Eating Disorders: How to Know When You Need Help, Where to Start, and What to Expect
Making the decision to seek help for your eating disorder can feel like the most confusing, frustrating, and isolating thing in the world. When chronic dieting and the pressures to constantly change ourselves is the cultural norm, it can be difficult to decipher if what you’re struggling with is a true, diagnosable eating disorder or some other underlying issue. Regardless of whether your eating patterns are diagnosable as an eating disorder or not, an unhealthy relationship with food is never good. If you find yourself restricting your intake, constantly thinking about food, and feel like the number on the scale or the calorie count on the package controls your life, it’s time to make a change. An unhealthy relationship with food, even without the “official” label of an eating disorder, should be addressed and healed (ideally with the support of a professional). If interested, you can use the National Eating Disorder Associations screening tool by clicking here.
This blog post does not serve as medical advice or as a replacement for a professional eating disorder screening. Every case is unique, and that’s part of what makes recognizing eating disorders so tricky. If you or a loved one is struggling with symptoms of disordered eating behaviors and patterns, please seek individualized treatment. Use the following information for general education and awareness only.
There is no “normal” way to eat. However, there are certainly “abnormal” ways of eating and viewing food. In my experience (again, just my perspective), if you think the way you’re eating might be unusual or disordered, it probably is. Here are a few examples of disordered eating behaviors.
Food Thoughts. One of the biggest and clearest red flags is having constant thoughts about food. You’re repeatedly counting calories in your head, recounting meals and snacks you’ve had throughout the day, assessing whether or not they were “good” or “bad”, and obsessing over if what you ate was “good” or “bad” for you. You’re always thinking about your next meal, and if it’s a heavier meal, you compensate for it by restricting earlier in the day. This is something I used to do all. the. time. Which leads me to my next point.
Incessantly Planning Your Day Around Food. Rather than just enjoying pizza for dinner on a whim, I would make sure breakfast and lunch were extremely low in carbs in order to “make up” for the higher carb meal I was having later that day. This resulted in me arriving at dinner extremely hungry and feeling as if I could inhale the entire pizza right then and there. It’s not normal to plan your day around food and miss out on plans if they don’t line up with your perfectly structured out eating schedule. You shouldn’t always feel the pressure to check the menu at restaurants before going to make sure you order the lowest calorie option. While it’s totally fine to be curious about the food options at a certain restaurant, it’s disordered to incessantly check the menu to ensure there’s a “safe” and “restrictive” option for you.
Feeling Emotional When Things Don’t Go According to Plan. Say you go to a restaurant and you’re looking at the menu. The spaghetti looks good to you, so you order it. The server tells you they’re all out of spaghetti and you’ll have to choose something else. For someone that doesn’t struggle with an eating disorder, this isn’t a big deal. You simply choose something else that sounds good on the fly. Conversely, when someone suffering from an eating disorder or disordered eating patterns is faced with this dilemma, the world stops. Your plan has crumbled and now you’ve been put on the spot. You have to quickly recount everything you’ve eaten that day to make sure your new choice is in alignment with what you’re “allowed” to eat. Review the menu again (with everyone watching and waiting) and inspect every single ingredient to make sure there are no surprises. Or maybe you choose something but then become uncomfortable when it’s brought out and barely touch it. Or, maybe you skip the meal altogether and decide “you’re not that hungry anyway”. OR maybe you do what I did in a restaurant once and have a total meltdown in front of your family and friends. I can recall a very specific situation where the fruit I ordered at breakfast had come out in syrup and the toast I ordered came pre-buttered. That just about sent me over the edge. I had took so long deciding on what I could order off the menu, and just when I thought I had it figured out, the cooks in the kitchen had to “taint” it with sugar and fat (the horror, right?). Everyone at the table offered me food off their plate in an effort to be friendly and supportive, but I was even more afraid of their food than I was my own. This is a dark memory for me. But it was these kinds of episodes that made it very clear I needed help.
Of course, while there are countless other examples of disordered eating I could give, I want to take a moment to talk about the kind of support you can receive if you’re struggling. An eating disorder treatment team can consist of the following: physician, dietitian, therapist, and psychiatrist. Each play an important role in your recovery. It’s important to clarify with each provider what their role will be in your treatment, what can be expected of them, and what their expectations for you are. After all, this is a collaborative team approach, so it’s a good idea to know who you can go to for specific questions or support. If you don’t know of a dietitian, physician, therapist, or psychiatrist that can help support your needs, a quick Google search can be a good place to start. Contact the provider you feel might meet your needs and ask any questions you may have for them. Often times, providers will offer a free consultation over the phone to determine if the two of you are a good fit.
Your treatment may be inpatient or outpatient, depending on your need (which can be assessed with your providers, mentioned above). Higher levels of care include “Residential” treatment and “Partial Hospitalization” (PHP). These types of treatment will require more of a time commitment, are highly structured, and your health and food behaviors are highly monitored. Other options, for those that may require less support, include “Intensive Outpatient” (IOP) and “Outpatient” treatment. While still a great form of support, these are typically intended for people who are stepping down from a higher level of care or feel they aren’t in need of such an intense form of treatment. Click here to learn more about the various forms of eating disorder treatment.
After you’ve assembled your treatment team, it’s time to prepare yourself for what to expect. Although eating disorder treatment might sound scary, it’s actually a really healing and restorative experience. Each treatment type will differ in its subject matter, but they all work together towards the same goal: your recovery and overall health. For example, with a therapist you may discuss the root causes or triggers of your disordered eating behaviors and how to emotionally cope with them, whereas with your dietitian you’ll discuss the nutritional component of your recovery. This could include setting intake goals, coming up with meal and snack ideas, and nutrition education.
The important thing is to be open and honest with your providers. There’s never a “right” or “wrong” answer in therapy, but having trust in your team and being candid with how you’re feeling is crucial for your progress. If eating disorder treatment is right for you, my hope is that your experience is a positive one. Even when things get challenging (and they will), remember why you started and keep pushing through. Being free from your disorder is more than worth the effort that treatment requires.
If you have any questions, comments, or thoughts, I’d love to hear them. Please feel free to drop a comment in the section below. Don’t forget to share this post with a friend that might benefit from it!
If you’re interested in finding food freedom and ditching diet culture forever, check out my 10-week, self-paced, online intuitive eating course by clicking here.