Am I anorexic if I can never decide what to eat?

Dear Reader,

It takes courage to ask for help. Your challenges in deciding what to eat may stem from a number of places. This might include challenges with executive function or decision fatigue, which can make it feel really hard to eat food. There may also be factors at play related to anorexia nervosa or atypical anorexia. However, only a mental health professional can provide a diagnosis. 

If you’ve noticed that you shake from not eating, it’s worth paying attention to. Taking note of your behaviors and how often they occur may help you figure out the next steps to take. Be curious and non-judgmental in exploring what might be driving these behaviors. 

Why is it hard to decide what to eat? 

There are a number of factors that could contribute to how you’re feeling. Thinking about and deciding what to eat involves a lot of decisions. Decision fatigue can lead to falling back on familiar, low-effort behavior. This can include not eating at all. Decision fatigue can also be linked to a mental health diagnosis or can exist as a response to stress or other environmental factors. 

For some people, challenges with executive functioning might also be relevant. Executive functioning consists of cognitive skills that control behavior, regulate emotions, and adjust to changes in your environment. This may also include having trouble with decision-making or switching tasks.  

Struggles with executive functioning can also be related to many mental health concerns, such as:  

• Depression 
• Anxiety 
• Substance use disorder 
• Impulse control disorders 
• Self-injurious behaviors  
• Neurodevelopmental disorders  
• Eating disorders (such as anorexia) 

Mental health concerns that impact executive functioning could all contribute to feeling paralyzed or an inability to eat. For example, depression and anxiety can create feelings of low motivation or trouble with in decision-making. ADHD is a neurodevelopmental disorder that directly affects your executive functioning skills.  

It’s also possible to exhibit challenges in executive functioning, and it may not be related to a mental health concern. Nevertheless, challenges with executive functioning can make it feel harder to eat.  

What counts as anorexia? 

Anorexia likely refers to anorexia nervosa or atypical anorexia.   

Anorexia nervosa is a type of eating disorder. It consists of three criteria:  

• Extremely low weight 
• Intense fear of gaining weight 
• Disturbance in how one experiences their body weight or denial of the seriousness of low body weight  

Atypical anorexia is also an eating disorder classified under Other Specified Feeding or Eating Disorders (OSFED). It shares the same symptoms of anorexia nervosa except that someone’s weight is at or above normal.  

Both anorexia nervosa and atypical anorexia can be diagnosed by a mental health professional and treated by a team of health care professionals.  

How can you create more consistent eating habits? 

As you consider longer-term options, here are some things you can try to help encourage more consistent eating behaviors:  

• Set reminders to eat at specific times of day. This can help you eat consistently, even when you might not want food, but your body may need nutrients.  
• Have scheduled meals with others. Being social can help us schedule meals more regularly and enjoy the added benefit of being with people we care about.  
• Have ready-to-go food options or snacks in areas you normally frequent. This can include packaged snacks or bottled protein shakes around your home, at work, or even in your bag. You might also consider keeping frozen or microwavable foods that are easy to prepare.  
• Stay hydrated. Water is important for your overall health and may help maintain your body’s functions when you are not getting enough food.  

All the same, feel proud that you took the first step in seeking information about problems with food. By learning about what may be going on, you can get the help you may need and, eventually, be able to eat when you're hungry and stop when you're full. 

Take care,