The Disordered Eating Continuum

Although eating disorders are not limited to competitive athletes, those who train in a competitive sporting environment and care deeply about their performance are particularly at risk for disordered eating patterns. The cultural emphasis on thinness and the high stress of competition contribute significantly to the risk of developing full-blown eating disorders. Some athletes turn to controlling their food intake when other things in their life may feel out of their control.

Disordered eating and eating disorders may be said to exist on a continuum; all eating disorders involve disordered eating, but not all disordered eating meets Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria for an eating disorder. The difference lies in the frequency and severity of behaviours and the level of distress they cause the individual.

The Australian Institute of Sport and National Eating Disorders Collaboration position statement on disordered eating in high performance sport offers some useful definitions and distinctions. Disordered eating (DE) is defined as “problematic eating behaviour that doesn’t meet the clinical diagnosis of an eating disorder,” involving “a wide spectrum of harmful and often ineffective eating behaviours used in attempts to lose weight or attain a lean appearance.” An eating disorder (ED) is defined as “a condition characterized by a consistent disturbance of eating or eating-related behaviour that significantly impairs physical health and/or psychosocial functioning and meets DSM-5 diagnostic criteria for a feeding and eating disorder.”