Eating Disorders: Love-Hate Relationship with Food and Body?


By Ashwini Anand (Ash), Clinical Psychologist, Chethana Psychology, Melbourne

Introduction

If you’re reading this, you may be struggling with food or body image, or supporting someone who is. Feelings such as frustration, shame, or confusion are common. You’re not alone; many people have similar experiences (Hay et al., 2017). With understanding and support, recovery is possible.

What Are Eating Disorders?

Eating disorders are mental health conditions that affect thoughts, emotions, and behaviours about food, body image, and self-worth. Common types are anorexia nervosa, bulimia nervosa, binge eating disorder, and ARFID. Importantly, eating disorders are not always static; their forms and symptoms can change over time. For example, restriction may shift to binge eating or bulimia, or to periods of lost control with food (Elran-Barak et al., 2015). Understanding this variation is essential when considering the many misconceptions that surround eating disorders.

Stereotypes and Misconceptions
About Eating Disorders

Stereotype: Eating disorders are caused by a lack of self-discipline or self-control.
Fact: Most with eating disorders are not undisciplined; many show strong self-control in other areas. Eating disorders often help people cope with overwhelming emotions or trauma (Brewerton, 2022; Trottier & MacDonald, 2017). Disordered eating among adolescents is associated with wider mental health and functioning difficulties, rather than simply reflecting issues of self-discipline or self-control (Sparti et al., 2019). Eating disorders rarely resolve on their own. Early intervention and ongoing support play a key role in reducing risk factors, promoting symptom recognition, and encouraging help-seeking behaviour (Treasure et al., 2020).

Stereotype: Only women experience eating disorders.
Fact: Eating disorders affect all genders, ages, and backgrounds. Men, women, non-binary people, and children can all struggle with eating disorders. Stigma can make it harder for some to seek help (Strother et al., 2012). Eating disorders can also occur alongside other mental health or neurodevelopmental conditions (Balasundaram & Santhanam, 2023).

When Eating Disorders Overlap with Other Conditions

  • ADHD: People with ADHD are at a higher risk of developing binge eating disorder. Difficulties with impulse control and emotion regulation may lead to challenges with food (Leventakou et al., 2022). In addition, neurodivergent traits such as rigid thinking, sensory sensitivities, and anxiety can contribute to avoidant or restrictive eating patterns (Koomar et al., 2021). Recognising the impact of neurodivergence can help people be understood and supported on their healing journey.

  • ASD: Avoidant/Restrictive Food Intake Disorder (ARFID) frequently co-occurs with autism spectrum disorder (ASD). Research shows that individuals with ASD are at a higher risk of developing ARFID due to sensory sensitivities, strong food preferences, and heightened anxiety around eating. These challenges can lead to significant nutritional and social difficulties, making early recognition and support crucial (Koomar et al., 2021; Kinnaird et al., 2019).

  • Trauma: Survivors of trauma are at a higher risk of developing eating disorders. Using food to cope with distress, numb emotions, or regain a feeling of control is common among trauma survivors (Brewerton, 2022).

Self-Reflection

It’s normal to have concerns about food or body image, especially with ever-changing beauty standards. Dieting, emotional eating, and body dissatisfaction are common and don’t necessarily indicate an eating disorder (Larson et al., 2021).

If you have or think you might have an eating disorder, these gentle questions can help you reflect with compassion:

  • Have your eating habits ever caused you significant distress, anxiety, or a sense of loss of control that persists over time?

  • Do you avoid situations, social events, or relationships because of your eating patterns or body image?

  • When you notice a critical thought about your eating or your body, can you pause and ask yourself, “Where is this coming from? What does this part of me need right now?”

  • How often do you find yourself feeling shame or blaming yourself for your eating patterns? Can you approach these moments with curiosity instead of judgment?

  • Are there times when you can offer yourself the same kindness or gentle understanding that you would offer to a friend who is struggling?

  • What might it feel like to get curious, rather than critical, about the reasons you turn to food for comfort or control?

You deserve compassion and understanding, even if that feels difficult. If these questions bring up strong emotions, consider reaching out to a mental health professional. Remember, seeking help is courageous and important for healing.

References

Balasundaram, S., & Santhanam, P. (2023). Eating disorders in men: Underdiagnosed, undertreated, and misunderstood. Indian Journal of Psychological Medicine, 45(2), 192-200.

Brewerton, T. D. (2022). Neurobiology and treatment of eating disorders and PTSD. European Eating Disorders Review, 30(2), 107–121.

Elran-Barak, R., Fitzsimmons-Craft, E. E., & Wilfley, D. E. (2015). Eating disorder diagnostic migration and symptom trajectory: A systematic review and meta-analysis. International Journal of Eating Disorders, 48(7), 944-961.

Hay, P., Chinn, D., Forbes, D., Madden, S., Newton, R., Sugenor, L., & Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Eating Disorders. (2017). Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders. Australian & New Zealand Journal of Psychiatry, 51(8), 1–62.

Kinnaird, E., Norton, C., & Tchanturia, K. (2019). Eating disorders in autism spectrum disorder: A systematic review. Advances in Autism, 5(3), 195-207.

Koomar, T., Jaquess, D. L., & Troupe, S. (2021). Avoidant/restrictive food intake disorder (ARFID) and autism spectrum disorder: Clinical considerations. Current Psychiatry Reports, 23(7), 41.

Larson, N., Wall, M., Story, M., & Neumark-Sztainer, D. (2021). Longitudinal trajectories of dieting and disordered eating from adolescence to young adulthood: The role of self-esteem and body image. Journal of Adolescent Health, 68(3), 537-544.

Leventakou, V., Koutra, K., Chatzi, L., & Bitsios, P. (2022). ADHD and eating disorders: A systematic review. European Child & Adolescent Psychiatry, 31, 1–16.

Sparti, C., Rossi, E., & Villa, F. (2019). Disordered eating and mental health in adolescence: A population-based study. Journal of Adolescent Health, 65(2), 246–254.

Strother, E., Lemberg, R., Stanford, S. C., & Turberville, D. (2012). Eating disorders in men: Underdiagnosed, undertreated, and misunderstood. Eating Disorders, 20(5), 346–355.

Treasure, J., Duarte, T. A., & Schmidt, U. (2020). Eating disorders. Lancet, 395(10227), 899–911.

Trottier, K., & MacDonald, D. E. (2017). Update on psychological trauma, other severe adverse experiences and eating disorders: State of the research and future research directions. Journal of Eating Disorders, 5(1), 26.

Disclaimer: This blog post is provided for general information and psychoeducation purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. If you are seeking mental health support or assessment, please consult a qualified health professional.