What we learned about food, disorders and eating better in 2023

CNN
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This was my year of appreciating bagels.

I was in my kitchen after a long day of building garden beds, hauling bags of soil and chasing my dog when he got hold of a broccoli plant, and I was agonizing over the bagel in my hand.

A voice in my head — which I have known most of my life — told me I should eat something with more greens and less calories. But my fatigued body was crying out for carbohydrates.

All my reporting as a CNN wellness writer has taught me that the shame and disregard of my own body’s request was not making me healthier. But it still took time to tell that to the nagging voice in my head.

This year was about starting to quiet that voice, understanding that an eating disorder is worse than not meeting a beauty standard, and not only eating that bagel, but enjoying it without shame.

If I asked you to imagine a person with an eating disorder, you would likely picture a white, affluent girl in her late teens. She probably has anorexia or bulimia nervosa and is so thin she looks frail.

That picture keeps large populations from getting the care and treatment they deserve, experts said this year.

“What I would say first and foremost is disordered eating — and this also applies to formal eating disorders — don’t look a certain way,” writer Emily Boring told CNN in March of her eating disorder experience. “They affect everyone regardless of gender, race, ethnicity, age, socioeconomic status. Disordered eating and eating disorders do not come with a ‘thin’ or underweight body.”

Although one study this year showed pediatric eating disorder hospitalization rising all around, the increase was particularly sharp for people who are often overlooked, such as males, young adolescents and those with diagnoses other than anorexia or bulimia nervosa.

Hospitalizations of young male patients increased by 416% from 2002 to 2020, in patients ages 12 to 14 by 196%, and those with eating disorders other than anorexia or bulimia nervosa by 255%, according to the research published in December.

The ways an eating disorder can manifest look different than the stereotype, too. Some have little to do with the goal of a smaller body.

Striving for a more muscular form and an obsession with eating “clean” or “healthy” can also ignite eating disorder behavior.

And other diagnoses include binge eating and avoidant restrictive food intake disorder, or ARFID, which is characterized by the avoidance of food groups for reasons such as texture or fear of vomiting.

It’s not just being picky, Dr. Stuart Murray, an associate professor of psychiatry and behavioral sciences at the University of Southern California and director of the Translational Research in Eating Disorders Laboratory, said in February. ARFID can cause problems with having energy or nutritional needs met and may lead to weight loss, faltering growth or issues with psychological and social functioning, Murray said.

The wide range means that those who don’t fit the stereotype are not safe from the insidious grasp of an eating disorder. Worldwide, 1 in 10 people are affected by an eating disorder, according to the nonprofit ANAD, which provides support services for people with these conditions.

Even for those who don’t fit the criteria of an eating disorder, disordered eating can be a big problem.

Disordered eating is when someone has a relationship with food that is not healthy and functional. Although it doesn’t meet the level of a diagnosable disorder, it can include concerning restrictions and rules around eating and exercise.

And it needs to be taken seriously, both for the depth in which it affects US adults and children, and the breadth.

More than 1 in 5 kids and adolescents around the world show signs of disordered eating, according to a February study.

“It’s important to note that both disordered eating and eating disorders are serious and deserve treatment and professional help,” said Jennifer Rollin, founder of The Eating Disorder Center in Rockville, Maryland, via email in February.

Why is disordered eating such a widespread problem? Often, the behaviors associated with it are normalized because society places such a priority on being as lean as possible, Rollin said.

In that culture, it is hard to recognize the harm that could come with counting calories, punishing yourself with exercise or demonizing a delicious food.

This year, dieting — with the restriction, shame and calorie counting — started to look a lot less appealing, according to the latest research.

The ideology that underlies a lot of disordered eating, restrictive dieting and bad relationships with one’s body comes down to diet culture, with societal messaging there is one ideal body type and rigid or restrictive measures that must be put in place to get it.

You can’t easily turn the volume down on diet culture with its fatphobic jokes in movies, parents stressing over children’s calories, certain types of bodies represented in fashion, and even the notion that broccoli is good and ice cream is bad.

It’s everywhere. And it turns out that diet culture and the restrictive practices that come with it may do more harm than good.

While some studies recommend losing weight to reduce the risk of conditions such as heart disease and cancer, both research and often those who have tried it say that restrictive dieting rarely results in long-term weight loss.

The most sustainable way to alter diet and exercise habits is to do so in slow, manageable steps, according to a 2017 study.

And those messages around diet culture go further than just encouraging dieting, according to the National Eating Disorders Association. They can encourage — and make it harder to recover from — eating disorders, the association said.

The case for ditching diet culture shouldn’t just focus on whether or not it will actually make your body smaller, however.

Perhaps even more importantly, I learned this year that, completely independent of body size and shape, everyone should get to enjoy food.

That voice that groaned, “Are you sure about that?” when I picked up a burger and french fries with my sisters on a weekend night was ruining the experience and keeping me disconnected from both my food and those around me.

It’s something many people experience, Charlotte, North Carolina, dietitian Natalie Mokari said in January. And the pendulum often swings from shame and restriction to dissatisfaction and loss of control around food, she said.

“Ultimately order something that is going to satisfy you and make you feel good when you walk out of the restaurant, so you (don’t) spend like $20 on lunch and (aren’t) left feeling hungry, still looking for snacks,” Mokari said. “The more satisfied you are with what you eat, the less you feel the need to mindlessly snack.”

Our bodies are built to tell us when we need to move and when we should rest — when a salad is perfect and when it is time for a big plate of cheesy pasta, or when we have had enough, even if there is still food on the plate.

The problem is that shame often overrides those cues, Mokari said. The solution is to build a more balanced relationship with food and your body so that you hear what it is telling you, she said.

With food and dining important to so many cultural and social events, you also don’t want to miss out just because you are worried about meeting a specific set of restrictions, Mokari said.

“Sharing a meal with people is in my opinion one of the many joys in life,” she added. “Enjoy the company you’re with.”