6 Warning Signs of Disordered Eating

Written by Amanda Geradts, RD

Edited by Brooke Bulloch, RD

As a dietitian who specializes in eating disorders, I care about helping people to pick up on early signs of disordered eating to help reduce the risk of developing an eating disorder. While there can be many factors that contribute to eating disorder development from self-criticism to childhood trauma, studies show that body dissatisfaction and dieting are also high risk factors. Disordered eating behaviours (including dieting) are often the start of a slippery slope that put people at risk for eating disorder development.

An estimated 1 million Canadians have a diagnosed eating disorder, which may include:

• Anorexia Nervosa;
• Bulimia Nervosa;
• Binge Eating Disorder;
• Avoidant Restrictive Food Intake Disorder;
• Or Other Specified Feeding and Eating Disorder.

This number is almost certainly an underestimate as many people are never formally diagnosed. Additionally, since the start of the COVID-19 pandemic, eating disorders have been on the rise. In Saskatoon alone, pediatrician Dr. Kurji has reported a 30% increase in youth eating disorder community referrals. This is concerning knowing that eating disorders have the highest mortality rate of any mental health condition.

The trouble is, because disordered eating in the form of dieting is so normalized in our society, it can be difficult to pick up on red flags. Here are 6 warning signs of disordered eating:

1) Unusually heightened interest in food and/or exercise.

This is so tricky because behaviours such as taking an interest in grocery shopping and cooking, joining a new sport or activity, or becoming more particular about food in general (e.g. eating more fruit and vegetables) are often encouraged. After all, how we eat and move our bodies are important aspects of taking care of ourselves.

Where it becomes problematic is when interests in these topics turn into obsessions. For example, careful measuring or weighing of foods, meticulously inspecting food labels, refusing to eat previously enjoyed foods, and not being able to miss a day of activity could all be causes for concern.

2) Using moralizing language to describe food.

Labelling foods as "good", "bad", "healthy", "unhealthy", “clean” or “junk” attaches moral value to food being described in this way. Eating certain food is associated with being a “good” person, while other food is associated with being a “bad” person.

You might notice previously enjoyed foods such as potato chips, pasta, fast food, ice cream, and candy being described as "disgusting", “bad”, "gross", or "too high in…” (insert demonized nutrient). This is evidence that someone’s relationship with food is compromised. Moralizing food drives guilt, shame, restriction (with a growing list of forbidden foods) and/or binging.

3) Increased negativity about body weight and shape.

Everyone runs into insecurities about their body, but for some people thoughts about perceived flaws with their appearance can become so intense that they interfere with a person’s ability to engage in daily activities. Severe distress about one’s appearance is a mental health disorder which can lead to depression and suicidal thoughts if left untreated. Signs may include:

• Complaining about one’s own weight or size, and comparing their body to someone else’s;
• Negatively describing parts of their body such as arms, thighs, or belly;
• Talking about wanting to become "jacked", "ripped", "toned", or even “healthy”, with the focus on changing body shape.
  

This type of body talk is so normalized in our culture where weight bias (negative assumptions about people based on their weight, particularly fatter bodies) is so pervasive. Thus, it can be easy for this red flag to be missed.

4) Body checking.

Body checking is a maladaptive coping strategy used to reduce anxiety by people who are fearful of changes in their body weight or shape. Body checking behaviours can take on many forms such as pinching belly fat to see if it has increased, trying on different pairs of pants to see if any have gotten tighter, and checking weight multiple times daily. These behaviours are often done in secret, making them hard to notice.

Although these “checks” are used to reduce anxiety about body changes in the moment, body checking actually increases anxiety, depression, and body dissatisfaction.

5) Increased rigidity and lack of flexibility with food and eating.

A person may develop strict guidelines about what they will and will not eat. They eat the same foods day after day, refuse to eat outside of “allowed” times, or choose to only eat what they can prepare themselves (refusing food prepared by someone else). The individual may struggle to visit restaurants or attend social events because there is "nothing for them to eat", or they may bring their own food to avoid eating something deemed off limits.

6) Unusual eating behaviours.

When food intake is being restricted, unusual eating behaviours can ensue, which might look like:

• Choosing combinations of foods that are unusual compared to their previous eating habits (e.g. oatmeal with ketchup);
• Excessive use of condiments or spices;
• Excessive consumption of caffeine;
• Drinking excessive amounts of water or other fluids with meals or snacks;
• Using a different utensil (e.g. eating cereal with a fork or using the smallest spoon in the cutlery drawer);
• Cutting food into tiny pieces and taking very small bites;
• Trying to distract from how much they are eating. For example, allowing food to drop on the floor, spilling beverages, or hiding food under dishes or napkins.
  

There is no criteria a person must meet to be "sick enough" for support from a health professional. If you suspect that you are struggling with disordered eating you’re not alone, it’s not your fault, and all the complex feelings connected to or driving the disordered eating are valid. If you suspect a loved one may be struggling with disordered eating, it’s absolutely worth starting a conversation. Approach the individual with empathy, patience, and let them know you’re there to listen. Validate their fears and seek support from your health care provider.

At Food to Fit we have 3 registered dietitians - myself (Amanda), Dayna Berry, and Sydney Wright - and a clinical therapist (BSW) - Monique Roy - all experienced in eating disorders and mental health. We support clients based in Saskatoon, Regina and around Saskatchewan, virtually. We collaborate with other providers involved as well as families, and highly encourage a team approach to care and recovery.

References:

• How to Nourish Your Child Through an Eating Disorder by Casey Crosbie RD, CSSD and Wendy Sterling MS, RD, CSSD
• https://nied.ca/about-eating-disorders-in-canada/
• https://www.cbc.ca/news/canada/saskatchewan/eating-disorders-in-teens-and-children-getting-worse-pediatrician-1.6284521
• https://www.eatingdisorderhope.com/blog/eating-disorders-disordered-eating
• https://changecreateschange.com/body-checking/
• https://www.hopkinsmedicine.org/health/conditions-and-diseases/body-dysmorphic-disorder
• https://www.euro.who.int/__data/assets/pdf_file/0017/351026/WeightBias.pdf