Eating Disorders are persistent conditions that disturb the behaviour of eating, leading to the impairment of physical and mental health. Most Eating Disorders have a combination of neurological drivers, cognitive drivers and often ignorance, that lead to the disturbed eating pattern. All of these need to be addressed for a person’s eating to return to healthy. In understanding Eating Disorders, we can be better informed on how to seek help to keep ourselves healthy.

Eating Disorders and Co-Occurring Conditions

There is a high correlation of Eating Disorders and ADHD [Source: External LINK]. Women with menstrual cycles often find they Binge or avoid food more during PMT, and often may be diagnosed with [External LINK], or BiPolar Affective Disorder (BPAD). Of course, this is a bit redundant as PMDD and ADHD have a very strong overlap [Understanding ADHD, PMDD and the Mid Cycle Crash]. ARFID is often an indicator for Autism [ARFID, Neurodivergence and You].

It is important to not confuse an Eating Disorder with culture, a food preference (such as bland, spicy, vegan), with developmental stages (where our taste buds change as we grow), or with allergy/intolerance avoidance. By the same token, sometimes an eating disorder can be concealed by the same traits.

It is very common that people with Eating Disorders will also have problems with food intolerances and sometimes allergies. The difference between the two is the type of reaction that your body gives you.

• Allergy
  • If you have an allergy response, you may get hives, swelling and generally need an antihistamine or the emergency room.
• Food Intolerance
  • Generally results in abdominal discomfort only,
    • Eg. stomach pain, diarrhea, nausea, or vomiting
  • Frequently diagnosed as IBS
    • IBS can also be caused by hormone issues, eg thyroid and/or menstruation

Treatment Basics

A Treatment Plan needs to recognise and map out potential neurodivergence, mood disorders (such as anxiety), specific food issues (sensory, allergy and intolerance), culture (where relevant), personal preferences and behaviours around food.

Once the above has been taken into consideration, a Treatment Plan should include a combination of:

• Targeted medication
  • to manage the biological aspects of neurodivergence / mood disorder / food allergies that underlies most eating disorders,
• CBT
  • to target the erroneous beliefs and behaviours that exacerbate the specific eating difficulties,
  • and to widen the safe food diet, and
• Diet Education
  • to understand how to create a balanced diet with the foods that you can tolerate.

Eating Disorders

An eating disorder is a condition that describes an eating pattern that leads to poor nutrition despite reasonable education and availability to food. While above I stated that often education is needed to help create a health eating practice, the person with the disorder is generally not ignorant of what they should normally eat and is aware that how they approach food is not the normal.

Diet education is focused on how to manage to eat a healthy balanced diet AND navigate the mood and cognitive drivers that make healthy eating hard.

Diet Educatoin should be empowering, not disabling.

ARFID – Avoidant Restrictive Food Intake Disorder

More specific information can be found on our ARFID Page.

ARFID stands for Avoidant Restrictive Food Intake Disorder.

ARFID is a diagnosis often given as to people with an extreme aversion to foods, that result in negative health consequences and meltdowns around eating food. ARFID can also be considered for people who have a more subtle aversion to core foods that can cause subtle consequences.

People struggling with ARFID can have a range of reasons why they are avoidant of foods.

• Sensory Nope, where something about that food triggers a sensory based rejection
• Food phobia, such as fearing that the food has gone off or isn’t safe to eat
• Frequent Fatigue, which interferes with the ability to make decisions about what to eat, make food and push oneself to eat
• Dopamine Chasing, where the person finds only beige foods are palatable

ARFID is very common with Autistic People and ADHD.

ARFID is wildly under recognised because it is hard to spot that someone has a lot of troubles eating regular food. ARFID people are often told they are fussy eaters, difficult or picky. Many people struggling with ARFID will have a repetitive diet of safe foods, either that they cook for themselves, or that they order as take away. A common ARFID clue is that you only ever eat the same thing at a restaurant.

Orthorexia Nervosa

Orthorexia is medical term to describe a condition where eating “healthy food” has become obsessive. It comes from the Greek words ortho, meaning ‘correct’ and orexis, meaning ‘appetite’.

People struggling with this condition are over focused on the “quality” of the food they eat, to the detriment of the quantity of the food. This condition can start with just trying to eat more healthy and can then combine with anxiety, rejection sensitivity or OCD to become a more manifest eating disorder.

It is important to understand the difference between “Healthy Food” and “Health Food”. Healthy food includes a healthy balance and quantity of fat, sugar, carbohydrates, protein, salt with vitamins, macro nutrients and micro nutrients. “Health Food” is a short hand for an extreme diet where important fat, sugar and often carbohydrates and protein has been removed. This can be an over compensation for a binge eating diet, or because peers, parents or mentors have over emphasised that evils of “junk food”.

For someone struggling with Orthorexia Nervosa, you have likely associated being a good person with eating health food, and lost the ability to eat a balanced diet of healthy food.

Eating Disorders Victoria [External Link] has a fairly good additional information.