Understanding Disordered Eating: For anyone whose relationship with food feels harder than it should

This week is the last of our summer throwback series. Next week, we will be back with an all-new episode. Until then, check out this vault episode.
Originally aired as Episode 166, this vault episode takes an honest look at our relationship with exercise and movement, and why it can become far more complicated than it appears on the surface. For many people, movement stops being something that supports well-being and starts feeling like an obligation, a way to earn food, manage anxiety, maintain control, or even punish themselves.
In this episode, we explore the warning signs of compulsive exercise, how movement can become intertwined with eating disorders and perfectionism, and what it means when skipping a workout feels emotionally unbearable. We also talk about the physical and emotional costs of staying stuck in that cycle and the first steps toward building a healthier, more flexible relationship with movement.
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This week, we are continuing with our summer throwback series.
Originally aired as Episode 174, this vault episode explores a question many people ask: What's the difference between disordered eating and an eating disorder? The line isn't always obvious, especially in a culture where restrictive habits, food rules, and body dissatisfaction are often normalized. In this episode, I break down the key differences, the warning signs to watch for, and when seemingly "healthy" behaviors may be crossing into something more serious.
Whether you're questioning your own relationship with food or trying to better understand a loved one's experience, this conversation offers practical guidance and reassurance. More than focusing on labels, we explore why the impact these behaviors have on your daily life is what truly matters.
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While we take a little summer break, we'll be rereleasing some of our most powerful and thought-provoking conversations, and this one tops the list.
Originally aired as Episode 175, this conversation remains one of our most impactful discussions on what it truly means to recover from an eating disorder. In this vault episode, I sit down with renowned eating disorder therapist and author Carolyn Costin to explore one of the field's most debated questions: Is full recovery really possible? Together, we unpack what recovery actually looks like, how to strengthen the healthy self, and why hope exists even for those who have struggled for years.
Carolyn also shares insights from decades of clinical experience, including her perspective on recovered clinicians, the evolution of eating disorder treatment, and the tools that have helped countless people move toward lasting recovery. Whether you're on your own recovery journey, supporting someone you love, or working in the eating disorder field, this conversation offers an encouraging and timeless perspective on healing.
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In this episode, I'm talking about why orthorexia is one of the most misunderstood eating disorders, how wellness culture can quietly reinforce it, and why the biggest warning sign has very little to do with what's actually on your plate.
Because when grabbing pizza with friends feels mentally exhausting, that's worth paying attention to.
Quotes
"The biggest problem isn't what you're eating. It's what happens when you can't follow the rule."
"A life controlled by food rules is still a life controlled by rules."
"Perfection can become a shield that keeps you trapped."
"Movement can absolutely be good for you. The problem starts when you can't stop. When you can't take a rest day, skip a workout, or change your plans without feeling like everything is falling apart."
"You don't have to be physically falling apart for your eating disorder to matter. The amount of mental energy spent calculating, avoiding, planning, and worrying is reason enough to take it seriously."
"When everyone around you calls your eating disorder discipline, you're fighting more than the disorder itself. You're also fighting a culture that keeps telling you you're doing everything right."
"The question isn't whether movement or certain foods are healthy. The question is whether your relationship with them leaves room for flexibility, rest, and actually living your life."
"Perfectionism can feel protective. If you do everything exactly right, maybe no one can criticize you. Maybe no one can decide you're not enough. The problem is that eventually those rules start controlling you."
"Sometimes the goal isn't eating a different food. Sometimes the goal is proving to yourself that you can break a rule and still be okay."
"If going out for pizza takes more emotional energy than almost anything else in your week, that's worth paying attention to. The problem isn't the pizza. It's what the pizza represents."
Frequently Asked Questions
What is orthorexia?
Orthorexia is an eating disorder that's centered around an unhealthy obsession with eating "healthy" or "clean." The food itself isn't the biggest issue. The problem is when your life becomes controlled by rigid food rules, anxiety around eating, and the fear of doing something "wrong." While orthorexia isn't currently a standalone diagnosis in the DSM-5, it is widely recognized by eating disorder professionals as a very real and serious condition.
 
How do I know if healthy eating has become an eating disorder?
A healthy habit becomes concerning when it no longer feels like a choice. If skipping a workout fills you with guilt, eating at a restaurant causes intense anxiety, or your food rules make it difficult to enjoy everyday life, it may be more than simply wanting to eat well. The biggest sign isn't what you're eating. It's how much control the rules have over you.
 
What is the difference between orthorexia and anorexia?
Both are restrictive eating disorders, but they often focus on different goals. Anorexia is typically driven by weight, body size, or fear of weight gain. Orthorexia focuses on the quality or purity of food and following strict health rules. That said, the two can overlap, and both deserve treatment and support.
 
Can exercise addiction be part of an eating disorder?
Yes. Exercise becomes a concern when it feels impossible to take a day off or change your routine without overwhelming guilt or anxiety. It's less about how often you work out and more about your relationship with movement. If exercise starts controlling your schedule, mood, or decisions, it's worth paying attention to.
 
Why is orthorexia so difficult to recognize?
Orthorexia often looks like healthy living from the outside. People may compliment someone's discipline, dedication, or healthy lifestyle without realizing those behaviors are driven by fear and rigid rules. Because the behaviors are frequently praised, many people struggle for years before recognizing there's a problem.
 
Can you recover from orthorexia?
Yes. Recovery is possible. Treatment often includes creating more structure around eating, gradually challenging rigid food rules, and exploring the deeper patterns that keep those rules in place. The goal isn't to stop caring about your health. It's to build a relationship with food and movement that includes flexibility instead of fear.
 
Do you have to be underweight to have an eating disorder?
No. People of every body size can have an eating disorder. You don't have to look sick for your struggle to be real. If food, exercise, or body image are taking over your thoughts, relationships, or daily life, you deserve support regardless of your weight.
Resources
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In this episode, we're digging into the tension between wanting to be exceptional and wanting to be ordinary. We talk about why "normal" doesn't always mean what you think it does, how your eating disorder may be protecting you from desires that feel too risky to admit, and why feeling stuck often has nothing to do with food itself.
Quotes
"When average means stability, you want it. Of course, who wouldn't? When average means invisible, then we're terrified of it."
"I'm exceptional because of my relationship to my body, my food, what I do with my food and my body."
"Restriction tends to create the chaos that you're trying to avoid."
"The eating disorder isn't just expressing the desires. It's actually protecting you from the risk of wanting them directly, admitting them directly."
"The eating disorder keeps both desires alive, but completely frozen. Being frozen is not the same thing as being safe."
"People can be exceptional and connected. People can be seen and feel safe. People can be ambitious and stable, and the either/or isn't in the wanting, it's what you learned at some point, the wanting could cost you." 
Frequently Asked Questions
Why do I want to be successful and invisible at the same time?
It sounds contradictory, but it's actually incredibly common. Part of you wants to be seen, recognized, and appreciated for what you're capable of. Another part of you wants life to feel quiet, predictable, and safe. Those aren't opposite desires. They just become confusing when your brain starts believing that being noticed will cost you your sense of belonging or security. Recovery often means learning that you don't have to choose one or the other.
 
Why does my eating disorder make me feel special?
For many people, an eating disorder becomes a place to measure worth. It creates an internal story that says, "I'm better because..." Maybe it's because you're more disciplined, more controlled, healthier, stronger, or more committed than everyone else. The specific behavior looks different for everyone, but underneath it often serves the same purpose. It gives you a way to feel valuable without having to ask directly for recognition or validation.
 
Why do I want to be normal but also stand out?
The word "normal" doesn't always mean the same thing. Sometimes normal means peaceful, stable, and free from constant anxiety. Other times it feels like disappearing into the background and not mattering. That's why you can crave an ordinary life one minute and desperately want to be exceptional the next. You're responding to two completely different meanings of the same word.
 
Why does controlling food make me feel safer?
Food often becomes something that feels manageable when everything else feels uncertain. It can create the illusion of stability during stressful or chaotic seasons of life. The problem is that while food rules may offer temporary relief, they rarely create the lasting sense of safety you're actually looking for. They often end up creating even more chaos over time.
 
Can the same eating disorder behaviors mean different things for different people?
Absolutely. Two people can engage in the exact same behavior for completely different reasons. One person may be trying to become more visible, hoping they'll finally be noticed or praised. Someone else may be trying to disappear, feel less exposed, or protect themselves from unwanted attention. The behavior might look the same on the outside, but the purpose underneath can be completely different.
 
Why does recovery make me feel stuck between two different versions of myself?
Recovery often asks you to let go of something that has been solving a problem, even if it wasn't solving it well. You may find yourself wanting a calmer, more grounded life while also worrying that you'll lose the parts of yourself that felt exceptional. Feeling pulled in both directions doesn't mean you're doing recovery wrong. It usually means you're starting to see the deeper beliefs your eating disorder has been carrying.
 
Can I be ambitious without letting my eating disorder define me?
Yes. Wanting to achieve something meaningful isn't the problem. The question is whether your worth depends on achieving it. You can be ambitious, driven, creative, and successful without using your relationship with food or your body as proof that you deserve to be seen. Recovery isn't about becoming less motivated. It's about separating your value from the way you've learned to measure it.
Resources
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You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com