The difference between an Eating Disorder and REDs

An eating disorder is a mental illness that is characterised by a preoccupation with eating, body weight/shape and usually a fear of weight gain. There are several types of eating disorder, including anorexia nervosa, bulimia nervosa, and binge eating disorder, and all can only be diagnosed by a qualified health professional. However, people may suffer with some but not all the criteria required to reach a diagnosis, and as such can still struggle with sub-clinical levels of disordered eating behaviours, compulsive exercise and/or body image challenges.

In certain fields of activity, such as in sport or dance, there is likely to be high levels of motivation to exercise in order to improve performance in the chosen activity. Furthermore, there may also be a focus on body image. When this focus becomes ‘excessive’ and starts to impact negatively on the person’s wellbeing then it might start to be viewed as more ‘disordered’. When someone tries to control their eating, maintain a low body weight, and exercises/trains at high volumes, then this can lead to an insufficient level of fuelling for the body. The sustained insufficient fuelling for activity purposes results is adverse systemic body changes that are collectively referred to as Relative Energy Deficiency (RED); and because it often occurs in sport or dance settings then is known as RED-S or RED-D, respectively. The RED-D presentation may occur with or without an eating disorder, but often does have psychological or emotional difficulties either leading to the RED-D physiological changes or can even be a result of such changes and therefore they often co-exist.

The assessment and treatment of an eating disorder requires referral to specialist health professionals such as psychiatrists and clinical psychologists. Eating disorders are often long-term illnesses and they present a high risk to the sufferer’s mental and physical health and therefore the earlier the treatment the better the prognosis. However, sufferers may deny treatment as they do not want to relinquish control or make any changes.

A RED-D diagnosis is often made by a specialist medical professional such as a sport and exercise medicine consultant and the treatment route primarily is about improving dietary intake to restore the various body systems that need replenishing to a healthy state once again. However, given that there may be psychological underpinnings behind the RED-D presentation, then it often requires input from a psychologist and psychiatrist as well, where relevant as part of multi-discinplinary management.

If you feel you have either an eating disorder or RED-D then please contact a health professional for help and advice.

Dr Huw Goodwin PhD CPsychol

Clinical Psychologist