Q&A with Susan Schulherr: What Disordered Eating Really Means
There’s a lot of confusion surrounding the definition of disordered eating. Is dieting disordered? Is overeating disordered? What does it even mean to overeat? In a society where dieting is synonymous with healthy eating, food is vilified and magazines promote tips to trick our bodies, it’s understandable how we’ve lost sight of what normal eating – and unhealthy habits – really are.
Today, I’m thrilled to present my interview with Susan Schulherr, LCSW, who cuts through the confusion and gives advice on seeking help along with tips on reducing disordered eating. Susan is an eating disorder specialist and author of Eating Disorders for Dummies. She also writes a fantastic blog that provides ideas and inspiration for eating disorder recovery. Plus, you can download free recovery worksheets on her website.
Be sure to check out part two of our interview tomorrow!
Many people get confused about various descriptions of excessive eating, such as overeating, compulsive overeating, disordered eating and binge eating. What does “over” really mean, and where do you draw the line and call it a problem?
Let’s start with “over.” When it comes to defining “over,” it’s not surprising that people get confused. The biggest reason for all the confusion is that eating, and overeating, has become matters of public definition instead of an issue between you and your body. We live in a culture that so narrowly defines what’s an acceptable body size that many, if not most, people end up feeling they can’t trust themselves to know what’s the right amount to eat.
Here are some of the questions to sort out in trying to find your way through the confusion about “over”eating:
- Who’s asking? Are you defining “over” while suffering from anorexia or otherwise restricting your eating in unhealthy ways? And just what is “unhealthy restricting” anyway? Is it only anorexia? Is it fasting, even for “healthy” reasons? Is it following a diet of under 1200 calories a day? Is it any kind of dieting? Is the person defining “over” you, the actual eater? Or is it someone else, deciding for you? Is this person (or entity, like a magazine or professional organization) qualified to decide what the right amount is for you?
- What’s the standard? Are we talking about eating excess from a point of view of health? Social norms? Physical appearance?
- How frequent? Are you looking at a one–time episode? Or something that happens once–in–awhile, like holiday dinners? Is it a pattern, like every time you’re depressed, angry, or at your in–laws? Or is it about how you eat each and every day (or night)?
- How does the eating feel inside, physically? Are you eating until you’re comfortably full? Or until it hurts?
- How does it feel inside, emotionally? Are you enjoying yourself? Are you eating with no awareness of what or how much you’re eating or how your body is responding? Are you responding to emotional or social cues rather than body cues? Do you feel driven to keep eating?
So what if you decide your eating is “over,” does that mean you are engaged in disordered eating? Not necessarily. Disordered means you are eating in a way that harms you psychologically and/or physically. Psychological harm may occur when you use food for reasons other than sustenance and pleasure.
Eating to manage your emotions is probably the most common example. When eating is your go–to emotional haven, you don’t learn more effective ways to manage your emotions. When eating for psychological purposes becomes compulsive—that is, you feel driven and as if the eating is beyond your control–you are bingeing (or at least in bingeing’s neighborhood). If you binge frequently or as part of a pattern, you have Binge Eating Disorder.
When you employ weight loss strategies that can or do compromise your physical health, you are also engaging in disordered eating practices. Examples include skipping meals, fasting, cutting out whole food groups, dieting repetitively, or using laxatives or diuretics. The more disordered eating practices you engage in, the more you are at risk for crossing the line into a formal eating disorder.
Why do you think individuals develop disordered eating?
The two most basic reasons people develop disordered eating patterns are: 1) trying to achieve unrealistic cultural ideals for thinness, and 2) using food or restricting to manage emotions and stress. Additional factors such as genes, childhood family patterns, psychological make–up, trauma history and having a career that demands thinness increase an individual’s vulnerability to sliding from disordered eating into formal eating disorder.
If readers think they have a problem with disordered eating, what can they do next?
The first thing they should do is STOP DIETING! Dieting sharply increases the likelihood of crossing the line from disordered eating into eating disorder, especially among vulnerable individuals. Shockingly, few people actually succeed at dieting and each dieting failure can invite more extreme and disordered practices the next time around.
The real solution is the plain vanilla one: develop a healthy way of eating now, a way that the reader can imagine following for the rest of his or her life. This includes learning to listen to and respect body cues that report what and how much a person needs to eat at any given moment. An internal eating gauge needs gradually to replace external prescriptions and controls. (Good news: our bodies come equipped to give us the information needed, if only we pay attention!)
If a person tries to turn to normal, healthy eating and finds they cannot disengage from their disordered practices, it’s probably a good time to consult a professional. Often working with a nutritionist who specializes in disordered eating and eating disorders can be just what’s needed. More stuck patterns suggest psychological issues may be holding disordered eating in place. In these instances, consulting with a psychotherapist who specializes in eating issues is probably a good idea. Some people with compulsive eating patterns find Overeaters Anonymous to be helpful. Alternative practices such as meditation, yoga, hypnosis and acupuncture have benefited others.
What are some tools and techniques that we can use day to day to reduce disordered eating?
Awareness is your best friend for reducing disordered eating. Anything that increases awareness about your disordered pattern will be helpful: journaling, eating mindfully, reconstructing what leads up to disordered eating events so you can better understand what triggers them, and so on.
Sitting through urges to eat or restrict compulsively, even if only briefly at first, builds tolerance for the feelings and sensations. You learn, little by little, that you don’t have to act on them.
Similarly, sitting through uncomfortable feelings or situations where you would normally turn to food or restricting also builds tolerance and capacity. You get better at this the more you practice.
Talk to yourself reassuringly in these circumstances: You’ll be okay; you can handle this; take it easy, you’ll make it…
Thanks so much, Susan, for clarifying an often confusing topic and providing such great insight! Stay tuned for part two tomorrow, where Susan talks about healthy eating myths, ending body hatred talk, her favorite body image tips and more.
On a side note, if you’re an eating disorder professional, you may be interested in an upcoming conference in Las Vegas this May (see here for more info) on advanced treatments for eating disorders. Speakers include Ken Weiner, M.D., Walter Kaye, M.D., Ann Kearney-Cooke, Ph.D, and Margo Maine, Ph.D., and Jenni Schaefer.
What are your thoughts on disordered eating? Anything else you’d like to know about disordered eating?
Tartakovsky, M. (2010). Q&A with Susan Schulherr: What Disordered Eating Really Means. Psych Central. Retrieved on May 27, 2015, from http://blogs.psychcentral.com/weightless/2010/04/qa-with-susan-schulherr-what-disordered-eating-really-means/