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Food & Fitness

Understanding EDs

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Body Image

(Diet) Culture & Society

The term “intuitive eating” has entered the mainstream, and it’s easy to find influencers and self-proclaimed experts on social media touting its benefits. As explained on, say, TikTok, the idea is pretty straightforward: you eat exactly what and how much you feel like eating, listening to your body’s 

 as well as its cravings. But in reality, intuitive eating is much more complex—especially for those who have struggled with an eating disorder. Read on to learn the definition of intuitive eating, its risks and benefits, how it relates to eating disorder recovery, and more.

Often when people learn about intuitive eating for the first time, their response is something like this: “But if I allow myself to eat whatever I want, I’ll just eat donuts and French fries all day.” Indeed, there’s a common fear that without the structure of a diet plan or food rules, eating will start to feel out of control, and you’ll only choose “

.” But while intuitive eating does emphasize giving yourself permission to eat a wide variety of foods, including the fun foods you love, this doesn’t mean saying “screw it” and never eating a fruit or veggie again.

“Intuitive eating is a framework that helps people improve their relationship with food,” says registered dietitian and certified intuitive eating counselor Jen Baswick. “Intuitive eating is all about unlearning and letting go of the external ‘rules’ taught to us by diet culture and re-learning your natural internal cues to let them guide your eating habits.”

Listening to and honoring your body’s cues instead of a diet (or eating disorder voice) is a foundational aspect of intuitive eating, but it’s not simply about eating when you’re hungry and stopping when you’re full—it’s a lot more nuanced than that. “Intuitive eating includes how and why we eat what we eat—preferences, nutrition, access, nervous system and health function—as well as our emotional relationship to food and even how we view physical activity,” shares eating disorder dietitian Tracy Brown, RD.

Developed in the 1990s by dietitians Elyse Resch and Evelyn Tribole, intuitive eating includes 

Giving yourself unconditional permission to eat

Developing healthy coping strategies for emotions

Balancing eating for health and pleasure (AKA “gentle nutrition”)

The risks and benefits of intuitive eating

Intuitive eating is a practice that can have a powerful and positive domino effect in your relationships with food as well as life beyond the plate. In my own practice as a dietitian, I observe clients of all genders, ages, body sizes and diagnoses reaping numerous benefits of intuitive eating, and my colleagues in the space report seeing similar changes.

“Some of the benefits of intuitive eating include fostering more self-compassion, higher self-esteem, and more optimism,” Baswick says. “It’s also associated with a decrease in 

, preoccupation with food, food-related anxiety, and 

.” Research shows associations between intuitive eating and better 

However, intuitive eating can be a risk for people who struggle with eating disorders and try to go all in before they’re ready, or for those who don’t have the right support (like a dietitian and therapist) in place.

“Sometimes, people can jump right into intuitive eating without understanding that as soon as the container of their ‘diet’ is lifted, often big emotions can arise that they aren't prepared for, and a ‘whack-o-mole’ situation can happen,” explains Brown. “Like ‘if I’m not restricting, then I over-exercise.’” There are a number of different ways this might show up, but people should be on alert for compensatory behaviors—like compulsively working out—that arise once the 

For this reason and others, it’s critical that those in eating disorder recovery take baby steps toward intuitive eating. Doing this allows time for organ systems to heal, for the eating disorder voice to quiet, and for a person to become reconnected with their body.

There’s one more risk that merits a mention: the risk of intuitive eating getting warped by the forces of diet culture. I often catch this in my own practice, when intuitive eating starts to morph into a perfectionistic hunger-fullness diet. “The 

 and diet industry has now co-opted the term intuitive eating and uses it in a restrictive way surrounding weight loss, which it is not meant for,” Baswick says.

Who is intuitive eating for (and not for)?

Generally, intuitive eating is meant for every human, since we come out of the womb connected to our hunger and fullness cues. However, diet culture, disordered eating, or eating disorders can often sever our connections to our bodies and require us to re-learn how to get in touch with them through professional support.

“Some people will need guidance as anyone who has struggled with emotional under- or overeating has been disembodied for months or years,” Brown says, “and they’ll likely progress more efficiently and with less guessing and stress with someone offering feedback and a safe relationship.”.

According to Baswick, there are a few populations that may have a harder time practicing intuitive eating, such as those who are food insecure or have food allergies. “Using intuitive eating with populations who may have a more complicated relationship with food is not impossible, but should always be approached on a case-by-case individualized basis.”

Intuitive eating could also be a risk for someone with a metabolic condition, like diabetes or hypertension. “If someone who has diabetes wants to practice intuitive eating, they should get the support of a dietitian to help them understand how to use the principles of intuitive eating while also understanding how to keep their blood sugar managed well,” says Baswick.

Can intuitive eating fit into eating disorder recovery?

 shows a link between using intuitive eating principles on college campuses and improved eating disorder symptoms among students, versus using self-weighing and calorie counting. 

 evaluated an intuitive eating program in an eating disorder treatment center, finding an association with intuitive eating abilities and positive treatment outcomes.

In my clinical opinion, intuitive eating can be successfully and effectively used at any part of the eating disorder recovery process, as long as it's done so consciously and carefully. For example, I’ve had clients who are still 

, disconnected from internal cues, and still need to mechanically eat and follow meal plans closely; however, they can start to learn to practice permission with food (a foundational part of intuitive eating), within the structure of their plans. I’ve also had clients simply start to notice hunger and fullness cues (another critical step in intuitive eating) before and after meals without necessarily letting these cues guide eating habits yet. For clients further along in recovery, we work to move them away from meal plans and into alignment with their bodies.

“I believe that aspects of intuitive eating can be very complementary to eating disorder recovery, especially rejecting the diet mentality, making peace with food, and body respect, to name a few,” adds Baswick.

However, Brown, Baswick and I all agree that honoring hunger and fullness are two of the trickier intuitive treatment principles to follow early on in recovery. “It takes time to develop accurate interoception, or feeling hunger and fullness separated from emotions or trauma body memories,” Brown says. “People can and do get signals back, but accuracy builds as physical, emotional, and mental healing occurs.”

Baswick adds that gastroparesis (slowed stomach motility) and feelings of early fullness despite needing more food (which is common in anorexia) can complicate things. She also points out that the rigid thinking common in eating disorders can make the looser framework of intuitive eating tricky. “One danger is if a patient turns following their hunger and fullness cues into another restrictive pattern to follow,” she says. “This is why it's so important to work with a dietitian that specializes in eating disorder recovery and knows intuitive eating well to support people along their recovery journey.”

Whether you are in eating disorder recovery or are simply working on your relationship to food and body, intuitive eating offers a liberating alternative to the rigid, black-and-white thinking of diet culture and eating disorders. A departure from eating and living with self-control, judgment, and punishment, intuitive eating provides a nuanced, compassionate way of nourishing yourself from an embodied place of self-care, self-trust, and self-respect.

Linardon, Jake et al. “Intuitive eating and its psychological correlates: A meta-analysis.” The International journal of eating disorders vol. 54,7 (2021): 1073-1098. doi:10.1002/eat.23509

Hayashi, Lauren C et al. “Intuitive and mindful eating to improve physiological health parameters: a short narrative review of intervention studies.” Journal of complementary & integrative medicine, 10.1515/jcim-2021-0294. 16 Dec. 2021, doi:10.1515/jcim-2021-0294

Tylka, Tracy L et al. “Intuitive eating is connected to self-reported weight stability in community women and men.” Eating disorders vol. 28,3 (2020): 256-264. doi:10.1080/10640266.2019.1580126

Romano, Kelly A et al. “Helpful or harmful? The comparative value of self-weighing and calorie counting versus intuitive eating on the eating disorder symptomology of college students.” Eating and weight disorders : EWD vol. 23,6 (2018): 841-848. doi:10.1007/s40519-018-0562-6

Richards, P Scott et al. “Can patients with eating disorders learn to eat intuitively? A 2-year pilot study.” Eating disorders vol. 25,2 (2017): 99-113. doi:10.1080/10640266.2017.1279907

What Is Intuitive Eating? (And Can It Fit into Eating Disorder Recovery?)

I spent several years of my life living in an energy (calorie) deficit. At the time, I never stepped back to wonder what happens if you don’t eat enough. I didn’t understand how my entire being—mind, body, and emotions—were being affected by living that way. I’m not dramatizing when I say that every part of me was drastically and negatively impacted by undereating. I suffered serious consequences, some of which I’ll share with you today. Fortunately, I committed to healing and recovery over a decade ago, which meant first moving out of an energy imbalance by eating more food, exercising less, and learning how to manage stress.

Today, as an eating disorder dietitian, I see the side effects of not eating enough in my clients and how it infiltrates every facet of their lives every day. Sadly, undereating and setting goals to undereat are normalized and supported across mainstream and social media, without much (if any) regard for the negative impact it might have.

Let’s look at the different ways that undereating can significantly impact you mentally, emotionally, and physically.

In my practice, I notice heightened anxiety is one of the main side effects of undereating, and, personally, I know now that spending years feeling on edge and suffering panic attacks was a direct result of not eating enough food.

Undereating, which often comes with malnutrition and excessive weight loss, can also 

 as well as anxiety due to changes in brain chemistry. 

, RDN, LD, explains that inadequate nutrition can lead to tissue damage in the brain, as well as a lack of nutrients—specifically vitamin B12, folate, and zinc—that 

may cause depression, cognitive decline, and irritability

, RDN, LD. She also notes that malnutrition may also lead to a decrease in production of dopamine and serotonin, two mood-regulating hormones, which can worsen symptoms of anxiety and depression.

On top of that, undereating makes it more difficult to deal with tough emotions and hard life experiences and relate to other people. “People who frequently underfuel often describe an increase in irritability, a decrease in patience, and a tendency to have diminished capacity for emotional regulation,” explains 

, MS, RD, CEDS. “They tend to experience mood swings, with less tolerance for ‘riding emotional waves’ throughout the day.”

When I was undereating, I remember feeling like I was abnormal because most of my mental space was taken up by thoughts of food. It was hard for me to stay present in conversations or to pay attention to my work and studies. Now, it’s one of the first concerns clients who are undereating share with me when we start work together: they believe they’re uniquely obsessed with food, when in fact their bodies are simply trying to survive. “Your body doesn't understand that this ‘famine’ is self-inflicted, so it's going to be on high alert to increase its ability to survive and find food,” explains Equip Nutrition Director Erin Reeves, RD. “Therefore, you might be thinking about food more or feel more out of control when you do eat because your body can't trust there won't be a famine again.”

In one famous landmark study (called the 

 on Human Starvation by researcher Ancel Keys), a group of men were intentionally underfed over an extended period. 

 the earliest and most present symptom of their starvation experience was a fixation on and thoughts about food. All the men said they experienced “intellectual inefficiency,” including decreased concentration and rate of learning, or poor judgment. Additionally, some men responded by gathering recipes and cookbooks, eating faster than normal, and dreaming of food, and some said they wanted to watch others eat often while others said they couldn’t bear doing so.

When you aren’t eating enough food, Burkholder says, “much of the ‘airtime’ in your mind is consumed by thoughts of food, leaving little room for other things. This is one of the non-physical effects of not eating enough that I find scariest: without room or energy for life outside food and body, it’s impossible to live in alignment with your true core values. In other words, it’s impossible to be yourself.

In the landmark study I mentioned, the men reported 

 alongside emotional issues like increased irritability. These personality changes included social introversion, loss of sexual interest, decrease in self-initiated activity, and lethargy. Underfueling can also lead someone to become a 

 than they are when they’re eating enough.

In my work with clients who aren’t eating enough, the changes that I observe over our time together can be mind-blowing. As they work toward fueling their body adequately, it’s as if they’re re-emerging from a dark haze that was keeping them disconnected from themselves, their lives, and the people around them. Their sense of humor and mental flexibility returns, their voices become more authentic, hobbies are more interesting, their ability to access life’s pleasures come back, boundaries become easier to set and relationships richer, and their genuine paths in life often become clearer.

Another common side effect of undereating is a decreased basal metabolic rate (BMR), or the amount of energy your body needs to perform basic functioning. The simplest way to think about this is that your body is focused on survival, so if you’re not adequately fueling your body, it will slow down all of its processes in order to conserve energy and survive with less energy. “There are no tricks around this by eating a certain spicy food or doing a certain workout,” explains Reeves. “Your metabolism will slow down if you aren't giving it enough."

This is one of the reasons that so many people who spend years yo-yo dieting to lose weight often end up at higher weights than when they started: their bodies get thrown off by undereating and try to recalibrate by adjusting metabolic speed, only to get confused again, and the cycle continues.

 (or loss of period for more than three months) was my body’s main indicator of not yet being fully recovered from my own eating disorder. It’s a common side effect of undereating and can lead to a myriad of issues, including infertility and osteoporosis. Food restriction, anxiety, depression, emotional stress, excessive exercise, energy imbalance, and malnutrition are associated with development of amenorrhea, according to 

The Journal of Clinical Endocrinology & Metabolism

 concluded that low energy availability from undereating can suppress all reproductive hormones. “In females, levels of estradiol and progesterone—two important reproductive hormones—decrease. Estradiol is responsible for bone growth and remodeling, so low estradiol levels can quickly diminish bone density,” Burkholder explains. “In males, low energy availability disturbs testosterone levels and leads to fatigue, low sex drive, sexual dysfunction, and low bone mineral density.” Essentially, when you don’t eat enough, your body prioritizes vital functions, like heartbeat and lung expansion, and shuts down processes it deems non-essential. “Your body downregulates to conserve as many calories as possible, and that means forfeiting reproductive function,” Burkholder adds.

6. Nutrient deficiencies & muscle breakdown

Another serious side effect of undereating is the development of nutrient deficiencies, which can lead to health conditions like anemia (often a result of iron deficiency), cold intolerance, hair loss, skin problems, insomnia, bone issues, and a weakened immune system. “Your immune system will be depressed, causing an increase in infection, cold and flu or other illnesses,” says Reeves. “Your heart rate slows, there’s less oxygen flow, dizziness and fatigue.”

Undereating can also cause catabolism, or when the body breaks down lean tissue like muscle for fuel, which can lead to loss of muscle mass and muscle wasting. “Your muscles will get broken down faster because there are neither the energy nor the building blocks—amino acids and protein—available to maintain itself,” Reeves explains. Since the heart is largely made of muscular tissue, it will also start to weaken with chronic underfueling, and vital signs like blood pressure and heart rate can fall dangerously low. “This weakening of the heart reduces the ability to pump blood throughout the body, which can lead to fatigue and shortness of breath,” Grimes explains. “Malnutrition also disrupts the electrical activity of the heart, the power behind the heart’s contractions, which can be fatal.” And without enough blood sugar circulating in your blood, which can occur when you’re regularly undereating and have depleted all the glucose stores in your liver and muscles, you can experience hypoglycemia, which can also be deadly. 

Plus, if you’re engaging in physical activity while undereating, your muscles will have a harder time recovering and you’re likely to experience decreased athletic performance, according to Burkholder.

Grimes explains that in addition to affecting heart tissue, malnutrition can result in the breakdown of tissue in the digestive tract, which can, over time, lead to a weakening of muscles in the stomach and intestines. In fact, 

 shows malnutrition and weight loss from undereating can slow down the gastrointestinal (GI) tract, which can cause general 

 (or slowed movement or motility of stomach muscles), constipation, reflux, heartburn, bloating, and diarrhea. Reeves explains that undereating will also decrease the amount of enzymes your body makes that help break down food, leading to further GI symptoms. In my practice, I’ve observed GI disturbances from undereating that cause significant disruptions in clients’ day-to-day functioning and overall quality of life.

 I mentioned, the men reported that once the restriction period ended, they felt an initial loss of control around food during the refeeding period. Some of them reported wanting to eat continuously, while others said they binge ate (and never had before the experiment). More than half of them reported overeating.

In my work, I’ve noticed that most of my clients are surprised when they realize their bingeing or overeating is often rooted in undereating. The thing is, when we’re underfed, our bodies will do everything possible to get us to reclaim a state of equilibrium, and that can sometimes manifest in out-of-control eating, binge eating, or an inability to listen to and honor your hunger and fullness cues. Additionally, undereating and 

“Some people find themselves in chronic deficits unintentionally—their lives are busy, schedules are packed, perhaps their physical activity is high, or they’re struggling with a low appetite,” Burkholder says. “Others may find their chronic deficit has deeper roots: body image concerns, pressure from family members or coaches to maintain a low weight, or an internalized list of rigid food rules.” Also, several of my clients presented with undereating that stems from trauma, and they’re using restriction to cope, numb, disassociate, and indirectly express hard feelings.

The effects of not eating enough are widespread and serious. But there’s good news: most can be reversed with adequate nourishment. Since I stopped undereating and now live within energy balance, my anxiety is manageable, I feel generally more at ease, my focus and ability to stay present with others is good, I have ample brain space for life outside of food, and my reproductive system is fully functioning.

However, it’s tough to get there on your own. Establishing or re-establishing energy balance and reversing the effects of undereating usually takes professional guidance from a team of providers (usually at least a therapist and a dietitian). “Learn from a non-diet dietitian how much your body really needs. It's difficult to use online calculators or providers that endorse weight loss, because you will likely get a calorie goal that is far too low,” Reeves says. “Stay in your lane: don't compare yourself to others or ask your friends how many calories they eat. Your body is its own unique machine, and looking at a snapshot from a peer or someone's 'what I eat in a day' is not going to give you the personal guidance you need to thrive.”

If you’re concerned that you’re not eating enough, we’re here to help. 

Reach out to our team for a free consultation

Issue 59 I The Starved Brain – Can What We Eat Determine How We Think?

https://nedc.com.au/eating-disorder-resources/find-resources/show/issue-59-i-the-starved-brain-can-what-we-eat-determine-how-we-think#:~:text=Restricted%20eating%2C%20malnourishment%2C%20and%20excessive

Lachance, L., & Ramsey, D. (2015). Food, mood, and brain health: implications for the modern clinician. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6170050/#:~:text=Several%20nutritional%20deficiencies%2C%20such%20as

Eckert E.D. et al. (2018). A 57-Year Follow-Up Investigation and Review of the Minnesota Study on Human Starvation and its Relevance to Eating Disorders. 

https://www.researchgate.net/publication/324507398_A_57-YEAR_FOLLOW-UP_INVESTIGATION_AND_REVIEW_OF_THE_MINNESOTA_STUDY_ON_HUMAN_STARVATION_AND_ITS_RELEVANCE_TO_EATING_DISORDERS

. (2023, May 9). Duke Department of Psychiatry & Behavioral Sciences. 

https://psychiatry.duke.edu/blog/starvation-experiment

. (n.d.). Mayo Clinic. Retrieved April 1, 2024, from 

https://www.mayoclinic.org/diseases-conditions/eating-disorders/symptoms-causes/syc-20353603#:~:text=Dieting%20and%20starvation.&text=Starvation%20affects%20the%20brain%20and

Gordon, C. M., Ackerman, K. E., Berga, S. L., Kaplan, J. R., Mastorakos, G., Misra, M., Murad, M. H., Santoro, N. F., & Warren, M. P. (2017). Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline. 

Montani, J. (2021). Ancel Keys: The legacy of a giant in physiology, nutrition, and public health. 

Wasserfurth, P., Palmowski, J., Hahn, A., & Krüger, K. (2020). Reasons for and Consequences of Low Energy Availability in Female and Male Athletes: Social Environment, Adaptations, and Prevention. 

https://doi.org/10.1186/s40798-020-00275-6

Iwasa, T., Minato, S., Imaizumi, J., Yoshida, A., Kawakita, T., Yoshida, K., & Yamamoto, Y. (2021). Effects of low energy availability on female reproductive function. 

National Centre for Eating Disorders. (2011). 

The Effects Of Under-Eating | National Centre for Eating Disorders

https://eating-disorders.org.uk/information/the-effects-of-under-eating/

Cost, J., Krantz, M. J., & Mehler, P. S. (2020). Medical complications of anorexia nervosa. 

Mathisen, T. F., Heia, J., Raustøl, M., Sandeggen, M., Fjellestad, I., & Sundgot‐Borgen, J. (2019). Physical health and symptoms of relative energy deficiency in female fitness athletes. 

Scandinavian Journal of Medicine & Science in Sports

https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787

‌Eckert E.D. et al. (2018). A 57-Year Follow-Up Investigation and Review of the Minnesota Study on Human Starvation and its Relevance to Eating Disorders. 

What Happens If You Don’t Eat Enough? 8 Ways Undereating Affects Your Body and Mind

When Equip Lead Peer Mentor Makailah (Mak) Dowell was struggling with binge eating, she turned to food for the sense of comfort and safety it provided. But while she found instant solace during each binge episode (the term for eating a large amount of food at one time while feeling out of control), any initial positive sensations were immediately replaced with fear and shame. Like many who have experienced binges, Dowell—who was diagnosed with 

—was left in distress once the food was gone, not knowing what to do after binge eating.

Often, Dowell felt the need to “compensate” for her behavior or “fix” the damage she had done, which is a common feeling after binge eating. “The ‘fixes’ had to be instant,” she says. “I would purge constantly and that’s how I was diagnosed with bulimia: my dentist saw my sudden tooth decay and knew something was wrong.” In addition to purging, Dowell’s other “fixes” included self-harm, excessive exercise, and continuous self-criticism. “I figured I had to show myself that I could never, ever do it again,” she says. “It would be this constant cycle of ‘everything’s fine, binge, response, self-hatred, a lot of time passing, then everything’s fine again.’ Then the cycle repeated itself. It is exhausting, ruthless, and no one comes out unscathed.”

As Dowell and eating disorder experts can attest, attempting to “fix” a binge through compensatory behaviors like 

, overexercise, restriction, and more, will never actually “fix” the issue at all. In fact, engaging in these behaviors just compounds and perpetuates a harmful cycle. Read on to learn more about binge eating, why it happens, and what to do after binge eating that will actually help you.

A binge is defined as an episode in which someone eats a large amount of food in a short amount of time—past fullness and often to the point of physical discomfort—while feeling a lack of control over what or how much they’re eating. Binges can look different from person to person, but are almost always followed by intense feelings of guilt, shame, or other distressing emotions. And while binge eating is a common symptom of serious eating disorders like bulimia and BED, it can also occur outside the context of a diagnosable illness.

“As an eating disorder dietitian, I’ve worked with countless people who have struggled with binge eating in the past,” says Equip Clinical Partnerships Representative and registered dietitian Christina Fattore, MS, RDN. “One common misconception about binge eating is that it only occurs in the context of bulimia or BED, which I’ve found is often not the case. Anyone who struggles to maintain a healthy relationship with food or deprives their body of necessary nutrients is at risk for engaging in binge behavior.”

The reasons why people binge and how they feel after the binge also vary. “We don’t live in a black-and-white world and the same thing applies to the binge cycle,” Dowell says. “Some binges might ‘feel good’ and fulfill an emotional need, while other binges feel like a complete spiral from the eye of the storm. Binges might de-escalate what is happening within yourself.”

Fattore says that one of the most difficult things for many people to reconcile is the shame they associate with binge behavior in contrast to the cultural glorification of restriction (especially since the two are 

). “I find that patients struggling with binge eating are often told to behave in a way that directly exacerbates the behavior—whether that be through dieting, cutting out certain food groups, or engaging in excessive physical activity,” she says. “Unfortunately, I’ve also found that these patients often struggle to seek help, likely due in part to the above. Until we stop pathologizing what can largely be viewed as a normal biological response to restriction, I think we will continue to see a significant number of people who struggle with binge eating.”

Because of the overwhelming shame many people feel following a binge, it’s understandable why you might be tempted to turn to compensatory behaviors like dieting or overexercising to “counter” the effects of the binge. But tempting as they may seem in the short-term, these methods aren’t helpful: they don’t address the root cause of binge eating, and they usually set you up to binge again.

“One of the mistakes I most commonly see is an attempt to compensate for binge behavior via restriction or excessive amounts of physical activity,” Fattore says. “This perpetuates an ongoing cycle of undernourishment and increased hunger cues that sets the stage for another binge episode to occur. By depriving the body of necessary nutrients in the aftermath of a binge, we subject ourselves to experience a desire for food far beyond what can ever be satisfied by ‘normal’ eating.”

you do after binge eating? Thankfully, there are constructive alternatives to the compensatory behaviors that tend to reinforce 

 habits. If you struggle with binge eating, try some of these actionable, recovery-supporting steps the next time you’re left wondering what to do after a binge:

“Call you friends, your recovery buddies, your aunt; call someone who encourages you and your chosen values,” Dowell says. “Every time I made that phone call, I would be brought back to reality. There is life outside of this binge episode, my people still love me, and I will be okay and I still honor my values.”

. “Engaging in mindful movement after a binge episode can not only help us mentally reset, but also encourages increased gastric emptying and GI motility, both of which can decrease physical discomfort and bloating after a binge,” Fattore says. As the physical discomfort abates, the mental and emotional discomfort also tends to lessen.

. “Have food after!” Dowell says. “I cannot stress this enough: do not react by not eating. Restricting makes your body and mental health feel much worse after the binge. Continue with your day with the same meals and snacks you would have normally. Remind yourself you are worthy to take space, nourish yourself, and be gentle.”

. Remember that binges are a natural evolutionary reaction to restriction, not a lack of willpower (more on that below). “The binge itself had nothing to do with personal failings and everything to do with biology,” Fattore says. “Your body is doing what it can to keep you safe—thank it for that.”

 “I cannot explain how exhausting and emotionally draining a binge can be,” Dowell says. “You may not have even enjoyed the food, you probably worried the whole time beforehand, and afterward is an exhausting experience itself. Curl up with your favorite book or TV show and rest. Let your body heal with sleep. Usually, I would feel so much better even after a few hours of rest.”

If you’re experiencing recurrent episodes of binge eating, you may be struggling with an eating disorder like BED or bulimia. Eating disorders are serious mental illnesses, and not something that you can fix on your own through sheer will or by just deciding to stop. Talk with your doctor or 

 to get a professional assessment and the support and resources you need to heal.

Struggling with binge eating?

Why binge eating is not an issue of willpower

, most binges are preceded by a period of restriction. “It’s important to recognize that binge behavior often results from a very normal biological response to ongoing restriction rather than a lack of willpower,” Fattore says. “As human beings, our brains have evolved to employ protective mechanisms that ensure our physical safety and physiological stability.”

Any time humans restrict their food intake—regardless of whether it’s due to famine, food insecurity, guilt, or a strict diet—the brain’s hypothalamus attempts to remedy the situation by signaling for increased production of ghrelin (the “hunger hormone”), and 

decreased secretion of insulin and leptin

 (the hormones that make us feel full). “When this occurs, there’s very little we can do to fight against our own biology,” Fattore says. “In this way, binge eating is our body’s attempt to keep us safe and return to a state of metabolic homeostasis.”

Fattore points to studies indicating that not only do dieting and restriction increase risk for binge eating, even in people who don’t have a history of disordered eating, but they have also been shown to prolong binge eating episodes, 

especially in those who may be struggling with bulimia or BED

. “We can safely assume, then, that binge eating truly has nothing to do with willpower,” she says. “It’s a learned evolutionary response to a dangerous physiological state: undernourishment.”

Having experienced the destructive cycle firsthand, Dowell can attest that attempting to “fix” the problem through “discipline” or self-punishment will only make things worse. “You cannot ‘will’ yourself out of a binge,” she says. “You’re facing a huge problem, and that is your eating disorder. I remember that I used to believe that it was my lack of willpower that was why I would ‘binge’ and be ‘bad.’ I was never bad. My eating disorder was bad and bad to me. And there is no such thing as will with an eating disorder. You need and deserve help to stop.”

What you choose to do after a binge can make a big difference in whether you binge again, but often it can feel impossible to make those healthier choices on your own. 

 to get a free, professional assessment and learn more about treatment for binge eating at Equip.

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What to Do After Binge Eating (And What Not to Do)

Like the medical world, the field of nutrition and dietetics encompasses a vast variety of niches and specialties. I have dietitian colleagues who are experts in almost every area of nutrition you could imagine, including diabetes, kidney health, food allergies, cancer treatment, gut health, and (like me) eating disorders. Just like your gynecologist isn’t also going to be your cardiologist, a dietitian who specializes in food allergies isn’t going to be the best choice to treat an eating disorder. In that case, you need to see an eating disorder dietitian.

Specialties and training aside, dietitians can also have varying philosophies on nutrition, weight, and health, and this perspective has an impact on their work with clients. When seeking treatment for an eating disorder, you’ll want to work with someone whose philosophy is aligned with recovery, which is another reason why it’s essential to seek out an eating disorder dietitian. Read on to learn more about the role of an eating disorder dietitian, why it’s key to include one in your care, what makes a dietitian equipped to work with you, and some tips to consider in your search.

What we mean when we say “eating disorder dietitian”

 is someone who has the skill set, training and philosophical alignment to work with someone through their eating disorder recovery,” explains Equip Director of Nutrition Erin Reeves, RD. “They’re familiar with all eating disorders and have robust knowledge in how to work through nutritional and therapeutic challenges associated with recovery work.”

Regardless of the level of care you choose (residential, inpatient, partial hospitalization, intensive outpatient, or 

necessary part of a multidisciplinary team

. This team may also include a doctor, therapist, psychiatrist, support people (like parents or spouses), and sometimes a recovery coach (

learn more about multidisciplinary care teams at Equip

).“Eating disorder dietitians work in tandem with doctors to ensure medical safety and with therapists to help patients cope by using new tools that are not their eating disorder,” explains Taylor Aasand, MPH, RDN, of 

 of a dietitian’s role in eating disorder care showed they can wear several hats. During eating disorder treatment, an eating disorder dietitian may help clients:

 and correct nutrient deficiencies if necessary

Meal plan, grocery shop, and prepare and cook food

Let go of destructive thoughts, beliefs, and behaviors

In my work as an eating disorder dietitian, I view my sessions with clients as opportunities to help them understand the emotional purpose of their disordered behaviors and to create more safety within their bodies and around food so they can live authentic and values-aligned lives.

Eating disorder dietitians also help clients leverage the skills they learn in therapy. For instance, a dietitian might help you employ the DBT skill of opposite action, where you work to choose and eat foods that your eating disorder mind declares off-limits, or to use the concept of wise mind, where you focus on making food choices from a place of alignment with your values. An eating disorder dietitian may also work with parents, spouses, or others to help them understand how to help their loved one normalize their eating habits and stop disordered behaviors. If a child or adolescent client is using 

 typically supports parents in the nutrition rehabilitation process by providing education and tips for nutrient-dense meals and snacks, and offering insight on energy and nutrient needs.

An eating disorder dietitian’s role in a person’s eating disorder recovery is typically dynamic and always essential. In fact, 

 of patients’ lived experience perspectives on the role and value of an eating disorder dietitian in treatment revealed a common theme: patients felt like they shared their recovery journey with their dietitians because they compassionately held space for their emotional struggles and listened to and honored their needs.

Why it's crucial to work with an eating disorder dietitian in recovery

Working with an eating disorder dietitian is critical in recovery because eating disorder dietitians undergo extensive training beyond the 

baseline education and experience required to become a dietitian

. Given that eating disorders are serious and sometimes deadly diseases, this additional training is a non-negotiable. “Eating disorders are the second deadliest psychological illness, and it’s vital to work with a dietitian who understands that,” Aasand says. “Eating disorder dietitians are often the ones sending patients to their doctor for vital checks, lab work, electrocardiograms, and whatever else may be clinically warranted.”

Patients with lived experience of eating disorder treatment 

 working with dietitians who specialize in eating disorders enhanced their treatment engagement, helped them learn to honor their bodies, and provided personalized and collaborative care. They also reported that dietitians who were thoroughly trained and “upskilled” in eating disorder therapeutic modalities were able to help them beyond food and nutrition intake, and in fact facilitated a larger understanding of their experiences.