Is this an eating disorder, or a very healthy lifestyle?

[gentlydoesntit]

Please be gentle with me if possible - I know this is an emotive subject and I don't mean to upset or annoy anyone. I just need some outside opinions if possible as I'm unable to be objective anymore.

Would you characterise the following as symptoms of a worrying eating disorder, or could it be just someone who's super healthy?

For context, person in question is diagnosed autistic and gets obsessive v easily. They would say they’re just health-conscious but for at least the last year they have:

• Stayed with a BMI around 18.5, at the borderline of underweight.

• Exercised daily, gets very upset if they cannot do so, wants to be healthy and is terrified of illness.

• Been very controlled about everything they eat, only eat certain foods, prefers healthy low calorie veg and whole foods and hates anything "processed". Agonises if breaks the rules.

• Stressed if eating more than a certain number of calories or unhealthy foods, logs every calorie

• Worried about putting on any weight at all, says they think they’re overweight and still need to lose body fat.

I keep swaying between two minds - is this an unhealthy eating disorder or is this “just” (for want of a better word) an obsessive and controlling lifestyle? (Is there a difference?)

imho, Deffo ED. I had an ED decades ago. DD is anorexic (functional but her life is highly limited by it) and does this crap.

Let me emphasise the thinking is crap, not the person who does the behaviour. It makes you unhappy, doesn't it, OP. So it's pretty awful.

Could you add "Lies about it if asked what they really ate today, and how much they worry about food intake" ? -- DD does that one, too. DD isn't autistic, just in the throes of severe mental illness.

Thank you all, again I appreciate it and the lack of harshness, I am mentally exhausted and can only say again that I appreciate it.

@Rewritethestars1 I'm sorry you struggle with this. I wish I could give you some peace 

@lljkk it's exhausting for sure. In this case I am confident that they're completely (perhaps overly) harsh and transparent, it's an obsession and they see lying as self-delusion.

@pointythings that's really interesting. I agree that something like in-patient treatment wouldn't help here, it's not like severe, obvious anorexia or malnourishment.

@Poppyliveshere PDA is almost certainly at play although never formally diagnosed.

Thanks again, lots to mull over.

Hi there - Orri www.orri-uk.com/what-is-an-eating-disorder/ has some good resources on their vimeo channel and instagram. Renee McGregor has also written a book about orthorexia (which is what it sounds like). It is a tricky area as some GPs will take it seriously, whilst others will dismiss it. Have a look at specialist eating disorder dietitians/therapists who will be able to offer you support. BEAT is also very good.

Sounds like Orthorexia, possibly health anxiety and/or OCD. I think most are co-morbidities with Autism.

Yes, ED - orthrexia at play. I have dd15 ASC and anorexia - def orthrexia, but cahms are sit at agreeing with me. At best, it is very disordered eating that definitely needs therapeutic input. Good luck with getting it If via CAMHS now though!

I have a friend who sounds similar.

She's very into her wellbeing, exercise, healthy eating, managing stress etc and will put strategies and plans in place to make sure all the guidelines are followed, then get very stressed if she has to deviate from them.

I don't think it's an ED, but it is definitely related to poor mental health.

I'm not qualified to diagnose anyone but the guilt and anxiety sounds too intense to be healthy and could easily spiral out of control. It's OK to miss exercising (I'm currently going stir crazy due to COVID interfering with my running!) but panicking or mentally beating oneself up about missing a day isn't a healthy attitude. Assuming the person in question is a woman of appropriate age, another factor to consider is whether they are having regular periods, as if they're not this is a pretty worrying sign. Researching the female athlete triad may be helpful.

Is this a male by any chance?

I'm thinking of possible 'Bigorexia' as well as Orthorexia, as the protein shakes suggest a desire to build muscle, combined with wanting to minimise body fat - and then it's more difficult, as the increase in muscle mass could mean their BMI is completely out of sorts compared to their actual body fat percentage.