Eating disorders are characterized by a relentless preoccupation with the experience of the body that interferes with functioning and is manifested by unhealthy behaviors and attitudes toward food and weight.

People who are struggling with these disorders often suffer from feelings of shame, sadness, powerlessness, and anxiety regarding their behaviors and their bodies.

It is important to recognize that while a fear of weight gain is seemingly the driving force behind many eating disorder symptoms, upon closer inspection such fears are a means to an end: a desire for prediction and control, a strategy to calm emotions, distraction from painful experiences, or a means to cope with difficult life circumstances.

Determining whether you have these problems is the first step. Treatment involves both learning how to manage the symptoms themselves, figuring out how the symptoms help the individual to cope, and learning alternative ways to cope that are more effective.

People are told they have an eating disorder when they have several of these features. However, the more we learn about these disorders, the more we realize that meeting all the criteria is not what is important.

People who only have some of these features are often experiencing as much unhappiness and distress as someone who has all of them. Ask yourself if any of these features bother you or interfere with your life (happiness, job, school, relationships) or interferes with the life of the person with whom you are concerned.

Feature One

The individual has an unhealthy relationship with food. Food is supposed to nourish our bodies. We need food to live.

When eating becomes a source of guilt, shame, or fear, then this relationship has become unhealthy. Eating should be one of many activities in an individual’s life. When an individual is preoccupied with food, this relationship is unhealthy.

An unhealthy relationship with food takes many forms:

• Having rigid rules about food. For example, people may create inflexible rules about foods that are allowed versus foods that are forbidden, the time of day that it is permissible to eat, and the amount of food that they are “allowed” to eat.
• Feeling guilty about eating.
• Engaging in eating binges. Binges are characterized by feeling loss of control over eating. The eating often occurs at a pace that is faster than usual and the eating episodes are usually followed by feelings of guilt and shame.

Feature Two

The individual has an unhealthy relationship with his or her body. This may take one or all of the following forms:

• Valuing body weight and/or appearance as the most important aspect of self-worth
• Having difficulty interpreting the body’s internal signals (hunger, satiety, emotions, etc.)
• Having difficulty responding to the body’s internal signals (hunger, satiety, emotions, etc.)
• Having a distorted view of their bodies
• Feeling an intolerable dissatisfaction with physical appearance
• Feeling preoccupied with the experience of the body to the degree that it interferes with other important aspects of life (job, school, relationships)

Feature Three

The individual engages in unhealthy weight regulation practices. Rather than viewing food and eating as nourishment essential to life, people with eating disorders are often not comfortable with the act of eating and may engage in unhealthy behaviors in an effort to reduce this guilt. These behaviors may include:

• Excessive exercise
• Abuse of laxatives or diuretics
• Self-induced vomiting
• Abuse of diet pills
• Chewing and spitting out food