When Dieting Goes Too Far: Eating Disorder Therapy for Anorexia Recovery
I often get asked, “How do I know if it’s just a diet or an eating disorder?” This post aims to answer that question. If you want the summary: sometimes it’s hard to tell. Keep reading to learn how to differentiate between diets and eating disorders, diet culture, how to know if someone has anorexia, and what to do about it.
So what’s a diet?
A diet (at least how it’s most commonly referred to in American pop culture) is a plan or program of eating and/or exercise to lose weight by reducing the amount of calories consumed. Basically, diets work by restricting the amount of energy available to one’s body with the hopes of creating a deficit so the body relies on its own cannibalization (i.e. burning muscle and/or fat cells) to survive. The result (sometimes) is weight loss, but it’s not usually long-lasting.
Once people stop dieting, they gain the weight back. At times, more because often their metabolism slows down and the body hangs on to extra weight as a survival tactic. Our bodies aren’t trying to sabotage us when it keeps on weight. This phenomenon has been hardwired into our biology to protect our ancestors from famine and disease.
What is diet culture?
Diet culture refers to a set of beliefs and practices that prioritize thinness, weight loss, and restrictive eating habits as markers of health and moral virtue. It often promotes the idea that certain bodies are more desirable or worthy than others based on their size or shape. This culture tends to perpetuate harmful attitudes toward food, body image, and self-worth.
In diet culture, people are encouraged to pursue weight loss through various means. This includes restrictive diets, extreme exercise regimens, or the use of weight loss supplements. This emphasis on thinness can lead to the development of disordered eating patterns, low self-esteem, and negative body image.
Diet culture’s narrow focus on thinness as healthy, better, more beautiful, etc. is harmful. It perpetuates systemic issues related to body shaming, fatphobia, and weight discrimination. Diet culture can be seen through the media, how people talk about weight and health, and the glamorization of thin bodies and food rules in pop culture.
What’s an eating disorder?
An eating disorder is a clinically diagnosable psychological (and research also suggests physical) disorder characterized by severe disturbances in eating habits that affect folks physically. People with eating disorders experience distressing thoughts and emotions often centered on food and body. Find out more specifics via the National Eating Disorders Association.
What is anorexia?
Anorexia nervosa, commonly referred to as anorexia, is a serious and potentially life-threatening eating disorder. It is characterized by an intense fear of gaining weight and a distorted body image. People with anorexia typically restrict their food intake, often to the point of starvation, despite being significantly underweight.
Common signs and symptoms of anorexia include:
Extreme restriction of food intake. Individuals with anorexia severely limit the amount of food they eat, often restricting entire food groups or obsessively counting calories.
Intense fear of gaining weight. Even if they are underweight, people with anorexia have an irrational fear of gaining weight or becoming fat.
Distorted body image. They perceive themselves as overweight, even when they are extremely thin, and may engage in behaviors like excessive exercise to try to lose more weight.
Denial of the seriousness of low body weight. Many individuals with anorexia may not recognize or admit that they are dangerously underweight.
Physical symptoms. These can include extreme weight loss, fatigue, dizziness, and fainting. In addition to irregular menstruation (in people who have periods), sensitivity to cold, decreased organ function, slower heartbeat, and hair loss, among others.
How do I know if a diet has turned into an eating disorder?
Sometimes dieting goes too far. The National Eating Disorders Association found that 35% of people who dieted became obsessed with food and body image. They also found that 20-25% of dieters developed an eating disorder. Nearly all people who have eating disorders start by dieting.
That said, many people who experience disordered eating, chronic dieting, over-exercising, purging, binging, obsession/compulsion, and general self-loathing about food and/or their body may not completely meet DSM (the diagnostic manual for mental health issues) eating disorder criteria.
Just because someone may not meet diagnostic criteria, the distress they feel can impact their daily functioning or relationships. Subclinical eating disorders and general disordered eating are still serious concerns that cause harm both to the person dealing with them and the activities and people they value.
The biggest way to tell whether or not someone has a problem is by looking at the level of distress, time, money, energy, thought, and feeling that food/body stuff takes up in one’s life. High preoccupation often means a high probability of disordered eating or an eating disorder.
Ask yourself the following:
Are they missing out on socializing because fear of foods or activities not fitting into their diet?
Do they always bring their own food to gatherings because what’s available isn’t compliant with their newest meal plan?
Is dieting, food, exercise, or their body something they can’t stop talking or thinking about?
Does it cause worry stress or guilt to think about missing workouts or not complying with a program/lifestyle?
Are there food prep or exercise things that have to be done a certain way or else there’s worry, shame, or guilt?
Do they get defensive when people don’t engage in talking about or disagree with the latest diet or exercise plan?
Are they always on the hunt for the next “biohack,” supplement, exercise routine, superfood, or food to eliminate due to assumed intolerance?
Do they worry about weight, fat, or muscle composition and does that affect their mood?
Is their day deemed “good” or “bad” based on what they’ve eaten or if they exercised?
Are foods labeled “good,” “bad,” “clean,” “dirty,” “healthy,” “unhealthy,” “processed,” “cheat meals,” etc.—basically, do foods have moral value?
Are they spending a lot of time exercising and how do they feel if they miss a workout or don’t work out “hard enough”?
Is exercise primarily about weight/body change?
Do they body check often on reflective surfaces or by pinching/squeezing/feeling their body?
Do they weigh themselves often and does the number on the scale (or body measurement) affect their mood?
Are they able to stop dieting and let go of food rules?
Do they continue to think they have more weight to lose despite previous weight loss?
The more “yes” answers to these questions, the higher the likelihood you or someone you know has an eating disorder like anorexia.
Even if there has not been a drastic shift in weight, body size, or shape, people can still have anorexia. Again, the level of distress, time, energy, and thought put into weight, food, and body behaviors can indicate an eating disorder. Moreover, folks may have unseen nutritional deficits that warrant medical intervention even if they are in a bigger body or don’t look like they have an eating disorder. There’s no “look” to disordered eating.
If you look at this list and think, “What’s wrong with that? I do some of those things.” you’re not alone. Diet culture has pervaded our vernacular so much that we don’t bat an eye when people do some of these behaviors.
But let’s get real. These thoughts, feelings, and high levels of distress diets and eating disorders can create are NOT NORMAL. As a culture, we have to find our way back to neutral. Just because there’s no diagnosis and diet behaviors become a social norm doesn’t mean it’s normal.
What do I do if I or someone I love has an eating disorder?
Diets, disordered eating, and full-blown eating disorders create body distrust, damage interpersonal relationships, and keep folks from living full lives. If you notice that you or someone you love fits the criteria in this post, I encourage you to reach out for support.
Here are a few national eating disorder resources:
National Eating Disorders Association helpline and screening tools
Eating Recovery Center resources for families, patients, and treatment center info
Eating Disorder Hope list of treatment centers and resources
Another way to get started is by ditching diet culture.
How to ditch diet culture?
Ditching diet culture means letting go of the idea that thin = healthy. It involves adopting a more positive and balanced approach to food, body image, and overall health. Here are some steps you can take to break free from diet culture:
Reject the diet mentality: Challenge the idea that thinness equals health and worth. Recognize that restrictive dieting is not sustainable or healthy in the long term.
Focus on health, not weight: Shift your focus from weight loss to overall well-being. Prioritize nourishing your body with nutritious foods, staying physically active in ways that you enjoy, and getting enough rest.
Cultivate body acceptance: Appreciate your body for what it can do rather than how it looks. Challenge negative thoughts about your body and practice self-compassion.
Diversify your social media feed: Follow accounts that promote body positivity, intuitive eating, and a healthy relationship with food and exercise. Unfollow or mute accounts that perpetuate diet culture or unrealistic body standards.
Seek support: Surround yourself with friends, family, or support groups who share your values and can provide encouragement and understanding as you navigate away from diet culture.
Educate yourself: Learn about the harmful effects of diet culture and the benefits of embracing a non-diet approach to health. Stay informed about body diversity, fat acceptance, and the social justice aspects of body image.
Challenge societal norms: Speak out against weight stigma and discrimination. Advocate for inclusive healthcare, workplaces, and communities that respect people of all shapes and sizes.
Remember that breaking free from diet culture and eating disorders is a journey. It’s okay to seek professional help from eating disorder therapists, dietitians, or other experts if you need support along the way. Embracing a more compassionate and holistic approach to health can lead to greater well-being and a more positive relationship with yourself and others.
You’re also welcome to contact me if you’re ready to find more peace with your body and food. You don’t have to suffer. At my Raleigh, NC practice, I can help.
Begin online eating disorder therapy today!
If you're grappling with whether it's merely a diet or potentially an eating disorder, know that you're not alone in this uncertainty. Understanding the nuances between the two can be tricky, but it's crucial to seek support and guidance as you navigate this journey. And if you're ready to begin the journey toward healing and self-discovery, I'm here to help.
Contact me today to schedule a consultation so I can get to know you.
Read more about my approach here.
Reclaim your relationship with food and your body in eating disorder therapy!
Other services I offer anywhere in North Carolina:
At Counselor Kate, my goal is to provide compassionate support to help individuals process and release trauma stored in the body with trauma and somatic therapy. Rediscover a harmonious relationship between food and your body through my intuitive eating services!