The dangers of disordered eating: Why your attitude towards food matters

When you think of harmful eating habits, eating disorders such as anorexia or bulimia might come to mind. What you might not realise is that trying fad diets or cutting out certain foods for no reason could be as bad – and could actually lead to eating disorders in the long run. This is known as disordered eating.

Thian Ai Ling, Principal Dietitian (Clinical) at Singapore General Hospital, explains that disordered eating refers to a spectrum of problematic eating behaviours and distorted attitudes and perceptions towards food, weight and body image. 

“Individuals with disordered eating may engage in compensatory behaviours which may range from being mild like minimising intake of food to more complex in nature such as purging and excessive exercising, excessive use of weight loss medications and/or products, diuretics and laxatives,” she adds.

Henny Irawan Tan, Senior Clinical Psychologist at Promises Healthcare, cites some examples of disordered eating – having strict and rigid rules or restrictions around eating without a medical reason (such as cutting out an entire food group), skipping meals, binge-eating, avoiding certain foods with specific colours or textures, excessive preoccupation with calorie counting of food intake, as well as going on a fad diet or a juice cleanse. Taking diet pills and engaging in compensatory or compulsive exercise to “make up” for food that was eaten are also examples of disordered eating.

Henny says the main difference between disordered eating and having an eating disorder is the frequency, duration and severity of the disordered eating habits. 

“For an eating disorder to be diagnosed, there are specific criteria – according to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) – to be met for each of them,” she explains. “Some individuals have disordered eating habits but may not meet the full threshold of an eating disorder diagnosis.”

Ai Ling adds that disordered eating patterns usually are less severe or frequent to meet the diagnostic criteria for eating disorders defined by the American Psychiatric Association. 

How does disordered eating affect your health?

Engaging in disordered eating habits doesn’t necessarily mean you’ll develop an eating disorder. However, disordered eating patterns will increase the risk of not just eating disorders but several other health issues too. Ai Ling mentions a few of them – obesity, metabolic syndrome, osteopenia/ osteoporosis, gastrointestinal problems, electrolytes and fluid imbalance, irregular heartbeat and low blood pressure. Cutting out specific food groups from your diet also has an impact on cognitive function and concentration.

“Individuals who suffer from disordered eating patterns may not be fully aware of its harmful effects and sometimes may even choose to ignore even if they have experienced the signs and symptoms,” says Ai Ling. 

The harmful mental health effects of disordered eating include anxiety about food and eating, excessive preoccupation about food, body weight and body shape, as well as increased body dissatisfaction and body image concerns, says Henny. Some individuals also experience low mood, feelings of guilt and shame, fatigue and social withdrawal.

Henny explains that individuals with low self-esteem, body dissatisfaction and internalised thin socio-cultural ideals are more likely to develop disordered eating.

“Experiencing weight stigma or discrimination as well as traumatic experiences such as being bullied or teased, or abuse, may be possible triggers for disordered eating,” says Henny. “Other triggers include social influences, social media use, as well as emotional factors such as stress, anxiety, guilt and shame.”

Cultivating a positive body image 

It’s important to note that, just because you try the odd fad diet every now and then, it doesn’t mean that you are following a disordered eating pattern. There are several behaviours that meet this condition. 

Ai Ling lists some of them:

• Rigid rituals and routines surrounding food and exercise, e.g. clean eating, no food intake after certain time, compulsive exercise 
• Excessive counting or tracking of calorie intake 
• Chewing and spitting of food  
• Avoidance of specific foods or social eating 
• Feelings of guilt and shame associated with eating or gatherings 
• Preoccupation with food, weight and body image that negatively impacts quality of life and daily activities 
• Chronic weight fluctuations 
• Compensating intake of ‘taboo foods’ with food restriction, exercise, self-induced purging or medications including laxatives, diuretics or slimming products

If you think you could be prone to disordered eating or already practice it, the dietician recommends ways to prevent or cope with it. “Understand the importance of different food groups and a healthy balanced diet from reliable sources,” Ai Ling advises. “Do not label food as ‘good’ or ‘bad. Also, eat a wide variety of food including nutrient dense food and food for pleasure eating.”

It’s also important to cultivate a healthy relationship with food by practising intuitive eating. Plus, eat at regular intervals and make time for meals and snacks. Emotional eating is a big no so try deep breathing, meditation or other stress management practices as these will help prevent eating as a coping mechanism and reduce disordered eating, she says.

“Additionally, do not engage in ‘fat’ talk; recognise that health and well-being come in different sizes and shapes,” says Ai Ling. “Avoid excessive body checking or weighing. Stay active and limit exposure to diet culture.”

And if you need tips on how to be more positive about your body, Henny has the following advice:

• Engage in physical activities that you find enjoyable instead of focusing on burning calories or losing weight.
• Be kind to yourself. Stop comparing yourself with others as everyone is different. We can learn to respect our bodies by challenging any unrealistic expectations and excessive criticisms we have towards our appearance and weight.
• Take a social media break if you notice you’re feeling overwhelmed. Delete and unfollow content that focuses on fad diets, glorifies being thin or perpetuates weight stigma.
• Do something nice for your body such as getting a massage, taking a bubble bath, doing a body scrub or simply getting more rest when your body is tired.