It’s National Eating Disorders Awareness Week and YouBeauty is publishing articles to educate our readers on eating disorders and how to get help. 

Twenty million American women will struggle with a diagnosable eating disorder at some point in their lives. You can count me as one of them. And, like many of us who get caught up in these dangerous behaviors — restricting, bingeing, purging, compulsive exercise — my eating disorder started out as a diet.

In the beginning, I got plenty of validation because I was doing what girls and women are taught and expected to do: I was watching what I ate and obsessing over the number on the scale. Then came the straight-up encouragement because I was getting results. “You look great, have you lost weight?” commented my well-intentioned neighbor as I jogged past her. She didn’t know that her question would echo in my head as I pushed myself to do three more laps around the block when I was exhausted, injured and malnourished.  At some point the “Wow, you’re getting so thin!” enthusiasm shifted to “Whoa, you’re getting too thin” concern. But I couldn’t digest the difference. So I kept pushing.

There are a million and one different diets under the sun, but the basic concepts of restriction and tracking combined with the moralizing language of control/indulgence, reward/punishment, good foods/bad foods can be very triggering, especially for people who are genetically predisposed to developing eating disorders and have traits like perfectionism or are prone to depression or anxiety.

Let’s be clear: diets are not eating disorders. But dieting is a significant risk factor. According to NEDA, 35% of “normal” dieters will progress to disordered eating and by the time girls are in high school, more than half will be engaging in unhealthy weight control behaviors such as skipping meals, smoking to curb appetite or using diet pills.

In our culture, dieting is pretty universally presented as a solution. Diets promise to make us feel better, improve our lives, boost our self-esteem. And after all, there’s the obesity epidemic, right? We Americans should get a grip because our over-consumption is making us sick, shouldn’t we? That was the message at the center of the Weight Watchers ad that aired during the Super Bowl. The spot was loaded with drug and addiction metaphors, narrated by “Breaking Bad” star Aaron Paul (a show about meth) and topped off with the tagline, “It’s time to take back control.” But the irony is that for those of us who have abused food or are vulnerable to developing eating disorders, dieting is the worst prescription. For us, dieting is not a solution; it is the precursor to a big problem.

Chevese Turner founded the Binge Eating Disorder Association (BEDA) after years of feeling alone and desperate to connect with others who could relate to her struggle — a struggle that was perpetuated by a lifetime of going on and off of diets. Now recognized in the DSM-5 as a diagnosable eating disorder, binge eating disorder affects more people than anorexia and bulimia combined. Because many (though not all) people who have binge eating disorder are medically overweight, the traditional default advice from friends, family members and health care providers is to lose weight. That might sound like it makes sense, but that can lead to cycles of disordered eating.

“What I did not understand was weight loss as a goal was actually getting in the way of helping me find health and was destroying any hope I had of a healthy body image,” Turner wrote on the BEDA web site. “I now know that my desire to lose weight set me up for binges, as it triggered the binge cycle and a lot of shame.” And the research underscores Turner’s experience: Girls who diet frequently are 12 times more likely to binge than girls who don’t diet. For many, dieting can be a slippery slope to an eating disorder.

We get a very narrow picture of what disordered eating looks like and these illnesses are often presented in extremes, which make it difficult for most women to relate. At the same time, behavior and mindsets that can be disordered are constantly applauded and advertised as the norm in mainstream culture. Am I sick enough to reach out if I’m not “dying to be thin?” Aren’t I supposed to feel guilty and ashamed if I eat something that’s “sinfully delicious?” No wonder I hear the words “I’m not sure if this is an eating disorder but …” almost every day in my work.

So how do you know if your dieting is making you sick? If your need to count every calorie is causing you to withdraw or if your self-esteem is contingent upon how well you did on your diet that day, you are losing much more than weight. But with help, you can get on a healthier track. I did — and I gained my life back.

Take a free, confidential screening to determine if your dieting could be something more serious.

If you need information, referrals or support contact the National Eating Disorders Association at (800) 931-2237

Claire Mysko is the Director of Programs for the National Eating Disorders Association. She is the author of You’re Amazing! A No-Pressure Guide to Being Your Best Self and Does This Pregnancy Make Me Look Fat: The Essential Guide to Loving Your Body Before and After Baby.

Read More From Eating Disorders Awareness Week:

Five Eating Disorder Terms You Should Know

Picky Eating vs. An Eating Disorder: What’s The Difference?