaviours outlined above. It is not the behaviours themselves that dictate the “label’ but the frequency, duration and severity. To reach a clinical classification and diagnosable eating disorder these measures have to meet a certain level. They might also include compensatory behaviour such as over exercising and issues such as body image distortion. Eating disorders are complex in nature with enduring disruptions to eating behaviours, mental wellbeing and functioning. Such disorders include anorexia nervosa, avoidant restrictive food intake disorder (ARFID), binge eating disorder, bulimia, orthorexia and PICA (eating non-food substances) as well as other specified feeding or eating disorder (OSFED).
Clients with an eating disorder or disordered eating will both exhibit psychological distress but those with an eating disorder often experience medical and physical problems with negative impacts on areas of life such as work and relationships as well as greater implications on mental wellbeing in terms of anxiety or depression.
Why does the distinction matter? It matters because if we are working ethically, any engagement with clients affected by food related issues should be within our competencies. I have been a qualified counsellor for many years and a decade ago I also qualified as a Psychology of Eating Coach (US based training). I work successfully with many clients around emotional eating, relationships with food and disordered eating but if I suspect a diagnosable eating disorder such as anorexia then I look to seek additional support for my client. Why? Because anorexia has the highest mortality rate of any mental disorder, with some research findings showing 10 per cent of people with anorexia dying within ten years of diagnosis because of heart issues, endocrine disorders, gastrointestinal disease and suicide. Getting the right help is paramount.
On a more positive note the distinction also matters because if we can confidently assess that a client has disordered eating, not an eating disorder, we can safely work with them and have an effective impact on their food “journey”. It is known that disordered eating is a risk factor to developing an eating disorder so early intervention makes a real difference and tackling the psychological hurt, damage, trauma or emotions behind the disordered eating is a skill set that counsellors and therapists can bring.
Jo Lloyd MBACP(accred) is an integrative counsellor and Psychology of Eating Coach working from The Practice Rooms Salisbury and nationwide/globally via video help@jolloydtherapy.com www.jolloydtherapy.com
(Eating Disorder Statistics: South Carolina Department of Mental Health, state.sc.us/dmh/anorexia/statistics.htm)
