Questions and Answers: Eccentric Eating or an Eating Disorder?

Q.Recently our clinic has received a number of calls from teachers worried about unusual eating patterns they have noticed in students. Is there any general rule that might help differentiate diagnosable EDs, such as ARFID or unspecified eating disorder from atypical idiosyncratic eating habits in general?  (LJG, Fort Worth, TX)

A. This is a good question, particularly in our present-day multicultural world with hundreds of different diets, including diets based on religious tenets, vegetarian diets, weight control diets, and bizarre or abnormal eating habits. Some students eat only at very specific times, eating foods of a single color, eating only when facing a certain direction, and so forth.Shulamith Kreitler, PhD, of Tel Aviv University, has written an interesting article addressing this very subject (Isr J Psychiatry. 2017; 54:8)

Dr. Kreitler focused on eating behaviors that fall short of clinical diagnosis and yet might signal disordered eating.  Dr. Kreitler  studied 250 students from 16 to 18 years of age (130 girls and 120 boys) from three different high schools in Tel Aviv. The students were given 3 questionnaires: the questionnaire for eccentric eating habit (EEH), which assesses tendencies for unusual eating habits and preferences. The second questionnaire was the Eating Attitudes Test(EAT-26). A third instrument, and perhaps most pertinent to the team’s goals, was the Cognitive Orientation Questionnaire of Eating Disorders (CO-ED), which assesses the tendency toward eating disorders by examining the individual’s beliefs about eating.

Of the entire group of students tested, 29, or 11.6%, of both genders scored above 20 on the EAT-26, which indicated possible eating disorders.  Most interestingly, the correlations between ow scores on the EEH and EAT-26 were low, suggesting the two assess largely different domains, and that eccentric eating behaviors may be just that, rather than signs of an ED.

According to the authors, much more research is needed to differentiate eccentric behaviors from true eating disorders.