Do I Have an Eating Disorder or Am I Overthinking Things?

Dear GoodTherapy.org,

I joined the all-natural trend years ago and loved it. I got more energy, built more muscle, stopped having stomach pains, etc. But my friends say I’m taking it too far, and I can’t tell if they’re right.

I moved to a smaller town recently. There are only fast food chains here, so I cook all my own meals. If my stomach’s growling at work and I forgot to pack lunch, I usually go hungry. I figure it’s better to skip a meal than dump all that salt and sugar into my body.

When my buddies and I go out for pizza, my brain obsesses over all the grease clogging my arteries. I have to force myself to pick up a slice, chew, and swallow. It’s like my body knows it’s eating chemicals. But if I skip pizza and stick to beer, my friends get worried.

I’m not anorexic. I’m fine with being a big guy. Actually, not to brag, but I can bench a full 230 pounds. All I care about is being healthy. My dad died of a heart attack when he was only 42. I’d rather skip pizza night than end up like him.

A healthy body is a good trade-off for being a picky eater, right? Or are my friends on to something and I’m just in denial? —Healthy or Unhealthy?

Dear Healthy or Unhealthy,

First and foremost, you are certainly not alone in wondering how far is too far when it comes to healthy lifestyle choices. The line that divides “healthy or unhealthy” is often a porous barrier rather than a hard and fast wall. It sounds like you’ve put a fair amount of thought into your choices around food for some time. I can imagine having a parent die at a young age from a heart attack would be a massive wake-up call to take your health seriously and make some positive changes in that area. I can also imagine that, in your mind, adopting the all-natural food trend, to some degree, is a way to feel protected from a similar fate.

I’m assuming the concern you and your friends have is if these food patterns are leading you down the path to an eating disorder. To help provide some guidance, let’s get some definitions out of the way. Engaging in disordered eating patterns—potentially dangerous behaviors around food, body, and exercise—doesn’t mean you automatically have a full-blown eating disorder. Orthorexia, for example, encompasses a wide range of behaviors where the focus isn’t necessarily on weight or body size, but rather on the perceived health or purity of food consumed. It is also important to point out that many myths surround eating disorders, one of which is that you must be severely underweight or physically weak. The truth is eating disorders and disordered eating patterns impact people of all walks of life, body shapes, ages, and genders. In fact, many individuals who struggle with disordered eating can be at or slightly above “normal” body weight and size.

I hear your very real concern that unhealthy eating habits could contribute to you leading a life where you follow your dad’s fate. My number one phrase to people in therapy is “it’s not about the food”; what I mean is it isn’t the food itself that causes distress but rather our relationship to the food.

What stands out to me is not only have your friends voiced some concerns with you (kudos to them!) but you also seem to share their worries about some of your food rules. Red flags to any eating disorder therapist are a hypervigilance around food, fears of how food impacts the person’s body, and skipping meals in the service of perceived benefit to the person’s body. What I am hearing in your letter that concerns me is the lack of flexibility around food in your life, justifications to skip meals if you have forgotten to pack a lunch, and sticking to only beer in order to avoid potentially unhealthy food. You also say that you can obsess over what you believe is happening to your body if you have some greasy food. While this may not be your thought process, it seems that at least a small part of you truly believes that pizza, for example, will harm your body—almost immediately—to the point that you have developed a physical aversion and must force yourself to take bites. I’m sure you’ve already guessed this, but that suggests it might be worthwhile to explore what’s going on underneath these rigid food rules that you adhere to.

I hear your very real concern that unhealthy eating habits could contribute to you leading a life where you follow your dad’s fate. My number one phrase to people in therapy is “it’s not about the food.” What I mean by this is it isn’t the food itself that causes distress but rather our relationship to the food. I can imagine your beliefs about food are closely related to your fears of following your dad’s path and dying young. A common goal among individuals working through disordered eating is to strive for balance with food and exercise choices. After all, even the American Heart Association doesn’t mandate a total avoidance of pizza and fast food. Increasing our ability to find intuitive balance and moderation with ALL foods can be what allows us to let go of rigid fear-based rules and even enjoy a slice every now and then.

I can imagine the idea of having disordered eating patterns is of concern to you, otherwise you wouldn’t be writing or taking your friends’ concerns to heart. The good news is it is possible to work through disordered eating patterns with a trained therapist who specializes in eating disorders. Learning new ways to relate to your body and food can help you increase flexibility in your daily life and decrease stress related to food. Remember, this isn’t about “good” and “bad” foods, but rather developing a positive relationship with food where you can make balanced decisions that don’t inhibit you from living a full life. I believe that with the guidance of a professional, you can make positive strides toward a more balanced relationship with food while honoring your desire to lead a healthy life.

Kind regards,

Mandy Rubin, LPC

Mandy Beth Rubin

Mandy Rubin is a Denver-based licensed professional counselor (LPC) who specializes in the treatment of eating disorders, mood disorders, and general life transitions. She has worked in the mental health field since 2010 and has had the privilege of working with a wide array of adults journeying through a multitude of issues. Mandy keeps the person in therapy at the center of all treatment and holds that person as the expert of their own experience. She believes therapy is a collaborative process and looks forward to assisting people on their journeys to a more balanced and fulfilling life.