If you have ever had a meal with a preschooler, you know it’s worlds away from how adults eat. You’ll put out some pasta, broccoli, and pieces of grapes, then maybe step away to answer a call. When you come back, half the pasta and all the broccoli is in the child (except one floret stuck into a penne tube to make a tree), and the grape bits, having been deemed “yucky,” are smushed into the table.
Left to their own devices, little kids will usually eat what appeals to them until they are no longer hungry. Even when offered ice cream or cookies, kids often stop mid-bite if they’re full. Then they’re bored and want to go back to dumping LEGOs on the floor for you to step on.
Here’s what they never do: choose blueberries when they want a banana because blueberries have a lower glycemic index. They don’t think, I shouldn’t have this french fry because I sat and colored instead of going to Tumbling Tots. They definitely don’t eat to the point of discomfort because their “eating window” closes at 7 p.m. and they can’t have food again until noon the next day. In the years before diet and wellness culture muscles its way between them and their innate ability to eat according to what their bodies need, they do so based on what’s available, what looks good, and how hungry they are.
But sooner or later—certainly by the time they’re old enough to absorb the myriad health and food messages flying by, including ads for everything from powdered cow’s colostrum to twofers at the Cheesecake Factory—these instincts get crowded out. That’s often when things begin to warp.
Becoming unbalanced
Simply put, “Disordered eating is any behavior that disrupts a harmonious, body-connected eating experience,” says Anna Sweeney, M.S., L.D.N., an intuitive eating registered dietitian and owner of Whole Life Nutrition Counseling in Concord, MA. Psychologist Margo Maine, Ph.D., a leading eating disorder specialist, describes it as the extent to which you move away from listening to what your body is telling you to eat to nourish and care for yourself, both physically and emotionally.
When you eat in a disordered manner, what you put in your mouth (or try not to) is chosen primarily because you’re following external food and exercise rules, some of which you may not be conscious of. It can get to the point where the way you eat (or don’t eat) leaves you unsatisfied, disappointed in yourself, and preoccupied with food, weight, and/or health. Disordered eating can be relatively benign, such as ordering salad over the more substantial meal you’d prefer because you didn’t get your workout in. Or it can be more disruptive: You sit out your niece’s graduation party because the food is processed or not 100% organic. You eat five hard-boiled eggs daily just to make a dent in your protein goal of 100 g, or have “healthy” foods in front of your family, then binge alone on ones that you didn’t allow yourself earlier. Disordered eating includes “dieting, skipping meals, fasting, restricting food intake, eliminating specific foods or food groups, binge eating, [and] excessive use of diuretics, laxatives, and weight-loss medications, as well as the use of compensatory behaviors” such as purging and excessive exercising, per the National Eating Disorders Association (NEDA).
Is all dieting disordered?
Doctors often advise patients to drop pounds in an attempt to prevent or mitigate health issues—is eating according to the rules of a weight-loss diet a bad thing? That depends on whom you ask. Scientists have known for decades that most people who lose weight through dieting (and are not on medications like Ozempic and Zepbound, which have been shown to help people keep weight off as long as they keep taking them) regain most if not all of it. Their heart health still may benefit for the next five years, according to recent research on intensive weight-loss programs, though that benefit diminishes as they gain the weight back. Balance those cardiometabolic gains against the fact that weight regain often leads to yo-yo dieting, which has its own health risks: New research has found that weight cycling is an independent risk factor—separate from any risk posed by body weight itself—for obstructive sleep apnea, type 2 diabetes, and heart failure.
And these findings don’t address the psychological fallout from restricting food to lose weight only to see the weight show up again like an ex turned stalker. Weight cycling can set you up to feel like a failure, believe you’re weak for “cheating,” and get locked into an endless cycle of trying again and again. “The diet industry is profitable not because diets work,” says Sweeney, “but because it creates return customers.”
“Dieting,” in this context, refers to restricting food in an attempt to lose weight rather than, say, shifting to a plant-based or Mediterranean diet if that’s what makes you feel your best. For similar reasons—that the end result leads you to feel better, physically and psychologically—medically prescribed eating plans can be experienced differently than weight-loss diets (see the box below).
Us vs. our bodies
Of course, not everyone who goes on a diet will wind up preoccupied by the number on the scale or whether a given week was a “good” or “bad” one food-wise. Still, Maine—who, like Sweeney, encourages intuitive eating in her practice—says dieting is a significant risk factor for developing an eating disorder: “It’s like a gateway drug—it’s not safe at any speed.” Intuitive eating aims to help you develop a less fraught relationship with food and tune into your body’s needs.
It’s hard to pin down exactly how many women engage in disordered eating behaviors, because studies use different criteria to define them. One older survey found that some 75% of American women had disordered eating, whereas a more recent one, focused on male and female undergraduates before and after the COVID lockdowns, put disordered eating at closer to 50% (up from 38% before the pandemic). Women in midlife are not immune, says Maine, author of Pursuing Perfection: Eating Disorders, Body Myths, and Women at Midlife and Beyond. Some research shows that eating-disorder behavior and body dissatisfaction are on the rise in women over 50. This makes sense when you consider that the hormonal, bodily, and life changes around menopause can be as disruptive as the shifts in young adulthood, when many girls and young women begin to have issues.
Disordered eating is so normalized in our weight-focused, diet-and-health-obsessed culture that many of us don’t see it as “disordered.” It isn’t always strictly about weight, either: Orthorexia is a pattern (not yet formally recognized as an eating disorder) in which people are obsessed with nutritional content and “food purity” and restrict what they eat accordingly. And to be clear, disordered eating is different from having an eating disorder such as anorexia nervosa, bulimia, or binge eating disorder. All eating behavior occurs on a spectrum, says Maine, with eating disorders at one end and eating like a typical toddler with no food rules on the other.
An eating disorder is clinically diagnosed when a person has a certain number of specific harmful behaviors around food, weight, and eating that are more frequent, last longer, and may cause more psychological harm than other forms of disordered eating, according to NEDA. A person’s life is also more disrupted with an eating disorder, which may lead to medical complications, depression and anxiety, and the inability to keep jobs and relationships.
Still, if you eat in a manner that leaves you feeling crummy, physically or emotionally, says Maine, the distinction is beside the point. “It would be better if we could stop pathologizing it and just talk about what someone’s relationship with food and their body means about their mental and physical well-being,” she says.
Why we eat this way
Countless factors, large and small, can lead people to disconnect from themselves. Back to the toddler: In a couple of years, maybe her well-meaning parents (wanting to spare her from being called “big Chloe” in her two-Chloe kindergarten class) suggest that she skip dessert, and she starts to feel shame about her weight. Maybe they decide the whole family is going to “get healthy” and make a big deal about portion size and label certain foods “good” or “bad.” Perhaps they buy only low-calorie snacks, so chips or cookies become “naughty” treats to Chloe, to be snuck when at sleepovers.
When Chloe is hungry at 10 a.m. and it’s not snack time, she learns that what her body wants and what the world requires aren’t always the same. Her ballet instructor tells her to pull in her belly, and she notices that “real” ballerinas don’t have tummies that stick out. She has a bad day and finds eating soothing, and after a series of bad days, food becomes the main thing that helps. By the time she’s a tween, she is conscious of how much she weighs relative to her friends. She starts exercising to burn calories rather than because she likes sports or movement makes her feel good. Social media and all the “perfect” bodies there reinforce that she is falling short.
Gradually, what Chloe eats becomes dictated by 7,000 external ideas she uses to measure her worth. If she loses weight after drinking only black coffee two days a week, she is exalted by friends, family, and doctors. Then the weight comes back; she feels terrible and moves further from trusting her body. “It is so easy and normal to outsource your own body’s wisdom that many people don’t actually know,
Food ads and snacks everywhere (even by the checkout line at Staples!) also confuse our bodies’ signals. “We live in such an unhealthy food culture,” says Maine. We are surrounded by folks who are preoccupied with weight and body shape, and then there are “the constant cues about food from the media, the fast-food industry, the $70-billion-plus diet industry, and the round-the-clock availability of food—it gets us off our centers,” she says. Some people, notes Sweeney, are extra susceptible to the belief that diet-book authors and influencers know what their bodies need better than they themselves do. (To avoid being part of that noise, Prevention makes every effort to avoid focusing on weight and restrictive eating.)
Here, some examples of disordered eating behaviors.
You are following someone else’s food rules
Are you eating artificially sweetened low-fat yogurt because it’s what you really want? Do you take the bread off your sandwich because you don’t want it or because carbs are not keto-friendly?
Foods are categorized as “good” or “bad”
Thinking this way “sets you up for cravings, and cravings will set you up to overeat,” says Maine (bingeing is also a disordered eating behavior and is often followed by restricting food). “You’re giving the food a lot of power by not letting yourself have it and attributing things to the food that may be beyond its function.”
You’re driven by numbers
Are your food decisions based on the number on the scale, net carbs, fiber, or the steps on your tracker? “We hook a lot of meaning to a number—If I am below a certain number, I am good, safe, and well,” says Sweeney. But a number doesn’t tell you how your eating or exercising habits make you feel.
You compensate for what you have eaten…
…or you eat (or don’t) depending on how much you’ve exercised. For example, you had a big meal while out with your friends, so you want to “make up for it,” such as by restricting food or exercising extra. Or perhaps you skip meals because you’ve missed a couple of gym days.
You scold yourself when you eat “too much”
“Normal eating includes eating more than you need sometimes just because food is available and good,” says Maine. And not all “emotional eating” is problematic, she says. “It’s OK to eat for pleasure, and it’s also OK to eat for comfort.” Sometimes having mac ’n’ cheese for dinner can give you the warm, connected feeling you crave, and that’s fine. Using food to abuse yourself, however—bingeing or restricting as a way to avoid scary or sad feelings, or making food your primary means of soothing yourself—is a form of disordered eating.
The way you eat gets in the way of life
You avoid meeting friends for dinner to stick to your eating plan, for example. Or when coworkers invite you to lunch—great networking opportunity!—you decline so you can eat the portion-controlled food you brought from home.
You restrict eating to certain times
If doing so requires you to ignore your hunger, your eating may be disordered.
These are just examples, and there’s no one “right” approach—only what works for you. Whether you might rethink your relationship to food is a matter of how you feel about it and whether your eating habits fail to support your physical health—perhaps you are hungry a lot, lack energy, or have other symptoms you suspect are related to diet.
The tricky part is that some disordered eating behaviors—radically avoiding carbs, say, or eating massive amounts of chia seeds—may make you feel great, at least initially, says Sweeney. Who doesn’t want to feel as if they’re totally on top of their health? “This is what diet culture plays to: How can I best take care of myself? That feeling comes from a good place,” Sweeney explains. But once the elation subsides, the new “healthier” way of eating may feel like self-punishment and deprivation. Ask yourself if, on balance, you feel good about how you eat and move. What people need “is very personal and individual,” says Sweeney.
Getting to happy
You can’t stop disordered eating overnight—it’s not easy to disregard decades of dieting and food rules. But even taking the first steps can be eye-opening and, hopefully, freeing.
Learn about intuitive eating
You can start by picking up a copy of Intuitive Eating: A Revolutionary Program That Works by Elyse Resch and Evelyn Tribole, both registered dietitian nutritionists. It will help you see diet culture clearly, heal your relationship with food, and relearn how to give your body what it needs. “Being able to reacquire the skill of listening to your body is beautiful self-care,” says Sweeney.
Pay attention to how what you eat makes you feel
If you notice that when you eat a certain food you have lasting energy, that’s listening to your innate body wisdom, says Sweeney. If enjoying a food you love feels shameful, you can get to the bottom of those feelings so you can eat without stress. It will take a while—and lots of trial and error—but you’ll learn which foods are nourishing to you, emotionally and physically. On the flip side, if that high-protein stevia-sweetened drink tastes like deprivation, you can have something else. “If you lean into trusting your body a little more, your body will show up,” says Sweeney.
Get mad about the hype!
Women in particular have been held to impossible standards for decades, even centuries. One thing diet culture has normalized, says Sweeney, is the idea that our bodies are supposed to look the same throughout our lives. News flash: Nope. “We are not supposed to have an 18-year-old body in our mid-30s,” says Sweeney, let alone in our 50s or beyond (hello, post-baby bounce-back timelines!). “Women get this message that if you do this thing with food or movement, it’s possible. For most humans, it’s just not.” Once you really think about all the unhealthy messages you have been fed in the name of thinness and health, you can start to let them go.
Get professional support
Making peace with food is easier with help, especially if you’ve ever had an eating disorder. Look for a dietitian or therapist certified in intuitive eating—they can help you find your center—or seek out a therapist who is familiar with disordered eating. The National Eating Disorders Association Helpline (800-931-2237) is a good place to start.
On a Medically Restricted Diet?
Eating exactly what your body is asking for can be challenging if you have a serious heart problem or diabetes and many foods are off the table. If you’re under doctor’s orders to eat a diet very low in salt, for example, regular consumption of chips or bacon could harm your health even if it feels intuitive. “We get in trouble when we focus too much on either intuition or intellect,” says Maine. “It’s not either/or—good decisions are an integration of the two.” The goal is not to reject common sense but to learn to listen to your body so you feel your best and enjoy eating, she adds. Move toward trusting yourself to make the best choices for you, which means incorporating science-backed advice that addresses any chronic conditions you may have and ignoring self-styled experts and anyone who believes they know what you should eat better than you do.
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