Healthy eating goals are a good thing. But they can also go too far. This is especially true in high school, where eating can become a coping mechanism for dealing with the added stress of extracurriculars, thesis papers, and exams. Using food to cope is more common than you might think—two-thirds of respondents in a recent Student Health 101 survey said they’ve used food to exert more control over their lives or feel better emotionally.
When good eating goes bad
The line between healthy eating habits and concerning behaviors can be a fine one. “Eating behaviors exist on a continuum,” says Elizabeth Curran, a licensed clinical therapist and clinical manager of the adolescent program at the Eating Recovery Center in Colorado. This can range from culturally normalized (and perfectly fine) behaviors, such as binging on Thanksgiving, to eating behaviors that negatively interfere with life, such as extreme dieting, she says. “‘Disordered eating’ is a descriptive way to label eating behaviors that may fall toward the unhealthier side of the continuum.”
Eating disorders and disordered eating are not the same thing
Eating disorders are extreme eating behaviors that fall into categories such as anorexia nervosa and binge eating disorder. Disordered eating can be any unhealthy eating habit or attitude about eating—such as compulsive eating, intense focus on weight or body image, or exercising like crazy to compensate for a big meal—and can be a precursor to having an eating disorder. However, not everyone with disordered eating habits will develop an eating disorder. These patterns can be exhibited by both men and women and by people of all ages, backgrounds, and identities.
What to know about disordered eating
People with eating disorders and disordered eating habits come in all shapes and sizes.
You don’t have to be underweight—many individuals with eating disorders or disordered eating patterns are of average weight or are overweight.
Disordered eating habits and eating disorders are often coping mechanisms.
It’s not vanity that drives people with eating disorders to follow extreme diets and obsess over their bodies; rather, it’s an attempt to deal with feelings of shame, anxiety, and powerlessness.
Eating disorders and disordered eating should be taken seriously.
All eating disorders can lead to irreversible and even life-threatening health problems, such as heart disease, bone loss, stunted growth, infertility, and kidney damage.
Identifying unhealthy eating habits
Using food and exercise to feel a sense of control or as a response to outside pressure is more common than you might think in high school. Thirty-six percent of students in a recent Student Health 101 survey said they had used food to exert more control over their life or to feel better emotionally.
According to the National Eating Disorder Association (NEDA), over 12 percent of girls in high school have taken diet pills, powders, or liquids (without a doctor’s advice) to try to lose weight. Disordered eating behaviors like this are even more common for athletes on high school sports teams. Over 41 percent of female athletes on high school teams reported disordered eating behaviors, according to NEDA—they were also eight times more likely to get injured. Guys aren’t immune either—rates of disordered eating are increasing faster in males than they are in females, according to NEDA.
So how do you know when a weight loss goal or increased focus on health becomes unhealthy?
Common signs of disordered eating include:
- Rigidity around timing or number of meals and snacks
- Excluding certain food groups or ingredients
- Regularly consuming excessive amounts of a food or beverage
- Categorizing food as either “good” or “bad,” “healthy” or “unhealthy”
- Avoiding situations that involve eating around others
- Increased weight monitoring
- Overindulging or feeling a lack of control when eating (on a regular basis)
- Using diet pills, diuretics, laxatives, or excessive caffeine
- Exercising excessively to “make up for” eating
You might identify yourself doing any of these, or notice a friend or peer behaving in a way that concerns you. “It’s best to recognize and address disordered eating patterns early on. Even if behaviors seem harmless or trivial, they have the potential to spiral out of control and [develop] into a clinical eating disorder if left untreated,” says Jenna Volpe, a registered dietitian who works with eating disorder patients in Waltham, Massachusetts.
What factors fuel disordered eating?
Troubled eating habits are rarely stand-alone issues—often, they’re not even about food. “Disordered eating can serve a multitude of different functions that are as unique as the individual struggling with the behaviors,” says Curran. There are two main driving factors, according to the experts:
1. Coping and control
“One way to view disordered eating is to see the eating behaviors as a coping strategy for an individual who has difficulties with emotional expression,” says Curran. “Disordered eating behaviors may serve as a distraction from daily stressors or a way to numb out difficult emotions.” This can be particularly problematic in high school, when you might be juggling an intense schedule and a lot of academic pressure. For some students, doubling down on the things they can control—in this case, their eating habits—can feel like a way to cope.
“Finding healthy coping strategies for dealing with stress is important,” says Lauren Smolar, director of Programs at the National Eating Disorder Association (NEDA). “If someone is finding that they use disordered eating as a coping mechanism, we recommend seeking help from a specialist.”
2. Unhealthy body image
The media, including social media, doesn’t exactly help our body image. Messages about body image start working their way into your brain before you even realize—media influence shapes body image ideas as early as elementary school. Sixty-nine percent of elementary school girls who read magazines said the pictures influenced what they thought was an ideal body shape, and 47 percent said the pictures made them want to lose weight, in a study published in Pediatrics.
Social media also plays a part. “Social media tends to have the most impact on us teens, since we’re constantly drawn to our phones,” says Katherine, a sophomore in Farmington, Connecticut. “Spending a good amount of our time liking and scrolling through pics of our friends makes us look to their appearance in comparison to the attention they’re receiving online, and causes us to wonder if our own body weight is keeping us from gaining that same standard as we compete for followers and social reputation.”
In one small 2014 study, 84 women were asked to either use Facebook or another site for 20 minutes, and researchers found that more frequent Facebook use was associated with anxiety over weight concerns and greater disordered eating behaviors.
- Anxiety and depression
- Sports (according to data from NEDA, a third of male athletes and two-thirds of female athletes engage in disordered eating behaviors)
- Major life transitions and stressors (think parents getting divorced, breakups, or trauma)
- Lifestyle changes
Building healthier eating habits
While it’s not always easy, it’s totally possible to turn unhealthy disordered eating behaviors around. The first step is recognizing them, says Curran.
How to help yourself
Identifying disordered eating behaviors in yourself can be particularly tricky—you have to be informed about the warning signs and then totally honest in evaluating yourself. “If you’re feeling like you’re having a hard time eating when you’re hungry, stopping when you’re full, or feeling guilty about the amount or the types of food you’re consuming, those may be signs of disordered eating,” says Smolar.
- Explore the intentions behind your eating patterns to illuminate emotional concerns.
- Consider societal, academic, and personal pressures that impact how you feel about your body.
- If you’re concerned, talk with a professional. You can call the confidential, toll-free National Eating Disorder Helpline, or complete a screening tool online.
How to help a friend
“Isolation is a common early sign,” Curran says. “If you notice a friend’s behaviors or attitudes around food, exercise, or their body are beginning to change, or their typical responses to requests to grab dinner are switching from a ‘yes’ to a ‘no,’ be curious and supportive in asking about their change in behavior.”
This can be tricky to talk about—people who are struggling with disordered eating are often reluctant to open up about it. Curran suggests taking a little time to prep before you bring it up. “Prior to the conversation, it may be helpful to gather recent observations or changes that led to your concerns, such as noticing they have been skipping or working through lunch, mood shifts around meals, emotional eating, increased exercise, etc.” If you’re not comfortable bringing it up with them directly, you can also share your concerns with an appropriate authority figure—such as a trusted coach or school counselor.
Also, if you’re going to bring this up to a friend, make sure you empathize; don’t pity. “The worst thing you can do is have a tone that comes across as feeling sorry for them and taking the stance that you’re almost better than them. They don’t always realize they even have an unhealthy relationship with food or what the big deal is,” says Delaina, a freshman in Boise, Idaho.
Getting help from a professional is often part of the treatment for disordered eating. “The most important task in the treatment for disordered eating is nutritional restoration [restoring nutrients in the body],” says Curran. “Subsequently, the work can focus on addressing temperament, identifying stressors, and learning alternative coping styles. Most treatment centers offer free and confidential assessments, both online or over the phone, to determine the appropriate level of care for treatment.”
National Eating Disorders Association Helpline (M–F, 9 a.m.–5 p.m., EST): 1-800-931-2237
Ann Chapman, registered dietitian, Lawrence, Kansas.
Emily Curran, licensed clinical therapist, clinical manager of the adolescent program, Eating Recovery Center, Denver, Colorado.
Lauren Smolar, director of programs, National Eating Disorder Association.
Jenna Volpe, registered dietitian and eating disorders specialist, Walden Behavioral Care, Waltham, Massachusetts.
Eisenberg, D., Nicklett, E. J., Roeder, K., et al. (2011). Eating disorder symptoms among college students: Prevalence, persistence, correlates, and treatment-seeking. Journal of American College Health, 59(8), 700–707.
Field, A. E., Cheung, L., Wolf, A. M., et al. (1999). Exposure to the mass media and weight concerns among girls. Pediatrics, 103(3).
Mabe A. G., Forney, K. J., & Keel, P. K. (2014). Do you “like” my photo? International Journal of Eating Disorders, 47(5), 516–523.
NEDA. (n.d.) Media and eating disorders. Retrieved from https://www.nationaleatingdisorders.org/media-eating-disorders
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Tylka, T. Pressure to be muscular may lead men to unhealthy behaviors, presented at the American Psychological Association’s 2006 annual meeting. Retrieved from http://researchnews.osu.edu/archive/maleobj.htm