What does a healthy relationship with food look like?

Shaming yourself for eating an extra slice of pizza, “working off” that brownie, skipping meals entirely or making yourself sick after eating — these could all be signs of a concerning relationship with food.

It can be confusing to navigate between societal pressures to look a certain way and misconceptions of what it looks like to struggle with your relationship to food.

You don’t have to do it alone, though, says family medicine provider Jennifer Banks, MSN, ARNP, FNP-C, with MultiCare Rockwood Clinic. Whether it’s your primary care provider, mental health counselor, dietitian, or trusted friend or family member, support is available no matter where you are.

If you’re concerned about your eating habits or those of someone you love, a good first step is understanding what a healthy relationship with food looks like.

Relationships come on a spectrum

Concerning relationships with food can be broken into three categories: an unhealthy relationship, disordered eating and a diagnosed eating disorder.

The lines between each of these categories can blur, and no one’s experience will look or feel the same, Banks says. You may be able to identify your own category, but a health care professional can help paint a clearer picture.

• An unhealthy relationship with food is often self-defined, Banks explains. “You recognize that something is off with the way you feel about food,” she says. “It may bring up an unhappy feeling, guilt, shame or negative emotions.” You may find yourself meal-planning down to the ingredient, limiting where you dine out, critically tracking everything you consume. You may be unable to enjoy what you eat.

• Disordered eating is much broader, but the key indicator is that your eating habits have become disruptive to everyday life or harmful to your physical and mental health. “It’s something abnormal that occurs on a regular basis with potential to become dangerous,” Banks says. “Things like binging, purging, irregularity with eating, rigidity about what you eat or avoiding social situations that involve food.” These habits do not include certain dietary limitations for health reasons, such as a gluten-free diet.

• An eating disorder requires a clinical diagnosis based on number of symptoms that are cross-referenced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), Banks explains. Some of the most common include anorexia nervosa, bulimia nervosa and binge-eating disorder. Symptoms or indicators could include excessive “fat, weight or calorie talk”; regular limiting of food choices; binge eating; excessive exercise; inducing vomiting or using laxatives, diuretics and diet pills; or avoiding eating around others. Not every person facing an unhealthy relationship with food or struggling with disordered eating will end up with an eating disorder, Banks says. But the factors that often lead to eating disorders are becoming more prevalent.

Who’s most at risk?

Unhealthy relationships with food are becoming the norm rather than the exception these days, Banks says. Eating disorders don’t discriminate despite our misconceptions that they only affect cisgender, white females.

There are, however, several internal and external factors that can put you at greater risk:

• Exposure to harmful types of social media, such as food-restrictive “What I eat in a day” videos
• Surrounding yourself with people or growing up in a family that verbalize body dissatisfaction or diet culture
• Family or personal history of mental illness
• A history of an unhealthy relationship with food

Food should be about feeling good

“Eating disorders don’t have a ‘look.’ It’s easy for people to assume that someone in a larger body is an overeater, but we see a lot of such people who have spent a lifetime on restrictive diets,” Banks says. “Everyone has their own journey with it, and we need to respect that.”

Oftentimes, it’s hard for people to see these potentially harmful habits in themselves — especially when surrounded by it at home or in society.

The mind-body connection is one way to examine where you are. Research has shown that bloating and digestion problems could be related to how you feel about what you’re eating, Banks explains. It’s also known that things like anxiety and depression can impact appetite.

How to practice body positivity

Learn more

“We have designed meals to taste good and we live in a society where we like to gather around a meal,” Banks says. “We should be able to enjoy that and be present and not be stressing about how we will ‘work it off.’”

Much of the challenge is rooted in decades-long systems and processes for measuring if someone is “healthy.” Banks approaches weight from a neutral viewpoint and avoids using numbers such as the body mass index (BMI) as an indicator of health as much as possible with her patients.

“We’re shifting our understanding of this topic in primary care as a whole too,” she explains. “We’re focusing on nutrition and physical activity as more important than your number.”

She encourages patients to research ideas such as joyful movement (not using exercise as punishment but rather as something you actually enjoy doing) and intuitive eating (learning how to nourish your body in a way that is satisfying and fills you up).

How can you support others? 

Most importantly, remember no one should have to talk about their body or relationship with food if they don’t want to, Banks says.

Do say: “I notice this happens when you eat this meal. Are you OK with that?” or “I noticed you’ve stopped going out to eat with us. Are you OK?”

Don’t say: “Wow, haven’t you had enough?” or “Shouldn’t you eat more than just that?”

Respect others’ boundaries and stay neutral where you can, such as during conversations about food or body image. If you do wish to express a concern, approach from a place of support and concern, not judgment.

“You’re there to be supportive, but it’s not your job to fix it. It’s their body and life,” she adds. “We understand you want to look out for one another, but if you get even an idea something is off, you don’t need to place them in a category.”

The best thing you can do is surround yourself and others with a supportive community.