Do you have an unhealthy relationship with food?

Eating disorders don’t discriminate. Any person, regardless of age, gender, or background, can develop an eating disorder, which is a serious, complex mental health condition where a person develops unhealthy eating behaviors and distorted thoughts about food, weight, and body image. 

These disorders, which are influenced by psychological, genetic, and social factors, often involve extreme food restriction, binge eating, purging, avoidance of certain foods, and distorted body image. 

According to Rachel Williams, LCSW, Clinical Lead Therapist at Loma Linda University Behavioral Health, an unhealthy relationship with food often stems from how a person copes with stress or traumatic events.

"How we handle stress or trauma can sometimes manifest as an eating disorder, whether through excessive food consumption, obsessive healthy eating, or avoidance or restriction of food,” Williams says. “This often ties into body image as well."

While many people associate eating disorders primarily with under-eating, an unhealthy relationship with food encompasses a spectrum of behaviors, including restrictive eating, purging, binge eating, and food avoidance.

Types of eating disorders

There are four primary eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder. Below, Williams addresses the different eating disorders and their warning signs. 

Anorexia nervosa

Characterized by extreme food restriction, anorexia is an intense fear of gaining weight and a distorted body image. Those with anorexia nervosa often restrict their food intake so severely that they do not have enough daily calories or nutrients to properly fuel the body.

Signs of anorexia nervosa can include:

• Severely limit their food intake

• Excessive exercise

• Binge and/or purging behaviors such as vomiting or using laxatives 

Anorexia nervosa can lead to severe physical and psychological health complications, including malnutrition, heart problems, and organ failure.

Bulimia nervosa

Bulimia involves cycles of binge eating followed by behaviors such as vomiting, excessive exercise, or laxative use. Individuals with bulimia often feel a lack of control over their eating during binges and may experience intense guilt, shame, or distress afterward.

Unlike anorexia, those struggling with bulimia typically maintain a relatively normal weight, making it harder to detect. The disorder can have serious physical consequences, including digestive issues, electrolyte imbalances, heart complications, and damage to the throat and teeth from frequent vomiting.

Binge eating disorder

Individuals who binge eat consume excessive amounts of food in a short period of time but do not engage in purging behaviors. “It’s almost like a loss of control or not being able to help eating in excess,” Williams says of binge eating disorder. 

Signs of binge eating can include:

• Eating rapidly and feeling out of control during binges

• Eating even when not hungry

• Feeling guilty, ashamed, or distressed after overeating

• Frequently eating alone due to embarrassment

Avoidant/restrictive food intake disorder (ARFID)

Those with ARFID tend to lack interest in food, or they avoid certain foods due to sensory sensitivities.

“ARFID involves sensory issues with types of food a person encounters or a lack of interest in certain foods,” Williams says. “This can be due to a person's intense fear of choking, vomiting, or not liking the texture of the food.” 

Indications of an eating disorder

Individuals struggling with an eating disorder often exhibit behavioral, physical, and emotional signs, such as:

• Behavioral: Secrecy around eating, excessive focus on healthy eating, over-exercising, sudden dietary changes, frequent trips to the restroom after eating, over-exercising, social withdrawal, or avoiding social situations involving food. 

• Physical: Rapid weight fluctuations, thinning hair, brittle nails, frequent dizziness, feeling cold often, or gastrointestinal issues.

• Emotional: Mood swings, low self-esteem, perfectionism, extreme fear of weight gain, or reliance on food-related rituals.

The influence of society on disordered eating habits

There are numerous external factors that can lead to a person developing an eating disorder, such as social media, family, and society. 

“Social media is obsessed with wellness and diet culture,” Williams says. “Also, families, sometimes unknowingly, reinforce the idea that thinness equals beauty.” 

Additionally, society fosters these pressures, making people feel they must look a certain way to gain attention, love, or success.

Providing support and seeking help

Overcoming an eating disorder requires professional intervention. Treatment options include therapy, support groups, dietitian guidance, and specialized treatment programs. Williams advises loved ones to approach the topic with care but be a part of the recovery process.

“I always say to my patients that eating disorders are a family affair,” she says. “Rarely does someone want to admit that they're going through a rough patch.”