Dr. Kristyn Gregory, D.O., is a medical director of behavioral health at Blue Cross Blue Shield of Michigan. Dr. Gregory received her medical degree from the Chicago School of Osteopathic Medicine. She then completed residency training in Adult Psychiatry at Henry Ford, and a fellowship in Child and Adolescent Psychiatry at Wayne State University. She is board-certified in Adult, Child and Adolescent Psychiatry. She has practiced in a variety of settings in the metro Detroit area including inpatient, residential, outpatient, school-based and juvenile justice programs.
Disordered Eating vs. Feeding and Eating Disorders: Signs to Watch For
5 min read
Rates of feeding and eating disorders – especially among teenagers – skyrocketed during the pandemic: calls to help lines nearly doubled. With routines disrupted and increased isolation, many individuals turned to social media and emotional eating to fill the void. Additionally, many people delayed annual physicals and other preventive health care visits. 2020 built a perfect storm for eating disorders.
Even as much of the world has resumed its pre-pandemic habits, the heavy influence of social media on teenagers and young adults has not waned. Diet culture, trending weight loss challenges and a distorted view of beauty permeate through popular social media networks in a way that can be damaging to individuals predisposed to depression, anxiety and eating disorders. Increasingly, young people turn to social media channels for their information instead of qualified, trustworthy sources.
Understand that feeding and eating disorders are biologically based illnesses, and some people are genetically predisposed. Working with a qualified behavioral health professional is important to getting someone the help they need. Learning the different types of eating disorders, as well as the signs of an eating problem, can help as a first step.
Disordered eating vs. feeding and eating disorders
Disordered eating is a broad-ranging term that refers to irregular eating behaviors such as frequent dieting and rigid food rules. It’s a descriptive phrase rather than a diagnosis. People with disordered eating may change their eating patterns in response to stress, boredom or emotional dysregulation. While disordered eating can have an impact on physical and mental health, it often doesn’t interfere with the ability to complete daily functions. It’s important to address disordered eating, as it could progress to a feeding and eating disorder as defined by the American Psychiatric Association – and is a sign that an individual has an unhealthy relationship with food and exercise.
Professionals use three factors to evaluate whether disordered eating can be classified as a feeding and eating disorder:
- Behaviors: A person with a feeding and eating disorder often demonstrates multiple behaviors concerning food and body image that they engage in multiple times a week or daily. However, many people hide their behaviors – so it’s important to consider the other two factors.
- Obsession: A person with a feeding and eating disorder is consumed with thoughts of food, calories, avoiding food, exercising and/or body image. These thoughts could be strong enough to interfere with the person’s ability to focus, sleep and stay present.
- Functionality: A feeding and eating disorder can cause significant issues with a person’s ability to complete daily functions, whereas a person with disordered eating may not experience this issue.
Signs of feeding and eating disorders
Signs of feeding and eating disorders can be emotional and behavioral:
- Eliminating food groups
- Extreme preoccupation with body size, shape and image
- Obsession with weight, food, calories and dieting
- Food rituals, including only eating one type of food or food group, excessive chewing, not allowing foods to touch
- Mood changes
- New practices with food or fad diets
- Skipping meals or taking small portions
- Uncomfortable eating around others
- Withdrawing from friends and activities
Signs of feeding and eating disorders can also be physical:
- Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)
- Big changes in weight, both up and down
- Cold, mottled hands and feet or swelling of feet
- Cuts and calluses across the top of finger joints (a result of inducing vomiting)
- Dental problems
- Difficulty concentrating
- Dizziness and/or fainting
- Dry skin and hair, and brittle nails
- Feeling cold all the time
- For women: missing periods or only having a period while on the pill
- Weakened immune system
- Muscle weakness
- Sleep problems
- Stomach cramps or general gastrointestinal complaints like constipation
- Swelling around salivary glands
- Wounds that heal poorly
Types of feeding and eating disorders
Some of the most common eating disorders include:
- Anorexia nervosa: Individuals with this disorder have an intense fear of gaining weight and exhibit persistent behavior that interferes with weight gain. This can be manifested by irrational, impulsive behavior and a distorted body image. They may follow a dangerously low-calorie diet, avoid eating altogether or exercise for hours per day to avoid weight gain. This can lead to physical signs of malnourishment like becoming extremely frail or appearing weak and emaciated. They may also exhibit thinning hair, brittle nails, and lanugo (fine hair that covers the entire body).
- Bulimia nervosa: Bulimia is characterized by uncontrolled binge-eating episodes where a person consumes large amounts of food followed by a compensatory behavior. Examples of compensatory behaviors include self-induced vomiting; misuse of laxatives, diuretics or other medications; fasting; or excessive exercise. This can lead to dehydration, dental issues, cardiac issues and tears in the esophagus.
- Binge eating disorder: Recurrent episodes of binge eating includes behaviors where a person eats much more rapidly than normal, may eat until feeling uncomfortably full or eats large amounts of food when not feeling hungry. They may eat alone because of feeling embarrassed by how much one is eating, and afterwards have feelings of disgust, guilt or depression. The key difference from bulimia is the lack of compensatory behavior in binge eating disorder.
If you suspect a loved one has developed a feeding and eating disorder, it’s important to start a conversation and seek treatment. Talking with a primary care provider is a good place to start, as they can offer referrals to qualified behavioral health professionals that specialize in feeding and eating disorders.
Kristyn Gregory, DO, is medical director of behavioral health at Blue Cross Blue Shield of Michigan. Shanthi Appelö, MS, RD, is health and wellness spokesperson at Blue Cross Blue Shield of Michigan.
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