What’s eating you?

Friday, March 30, 2012

YOUR diet’s healthy during the week, but you binge on junk food at the weekend. Guilty, you eat too little for the next five days, or you wait until 6pm to eat a solid meal.

Perhaps you’ve replaced meals with the lemonade diet (water mixed with maple syrup, lemon juice and cayenne pepper) a la Beyoncé, or resorted to Elizabeth Hurley’s tip of eating food with small cutlery off tiny plates.

You haven’t lost much weight — your BMI’s nowhere near the 17.5 that would label you anorexic — and you’re not bingeing-and-purging twice a week for three months, as a bulimic would. So you don’t have a problem. Right?

Well, not exactly. You may not have an eating disorder, but you could be a disordered eater.

A classification within the USA’s Diagnostic Statistical Manual of Mental Disorders describes disordered eating as a irregular or unhealthy eating and weight-control behaviours that don’t warrant diagnosis of an eating disorder.

“A person may feel bad about their weight and comfort eat or binge eat, and then purge so as not to put on weight. This may happen only once a month and as such it wouldn’t fit the criteria of binge-eating disorder. A person may chew and spit out their food,” says Suzanne Horgan, director of the Eating Disorder Resource Centre of Ireland, who estimates that 20% of people presenting to her practice do so for disordered eating.

About 200,000 people in Ireland are believed to have an eating disorder, but there are no statistics on how many people suffer from disordered eating. In the US, a University of North Carolina study found 65% of women aged 25-45 reported having disordered eating behaviours.

If behaviours around food are considered along a spectrum, where, at one end, a person has a normal relationship with food, and, at the other, an eating disorder, disordered eating falls between the two, says Ruth Ní Eidhin, communication officer at Bodywhys.

“It’s when you pass the compulsive point — where you have to do something to feel okay and where it’s impacting on you on a daily basis. It may be affecting mood or whether or not you meet friends. You need to watch out if it’s developing a reach beyond just meal-times,” Ms Ní Eidhin says.

Celebrity practices around food often verge on the obsessional and behaviours that would most likely fall within the parameters of disordered eating include the boiled-egg-only diet, the baby-food diet (Reese Witherspoon, now pregnant with her third child, and Jennifer Aniston are reported to have used this) or the colour-food diet, where you eat foods of a different colour each day (such as red on Monday, yellow on Tuesday — this is a fruit-and-vegetable diet).

Ms Horgan says another manifestation of disordered eating is pathological obsession with biologically pure food, or orthorexia.

“The person insists on no chemicals, additives or preservatives. It starts as a health kick or detox, but ends up being very rigid. It’s a distorted relationship with food. It’s quite common and can ultimately become so rigid the person can’t eat in someone else’s house or in a restaurant, because they don’t know how food has been prepared. Some people end up bingeing because their body can’t maintain the restrictions,” she says.

So, has a particular food behaviour become obsessive (can’t stop thinking about it), compulsive (urge is so strong you’re compelled to do it rather than wanting to) or impulsive (happens so quickly it’s done before you realise)? If you’re ticking these boxes, alarm bells should ring, says Ms Horgan.

“With media messages telling us, one day, a particular food is fine, the next day it isn’t, there’s probably a lot of disordered eating going on. People don’t even realise, because they feel it’s in some way the norm,” she says.

Ms Horgan says food avoidance emotional disorder is in the category of disordered eating. “This is marked food avoidance. Weight loss can be as severe as with anorexia, but there’s no preoccupation with weight or shape and no distortion of body image. Food avoidance is a result of anxiety, depression and stress. The sufferer’s appetite centre gets switched off by anxiety — they physically can’t eat. They feel full all the time and feel really bad if they eat anything. I think there’s a fair amount of it about in these stressful times,” she says.

While an eating disorder’s a coping mechanism, a way of managing the emotions through food behaviours, disordered eating patterns may play a similar role, says Ní Eidhin. “It may be useful to look at when it started — was their some background issue?”

Disordered eating may be a precursor to an eating disorder.

“Many behaviours that would be part of an eating disorder start off as disordered eating. If a person starts restricting their diet or cutting out substantial food groups, they’re not dealing with food in a healthy way,” says Ms Ní Eidhin. It’s not surprising that this should be so, says Ms Horgan. “The more a behaviour’s repeated, the more it becomes ingrained and the norm.” So what should you do if you suspect you’re a disordered eater? Experts advise asking if you’re using food to distract from something that needs attention in your life. Are you using food for comfort or reward when it might be more appropriate to exercise, ask for a hug or go for a nap? Ms Horgan urges becoming mindful around eating behaviours.

“Take at least 20 minutes to eat a meal, without distractions. Be mindful of what you’re having and how it tastes. Come out of your head, go into your body, tune into your hunger and your full signals. These enable you to know what to eat, when to eat and how much. In that way, your body’s in harmony,” she says.

¦ Visit www.eatingdisorders.ie; www.bodywhys.ie.

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