By SAMANTHA KAVANDER

Do you know anyone with signs of disordered eating? A larger percentage of people struggle with symptoms that do not meet the full criteria of an eating disorder.

Signs such as significant fluctuations in weight, frequent dieting or anxiety associated with meals, feeling weak, changes in skin and hair or even change in menstrual regularity are all signs of disordered eating. Disordered eating is a descriptive phrase, while an eating disorder is a diagnosis.

An eating disorder is an illness where people experience severe disturbances in their eating behaviors, thoughts and emotions. The three most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder.

According to the American Psychiatric Association, anorexia nervosa is characterized by the restriction of food intake that leads to a significantly low body weight. Other symptoms include fear of weight gain, exercising excessively and disturbed perception of body weight and shape.

Bulimia nervosa is described as a cycle of binge eating followed by compensatory behaviors that include vomiting or taking laxatives to undo the effects of the binge eating. Symptoms include intake of large amounts of food followed by a sense of loss of control, and regular purging behavior or use of compensatory behaviors to prevent weight gain. Patients may also experience disturbed perception of one’s body weight or shape, or may be in the normal or overweight body mass index (BMI) range.

Binge eating disorder is described as binge eating without the use of inappropriate compensatory weight control behaviors. Symptoms include large intake of food accompanied by a sense of loss of control over eating behavior, binge eating episodes more rapid than usual, eating until feeling uncomfortably full, eating alone because of feeling embarrassed by how much you are eating, or feeling guilty and depressed after a binge eating episode.

There is no doubt that nutrition and exercise are linked, and the relationship between the two becomes complicated while in the presence of an eating disorder.

Research and clinical practice have provided insights into how exercise, nutrition and eating disorders interact to create both a beneficial and detrimental outcome.

There are several myths about eating disorders and exercise such as “most individuals with eating disorders excessively exercise” or “including exercise in treatment will lead to harmful outcomes.”

Meta-analyses on therapeutic exercise in eating disorder patients state that exercise appears safe when it is not associated with weight loss but is associated with improved strength, cardiovascular endurance and psychological well-being.

Managed exercise is possible for some but not all individuals with eating disorders. There is some evidence of resistance training benefiting severe anorexia patients.

Research shows between 20% to 40% of patients experienced increased muscle strength improvement and 4% to 8% showed improvement in bone density by a 6-month follow up.

Another myth about exercise and eating disorders is that exercise should not be included in eating disorder treatment. Over 90% of clinicians believe that exercise and eating disorders are related, yet only 68% of treatment centers assess physical activity. Out of the 68% of treatment centers that assess physical activity, only 65% of treatment facilities include exercise in their recovery process.

Exercise in eating disorder patients does not need to be at a high intensity. The benefits of exercise with eating disorder patients are possible at a low intensity. Activities that are at a low intensity are more enjoyable and more likely to be continued.

The key consideration in changing the functional relationship of exercise in eating disorder patients is differentiating perfectionism versus excellence. Exercise straddles the thin line between perfection and excellence. Perfection mediates the relationship between eating disorders and exercise.

Perfection versus excellence is a challenging concept when it comes to patients with eating disorders. For example, perfection has a negative connotation, while excellence is taking the positive out of every situation. A good example of perfection would be a fear of failure, while excellence would be a desire for success.

If you know anyone with any of the signs and symptoms listed above, consider seeking professional help. The National Eating Disorder Helpline offers support via phone and text at 1-800-931-2237.

Kavander is a dietetic intern from Bluffton University at the Ohio State University Extension of Hancock County.

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