Does Body Size Determine If an Eating Behavior is Disordered?
Disordered eating is difficult to define when it is often disguised as a “diet” or masked by the skewed perception of what a disordered body should look like. Whether it is restricting food or reactive eating that develops from deprivation, these behaviors are our body’s way of trying to signal that something is wrong. Ironically, instead of seeing these as red flags, they can be normalized by society to control body size.
It’s important to realize that restrictive behaviors such as dieting look exactly the same as a restrictive eating disorder: counting or tracking calories, skipping meals, depriving the body of nutrients, and checking weight obsessively.
What's interesting is that depending on the person’s body size, we perceive these behaviors differently. If a person appears emaciated, then the behaviors are deemed disordered. If a person appears any other size, then the behaviors are labeled as “dieting.” This is especially problematic for people recovering from a restrictive eating disorder, such as anorexia nervosa, when the message becomes, “heal and gain weight, but not too much weight.”
What?! So basically, “save your life from an eating disorder, but don’t get fat?!” To be clear, being fat is not pathological and is not the determining factor for when to stop recovery. I am sad to say this is more common than not in health care.
Conversely, bingeing or reactive eating is sometimes even encouraged in those recovering from a restrictive eating disorder who are severely underweight as a means for weight restoration. What people fail to realize is that bingeing is a defensive mechanism of the body and is itself a disordered behavior. Ignoring this or any other disordered behavior can lead to persistence of the eating disorder instead of a full recovery.
Bingeing is independent of weight or size. When the body feels it has been deprived, either physically or mentally, reactionary eating is almost inevitable. Even if the body is being fed, if part of the brain still feels that some foods are off limits or is emotionally deprived, there is the potential to binge. Disordered eating comes full circle when bingeing encourages the same restrictive behavior that you are trying to eradicate. For many, a hangover day of restriction follows a night of bingeing. Working with a professional to develop more effective coping mechanisms helps to shift away from both disordered behaviors.
A similar problem arises when when autonomic processes of the body are manipulated to attempt to control body size. However, if you turn off these signals, the body can’t function properly. Imagine walking outside in 95 degree weather and not being able to sweat or if your body couldn’t tell you when your bladder is full. Hunger is no different, yet there are prescriptions for appetite suppressants. Turning off someone’s ability to recognize hunger doesn’t make them healthier. Rather, it starves their cells of nutrients, which then interrupts necessary signals from the gut to the brain and continues the domino effect of disordered behaviors. Another factor to note, I never see appetite suppressants prescribed to someone in a smaller body.
It is apparent that minimizing disordered behaviors or even prescribing them to manipulate body size doesn’t equal health or recovery. We can’t dismiss one disordered behavior to “gain weight,” just like we can’t use a disordered behavior to “lose weight.” (listen to these episodes of Food Psych!) Instead, we should offer solutions that don’t try to control weight, but address the underlying contributing factors. Eradicating all disordered behaviors leads to the body’s ability to heal and find a stable set-point. Cultivating a better relationship with food and working toward body acceptance are gold standards in eating disorder recovery, and this is possible for anyone at any size.
If you feel you may be struggling with disordered eating and are needing more support, connect with me today! If you are struggling with an eating disorder but unsure where to get help, consider calling the toll-free helpline at the National Eating Disorder Association at 1-800-931-2237.