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Is fasting an eating disorder?

Eating disorders like anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are well-known conditions, with their own definitions in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official record of all recognized mental health conditions.

But there is also a group of conditions known as other specified feeding and eating disorders (OSFED), which include a number of disordered eating behaviors that may not be officially recognized as part of a specific condition but are nonetheless harmful.

In some cases, fasting—or the extreme restriction of caloric intake over extended periods of time—may be considered one of these disordered behaviors. However, the action in and of itself doesn't necessarily represent an eating disorder.

Last updated on 
January 11, 2024
Is fasting an eating disorder?
In this article

What is fasting?

Fasting is a type of behavior that involves refraining from food and sometimes liquid for extended periods.

One may participate in this type of behavior for many reasons, including religious observations and medical concerns. (Some medical tests require someone to refrain from eating for several hours.)

But fasting to encourage weight loss—sometimes called intermittent fasting—has become an increasing trend in recent years. People may fast on alternating days, for certain portions of the day, or fast following a large meal, whether as part of an overall diet plan or on a more intuitive basis.1

Intermittent fasting

Is fasting an eating disorder?

Fasting often represents disordered eating behavior, and while it may contribute to developing an eating disorder, the action in itself is not an eating disorder.

Eating disorders are technically considered behavioral conditions or mental health disorders. They involve disturbed behaviors and actions and repeated, disturbed, or distressing thoughts.2

Things like disturbed body image, low self-esteem, trauma, and even a desire to be "healthy" may drive interest in fasting for losing weight. However, fasting alone does not represent the suite of psychological concerns at play in an eating disorder. The behavior can be more accurately described as a symptom of an eating disorder.

Can fasting cause an eating disorder?

None of this is to say that fasting can't be dangerous or be part of a slippery slope.

When used to help control weight, the behavior can be (but isn't always) indicative of an unhealthy relationship with food or a fixation on body image. These are often hallmark signs of an eating disorder or potentially correlated behaviors.5

It's also plausible that someone would experiment with fasting or intermittent fasting before moving toward more disordered behavior. Consistent dieting behavior has long been noted as a precursor to eating disorders.3 Studies have shown that intermittent fasting, in particular, is linked to higher levels of eating disorder psychopathology.6

Still, more likely than cause an eating disorder, fasting to help control food intake or weight may serve as an indicator that someone is already dealing with an eating disorder or the types of thoughts that lead to one. Fasting is among the eating disorder behaviors often used by people struggling with AN and BN.

Still, more likely than cause an eating disorder, fasting to help control food intake or weight may serve as an indicator that someone is already dealing with an eating disorder or the types of thoughts that lead to one. Fasting is among the eating disorder behaviors often used by people struggling with AN and BN.

If you think you or someone you know may have an eating disorder, call Within to learn more about remote treatment and to get help.

Learn more

Signs fasting is leading to an eating disorder

The line separating fasting from an eating disorder can quickly become blurry. It's important to monitor your habits or those of your loved one, for additional signs of an eating disorder or any of these warning signs:

  • Fasting even when feeling hungry or low on energy
  • Using additional behaviors, like compulsive exercise, to make up for calories consumed
  • Using intermittent fasting as an excuse to skip meals, not eat food, or only drink zero-calorie beverages
  • Feeling fearful of gaining weight or breaking your fast ahead of schedule
  • Being dishonest with people about your actual calorie consumption
  • Feeling mentally or physically unwell during your fast and experiencing unwanted outcomes
  • Avoiding contact with loved ones and withdrawing socially

Fasting also has the potential to lead to binge eating behavior. Many people experience a strong urge to overeat following periods of fasting.1 This can cause people to engage in a binge eating episode, then turn to fasting—or other behaviors—to compensate for the binge, kicking off an unhealthy eating pattern of binging and purging.

Is fasting dangerous?

Fasting to lose weight is still a relatively new phenomenon. In light of the intermittent fasting trend, the behavior is being looked at with a closer eye to health. While studies are ongoing, and some potential health benefits have been identified, some reports have noted a few potential dangers around the behavior.

Research has shown that fasting may cause gallstone issues for some people.4 Intermittent fasting can also be problematic for people with diabetes due to its impact on blood sugar levels, resting metabolism, and other related issues.

In fact, due to these potential concerns, intermittent fasting diets are not recommended for those with diabetes or people who take medicine for blood pressure or heart disease.1

Getting treatment for a restrictive eating disorder

If you're concerned about your behavior or that of a loved one, reaching out to a professional who can offer more guidance is important.

Filling out an eating disorder examination questionnaire can help a doctor or therapist determine whether your fasting behaviors have become dangerous or are presenting as part of a deeper problem.

Regardless, anytime someone becomes fixated on losing weight, experiences frequent distress over their body shape or size, or starts resorting to increasingly extreme behavior to achieve their weight loss goals, it's often worth examining the situation further.

Remote treatment is an option

At Within Health, we offer flexible and comprehensive treatment for all types of eating disorders and disordered eating behavior. We understand that people of all kinds use these behaviors for all sorts of reasons, and strive to help through treatment that's compassionate and tailor-made for each of our patients, representing their best interests for all their specific needs.

Get help

Contacting a professional can be the first step toward building a healthier relationship with food, your body, and yourself and starting on a path toward a happier future.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Not so fast: Pros and cons of the newest diet trend. (2019, July 31). Harvard Health Publishing. Accessed September 2023.   
  2. What are Eating Disorders? (n.d.). American Psychiatric Association. Accessed September 2023. 
  3. Heatherton, T. F., Polivy, J. (1992). Chronic Dieting And Eating Disorders: A Spiral Model. Taylor & Francis. Accessed September 2023. 
  4. To Fast or Not to Fast: Does When You Eat Matter? (2019). National Institutes of Health. Accessed September 2023. 
  5. Warning Signs & Symptoms. (n.d.). National Eating Disorders Association. Accessed September 2023. 
  6. Ganson, K. T., Cuccolo, K., Hallward, L., Nagata, J. M. (2022). Intermittent fasting: Describing engagement and associations with eating disorder behaviors and psychopathology among Canadian adolescents and young adults. Eating Behaviors, 47, 101681.

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