What’s the difference between an eating disorder and a diet? With one considered a mental disorder and the other normalized as something everyone is doing or trying to do, they may seem an ocean apart.
But the line between an eating disorder and disordered eating is not as clear as you might think.
With thinness as the “beauty ideal,” our society paints weight-loss diets as safe and normal. We believe it’s healthy to strive for a size or weight that’s “right” for us according to a chart. And we end up believing hunger is a bad thing or a sign of failure.
It doesn’t help that diet culture reinforces this belief by treating restriction as healthy (or that it plants this idea in our minds in the first place).
But if a person has a genetic predisposition to an eating disorder, even casual dieting could be a trigger that leads to an extreme: an eating disorder with life-threatening consequences. The image of this that we see in the media, everywhere from Netflix to Lifetime, is a specific type of person: thin, white, young, middle-class or higher, and most often female.
But this stereotype overshadows a truth we need to hear: Hunger is our body’s way of fighting against dieting and eating disorders.
And when we neglect to consider fat bodies in favor of the stereotype, we create space for eating disorders to flourish unnoticed. When our society sees a certain body size as ideal, it becomes unconcerned with what people do to achieve that ideal.
When society paints fat people as people who eat too much, who should be on a restricted diet, it overlooks the fact that ignoring hunger cues can fuel disordered eating and eating disorders.
And this fatphobic behavior drastically affects people in larger bodies because sometimes, even when those people have eating disorders, doctors prescribe portion control, calorie counting, or even limits on the types of foods to be eaten — supposedly for “higher-priority” health reasons.
But that’s still food restriction. And restriction only reinforces the eating disorder’s voice and weakens a person’s connection with their body.
(Granted, restriction isn’t the recommended approach, but the reality is that weight bias still shows up in medical professionals.)
Fat folks engaging in dieting and restriction may never look as emaciated as Netflix’s “To the Bone”portrayal of anorexia, but that doesn’t mean they’re in less danger of medical complications from an eating disorder, that they don’t deserve the same treatment thinner folks get, or that their relationship with food and their body is any healthier than those of people who look stereotypically disordered.
In fact, based on how much more often anorexia and bulimia are portrayed in TV and movies than other forms of eating disorders, you would think that they have the highest rates of incidence.
But it’s actually the less commonly known eating disorders that are the most prevalent:
- purging disorder — 3.4%
- binge eating disorder — 3.0%
- atypical anorexia — 2.8%
Anorexia and bulimia have prevalence rates of 0.8% and 2.6%, respectively.
(There are also subclinical levels of eating disorders, or less frequent behaviors that may be missing some criteria of other eating disorders. The general category for these eating disorders is called OSFED.)
And when obsessing over food restriction is normalized, it becomes harder to see that diet culture is inherently disordered.
When anorexia and bulimia become the face of eating disorders, it can make fat folks think they’ve achieved a “normal weight,” have their eating disorder reaffirmed as a good thing, or feel a need to keep “dieting” and get thinner. They may start believing that ignoring their hunger cues is a healthy thing to do.
Sometimes the problem is the stigma connected with eating disorders. For example, the term “binge eating disorder” gives weight to the belief that the bingeing is the problem, but dieting alone naturally leads to bingeing.
It is the most normal and healthy thing in the world to binge or overeat when you are restricted.
The human body is evolved to save itself when there’s a risk of starvation by releasing a hormonal flood that makes us feel hungrier and get full less easily in order to keep us searching for food. And as soon as there’s a crack in our resistance when we diet — just like stumbling upon a source of food in a famine — we feel a need to eat.
Another word for this? Yo-yo dieting. A sign that your body is doing what it needs to in order to protect you, to store energy and prevent starvation.
Now imagine how our bodies feel when we do this again and again.
In restriction, our bodies feel in crisis from a loss of nutritional support and safety from stored calories. Then our bodies become very efficient at releasing the hormones that are likely to make us eat, at sending signals for us to seek out food and eat a lot.
But bingeing or eating more, for most, is a normal bodily reaction.
The problem isn’t and never was body size. It’s our expectations of people’s bodies and the belief that some bodies are better than others. Anorexia should never be an eating disorder we “wish” we had, and neither should binge-eating be portrayed as only a fat person’s experience.
In the same way, we need to stop putting eating disorders on a hierarchy. Dieting, including yo-yo dieting, is on that hierarchy, too. It’s a hierarchy of societally acceptable disordered eating. No eating disorder is better to have than another. They are all life-altering, miserable, dangerous, and awful.
Binge-eating does not mean you are a bad dieter and need to try harder. Atypical anorexia or any other eating disorder in a larger body is not a sign that you deserve to refeed less than your peers with a lower body weight. And there isn’t a point in your recovery when you need to start worrying about your intake being too much.
Restricting does not need to have a place in your recovery or your life in any way — in fact, restriction has been near the root of the problem all along.
Amee Severson is a registered dietitian whose work focuses on body positivity, fat acceptance, and intuitive eating through a social justice lens. Learn more and inquire about services at her website, Prosper Nutrition and Wellness.