5 Signs You Are Sick Enough for Disordered Eating Treatment — Registered Dietitian Columbia SC

Because dieting is so normalized in our culture, sometimes it can be hard to know if your struggles with food are enough to need treatment for disordered eating or an eating disorder. This blog post shares 5 signs that you are sick enough for treatment.

As we kick off the new year and the “new year, new year” discourse that comes with it, I’m reminded just how disordered our cultural relationship with food is. Thankfully, most people in my life know that I’m not the person to talk dieting and weight loss with. However, that makes it a bit of a shock to the system when lots of friends, family, and people I follow online are suddenly talking about their diet or exercise plan.

Because it’s really common for people to engage with strict food and exercise regiments or to swing back and forth going on and off diets, it can make it hard to know if you’re struggling with disordered eating. Of course, I would argue that dieting is a form of disordered eating, but I know I might be in the minority with that!

That said, while I am an anti-diet dietitian, I also know there are some people who can pursue weight loss and it doesn’t have any major impact on their physical or mental health or lead to an eating disorder. Decades of research suggests the vast majority of these people will not attain significant, sustained weight loss, but for some people these attempts at weight loss (whether they succeed or not) are mostly neutral or just mildly unpleasant. Others might consider their experience dieting a positive one – we can hold space for all these experiences while also recognizing the risks inherent in dieting, and the societal fatphobia it plays into. So while dieting can be a form of disordered eating, it doesn’t necessarily mean every person trying to manage their weight has disordered eating. How do you know if your attempts at weight loss or management are getting into disordered eating territory?

Sometimes it is really obvious someone is struggling with disordered eating or an eating disorder. Other times someone may feel unsure if what they’re dealing with requires professional support. Add to that the many myths and misconceptions about what someone with an eating disorder looks like (it’s not all thin, young, white women!), and it’s no wonder so many people struggle with food without any idea that it could be an eating disorder.

Even if someone knows their relationship with food is disordered, many people will minimize their struggles or think they’re not sick enough to get help, especially if they are basing their judgements on comparisons to other people in their life who might be dealing with their own disordered eating. This belief that one is not “sick enough” is so common that one of the most popular eating disorder books is actually called Sick Enough.

Are You Sick Enough for Treatment for Disordered Eating?

If you’re wondering if you’re sick enough for treatment, here’s 5 signs you could use more support. As a side note, treatment for disordered eating/an eating disorder can look really different from person to person. Some people who have an eating disorder with medical complications or who need the containment of a treatment facility will benefit from hospital or residential treatment. Other levels of care include partial hospitalization programs, which are typically 5-6 days a week for full days of programming, and intensive outpatient programs, which are typically 3-4 days a week for a few hours. Others will benefit from outpatient counseling from a therapist and/or dietitian, which typically occurs weekly or every other week. Most of the time some or all treatment is covered by insurance, but this can vary quite a bit state to state, from insurance plan to insurance plan. Here is a link with more information about insurance and treatment from Project Heal, who also offer scholarships for treatment.

Thoughts about food and your body take up the majority if your headspace.

If thinking about food and your body are a distraction from other important things in life, that’s a sign you need help. This can also be a sign that your body is medically in need of renourishment, because one of the symptoms of being underweight and/or undernourished is constant thoughts of food. In fact, many of my clients learn to identify an increase in food/body thoughts as a warning sign that they’ve been slipping with food. For many people these ruminating thoughts resolve or significantly diminish with adequate nutrition and weight gain.

You engage in compensatory behaviors with food, exercise or by purging.

Many people with disordered eating will find themselves stuck in a constant cycle of trying to make up for perceived “indiscretions” with food by trying to burn it off through exercise, or being stricter with their diet. As I remind my clients, this is an equation you will never solve – you can spend the rest of your life trying to make up for “mistakes,” or you can break free of that cycle. Another reminder: using laxatives, diuretics or making yourself throw up also is a sign you need help, even if it’s only on occasion, or if people around you do these things casually.

It’s hard to socialize or go out to eat because of your diet.

This isn’t automatically a sign of disordered eating. For some people with allergies or other medical food needs, these things can be a challenge. However if you are optionally choosing to avoid certain foods out of health concerns or to manage your weight, this is a sign that you need help. Orthorexia, a type of disordered eating where one obsessively focuses on the perceived healthfulness rather than weight or body size, can be just as serious as anorexia and deserves support.

The scale controls food and your mood.

Is hopping on the scale part of your morning routine? Does the number determine what or how much food you allow yourself to eat, or does it control how you feel about yourself that day? There are over 100 different factors that impact body size (link) and many reasons your weight will fluctuate by small amounts day-to-day that don’t indicate actual changes to adipose or lean body mass. You can drive yourself nuts trying to analyze and control the scale! If you have an overly dependent relationship with the scale, it is likely playing a part in your self worth. If so, you may need support in breaking up with the scale.

Your relationship with food and your body is negatively impacting your quality of life.

You don’t have to be experiencing any of the medical side effects of disordered eating to get help. It doesn’t have to qualify as a diagnosable eating disorder. Diagnostic criteria are used to determine insurance reimbursement and can be useful for providers in figuring out treatment paths. It is not a measurement of whether you are struggling or need help. If your attempts to control your body size or health are negatively impacting your quality of life, you deserve help. It really is as simple as that.

If you are looking for support in this new year, just reach out. We work with clients virtually throughout the US and my associate dietitian Kate sees clients in person out of our Columbia, SC office. We are also in network with BCBS and can accept insurance in many states. Read more about our practice philosophy and email if you’d like more information to see if we’re a good fit to work together.