Disordered Eating Help in Toronto

how I see it:

In my practice, I do not officially assess or diagnose eating disorders.

People come to me because they sense they are in trouble and could use some professional help.

I created this page about disordered eating to show how:

• • • • So-called ‘normal eating’ (if that even exists nowadays) differs from eating which is disordered

• • • • Certain types of eating behaviors can gradually shift into an official eating disorder

The Disordered Eating Continuum

At-a-glance, this diagram shows the different types of disordered eating.

• • • • Above the line, official eating disorders range from one extreme (anorexia, AN)*** to the other (binge-eating disorder, BED)*** which is also referred to as compulsive overeating. Sometimes these disorders shift along the continuum. So someone with bulimia (BN)*** can become anorexic or a binge-eater, or someone who is a binge-eater can develop orthorexia, which is an obsession with eating only healthy foods.

• • • • Below the line shows eating behaviors. Some, like emotional eating and occasional binge-eating are part of normal eating patterns, if they happen during a time of stress or a personal crisis. But if the behavior continues, it can get out of hand and move closer to an extreme end of the continuum.

• • • • Note that food addiction is not (yet) recognized as an eating disorder, but it can be part of one. Research increasingly shows that people can become addicted to certain behaviors, and to certain foods like sugar, fat, salt or any combination of these — the ingredients in most junk and ultra-processed food. I’ve contributed a chapter to a textbook on food addiction (Processed Food Addiction: Foundations, Assessment and Recovery, 2018) showing that my own history meets all eleven criteria for substance use disorder (i.e., addiction) in the DSM-5.

Where on the disordered eating continuum would you place yourself? Are any of the following stopping you from enjoying a happy and fulfilling life?

Physically … How often does your body suffer because:

• • • • • You can’t say no to a food craving – you “have to” have it
        • Once you start binge-eating, you can’t stop
        • You’ve eaten way past the point of fullness, to the point of discomfort
        • You wake up feeling hung-over, bloated, sluggish, and sometimes nauseous
        • Your clothes are too tight (but you don’t want to buy new ones until you lose weight)
        • Your weight fluctuates up and down like a yo-yo
        • You feel tired a lot of the time because you are eating so much junk

Mentally …  How much time do you spend thinking about or obsessing over:

• • • • • Food you’ve already eaten, should eat, shouldn’t eat, plan to eat, want to eat, wish you hadn’t eaten
        • How much weight you’ve gained, lost, regained or want to lose
        • How much exercise you used to do, don’t want to do, should be doing, are doing now, wish you were doing
        • How different your life would be if you were a certain size or weight
        • Whether or not there is any diet or weight loss scheme you haven’t tried

Emotionally … How much time do you spend hating how you feel because:

• • • • • You can’t seem to control your eating (at least not for very long, and certainly not as long as you used to)
        • You can’t let anyone see what or how much you eat
        • You’re tired of feeling frustrated, disappointed, ashamed, guilty and hopeless
        • You wake up feeling bad because of what you’ve eaten the night before
        • You go to sleep feeling bad because of what you’ve eaten that day
        • You let the scale decide whether your day will be a good or bad day
        • You feel stuck — you’ve been here too many times before

Socially … How often do you avoid social situations because:

• • • • • You can’t commit to anything in case you have a binge or purge session, or both
        • You avoid getting together with friends whenever food is involved, so they won’t comment on how much or how little you are eating
        • You avoid parties because of the food that’s usually there — you won’t be able to stop thinking about it, and worry that others might see you eat
        • You don’t feel good about the way you look
        • You can’t go to the gym because you’re embarrassed about how you look in gym clothes

*** Note: I’ve used clinical definitions from one of the best eating disorder resources — nedic.ca (National Eating Disorder Information Centre)