Ask an Expert: Do I Have an Eating Disorder?

By Stacey Rosenfeld 11/05/14

Today's question is about how to tell the difference between an eating disorder and dieting.

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 EDITOR'S NOTE: "Ask An Expert" is guidance for the general public. Responses from our experts are not to be construed as doctor/patient relationships, which require private and extensive consultation.

 

I am really obsessed with food. I am constantly thinking about what to eat and I do a lot of research on diets. I am not obese, but I want to lose about 20 lbs. I try to cut out the really fattening foods but I splurge sometimes and lately I have been making myself throw up after eating those big meals. It's only like once a week. I get a sore throat and it feels gross, but I am willing to do it because it seems like an easy way to keep from gaining the weight from those meals. I know it's not healthy but is it an eating disorder? I don't really want to stop. Thanks - Cathy

Stacey Rosenfeld: To answer simply, yes, this is disordered. Whether or not you would meet criteria for bulimia nervosa versus what we now call other specified feeding and eating disorder (such as bulimia nervosa of limited duration or purging disorder) depends on the quality of the eating prior to your throwing up (i.e., Does it constitute a binge?), as well as how long this has been going on and how much your body image impacts your self-esteem. Either way, I'd be concerned.

Self-induced vomiting, or purging, comes with a number of dangerous medical consequences, and can even be life-threatening. For many, the behavior can become addictive and out-of-control. It might seem like an easy way to compensate for your splurge meals, but the reality is, the body still absorbs a significant amount of calories, despite a purge, and the behavior is definitely not worth the cost.

Now on to your splurge meals. . . It sounds like you're caught up in some variation of the diet-binge cycle, whereby you restrict your food, which leads to periodic overeating. The solution to this? Be less restrictive with your intake. Eating a healthy, nutritious diet is fine, but if you're cutting out so much that you feel deprived and then end up overdoing it, then you're overdoing the restriction. So, I would add back in some substance and some more satisfying foods to your intake. The likelihood is that you'll find yourself splurging less frequently (which should help with the purging) and reducing your obsession with food.

To get help with all of this, I'd recommend seeing a therapist who specializes in eating disorders. Evidenced-based approaches, such as CBT, are best. You can find a therapist through the Academy for Eating Disorders or the National Eating Disorder Association.

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Stacey Rosenfeld, PhD, is a clinical psychologist who treats patients with eating disorders, anxiety/depression, substance use issues, and relationship difficulties. A certified group psychotherapist, she has worked at Columbia University Medical Center in NYC and at UCLA in Los Angeles and is a member of three eating disorder associations. The author of the highly- praised Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight, she is often interviewed by media outlets as an expert in the field. www.staceyrosenfeld.com    Full Bio.

 

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