This week, February 26- March 3, is National Eating Disorder Awareness Week. With the theme “Let’s Get Real,” the National Eating Disorder Association (NEDA) aims to promote an open conversation about eating disorders and bring to light stories that aren’t often represented. As with any mental health disorder, it is important to broaden the conversation so diverse voices can be heard, and so that we together can promote a better understanding of the surrounding issues and enable access to better care.
Eating disorders are extremely serious. Not only do they have the highest mortality rate of any mental illness, they are not rare. According to the National Eating Disorder Association (NEDA), “30 million Americans will struggle with a full-blown eating disorder and millions more will battle food and body image issues that have untold negative impacts on their lives.”
Every eating disorder is unique, and each person’s relationship with food affects that person in a highly individual and personal way. However, stigmas and stereotypes can paint eating disorders in a limited way that can leave many individuals unrepresented. Because of these stereotypes, many people don’t get the support or care they need and deserve. We’re busting these common eating disorder myths, so we can spread both awareness about their impact and shine light on stories and perspectives that often go unheard.
Myth 1: Eating disorders are a women’s issue.
It is no secret that the primary image that comes to mind of someone suffering from an eating disorder is a white, thin, cisgender, heterosexual, middle class, adolescent female. However, this representation is a highly inaccurate depiction of eating disorders; eating disorders affect individuals across every background, race and ethnicity, gender identity, sexual identity, age, and socioeconomic status.
Women are not the only ones who struggle with eating disorders. In fact, men account for ⅓ of the people that struggle with eating disorders. Subclinical eating disorder behaviors (such as purging, laxative use, binge eating, excessive exercise) are nearly as common among men as women. Men face unique societal pressures that contribute to eating disorders, which are not as widely covered in the mainstream media or literature. These pressures and stigmas can often discourage those who identify as male from coming forward and sharing their own experiences and struggles.
Gender identity plays an important role in the development of eating disorders. Critical new research shows that transgender individuals may be significantly more likely to struggle with an eating disorder than their cisgender peers. In a study published in the Journal of Adolescent Health, transgender youth were four times more likely to report an eating disorder diagnosis than their cisgender heterosexual female peers. Transgender individuals face unique experiences and pressures that not only make them more likely to develop an eating disorder but also inhibit their access to the proper high-quality care they need and deserve.
Myth 2: Eating disorders affect primarily white, middle-class teens.
Eating disorders affect individuals from every racial and ethnic background at relatively similar rates, but minority groups are often at a higher risk of exhibiting certain eating disorder behaviors than white individuals. In fact, Hispanics have an increased risk of suffering from bulimia than non-Hispanics, and black teenagers are 50% more likely to exhibit bulimic tendencies than white teenagers.
People of color are also significantly less likely to receive the treatment they need, and face significant biases that affect the treatment they receive. In one study, clinicians were presented identical case studies about a patient exhibiting eating disordered behaviors with only the race of the patient differing across the case studies. The clinicians were then asked to identify the eating disorder behaviors as being problematic. 44% of clinicians identified the white woman’s behavior as problematic, 41% of clinicians identified the Hispanic woman’s behavior as problematic, and only 17% of clinicians identified the Black woman’s behavior as problematic. Abolishing racial stereotypes toward those who are affected by eating disorders is key to ensure everyone has equal access to care and support from medical professionals.
Eating disorders also disproportionately affect parts of the LGBTQ+ community, making those that identify with a sexual identity other than heterosexual at an increased risk of eating disorders.
Eating disorders also do not discriminate in terms of age. While commonly thought to primarily affect teenagers, a significant number of people develop an eating disorder in early adulthood. Sometimes, eating disorders can begin in children as young as five or six years old.
Those in midlife also experience eating disorders, which can stem from a relapse of a previous eating disorder or can begin in late adulthood. In fact, 13% of women over 50 have engaged in eating disorder behaviors, and many older adults who develop eating disorders remain undiagnosed, as their symptoms are often misattributed to the natural aging process.
These facts and statistics highlight the importance of more research on effective interventions, which target minority communities that face stigma and biases that affect their diagnoses and access to care.
Myth 3: Eating disorders are just a phase.
One of the most common misconceptions surrounding eating disorders is that they are just a phase someone goes through, and something an individual can “snap out of” by simply changing their behavior. Eating disorders are not based on vanity, nor are they a choice, and they do not go away on their own. Eating disorders should not be ignored, neither by the individual struggling or by the ones that may identify warning signs. Recovery is achieved through a combination of proper care and support. Eating disorders are a mental illness, which can be compounded upon by societal factors, but they are not solely caused by these societal pressures.
Myth 4: You have to be thin or be of a certain weight to have an eating disorder.
A particularly concerning misconception surrounding eating disorders is that one needs to be of a certain weight or BMI to have an eating disorder. This misconception can be dangerous, and can significantly inhibit some people from having their eating disorder recognized and getting the care they need.
Eating disorders can be present at any size. Not all people who struggle with anorexia are extremely thin, just as not all people who struggle with binge eating disorder are overweight. Eating disorders are mental disorders with physical manifestations that sometimes are seen, and sometimes are not.
It is important to note that this misconception can also contribute to a toxic thought process common in those with eating disorders- that one is simply “not sick enough” because they don’t match the stereotypical physical image commonly associated with an eating disorder. This thought process can further encourage eating disorder behaviors and can prohibit people from recognizing that they have a relationship with food that is taking a toll on their mental health and life.
Myth 5: The only types of eating disorders are anorexia and bulimia.
Eating disorders, like the people they affect, are diverse and don’t necessarily reflect the most common symptoms presented in the media.
Since every eating disorder is unique, many subtypes of eating disorders are often less discussed. For example, those that struggle with anorexia can have binge-purge subtypes, where they occasionally engage in binge-purge behaviors. Some bulimic individuals may never throw up, but may use excessive exercise as their purge mechanism of choice. The various subtypes of clinical eating disorders need to be more widely discussed, as they make necessary treatment options for specific eating disorders more nuanced.
One eating disorder gaining increasingly more awareness is orthorexia: which encompasses an obsession with only eating healthy food. While orthorexia is not yet recognized in the DSM, it is recognized by NEDA. Those with this eating disorder put less focus on the quantity of the food they consume, but exhibit a preoccupation with the quality of food put in their bodies. They resort to restricted diets to achieve a certain ideal of “health,” to the extent that it actually damages their well-being. Studies show that there is a high comorbidity of orthorexia with obsessive-compulsive disorder.
Binge eating disorder is another severe, yet less commonly addressed eating disorder. Those with binge eating disorder consume extremely large quantities of food in short periods of time, often in response to stress, to cope with emotional difficulties, or for punishment. The type of food binge eaters binge on is not limited to any type of food; it can range from “unhealthy” foods typically associated with a binge, to foods commonly associated with being healthy. While it is often correlated with being overweight, being overweight is not necessarily an indicator someone is suffering from binge eating disorder.
Finally, let us not forget to address the eating disorder that is the most common among both adults and adolescents: an Otherwise Specified Feeding and Eating Disorders (OSFED). Many individuals diagnosed with OSFED exhibit eating disorders that do not clearly fall into an existing category and may not present all the diagnostic criteria for a specific eating disorder. These individuals exhibit disturbed eating habits, an intense fear of gaining weight, and a distorted body image.
Ultimately, eating disorders are real, mental disorders that affect every type of individual, and manifest themselves in ways unique to each person that struggles with one. We must not allow stereotypes and misconceptions to become barriers to care, or to discourage people from sharing their own experiences and stories. This week and every week of the year, let us open up the conversation about eating disorders. If we do, we will be able to effectively diversify our understanding and treatment of this mental health disorder.
If you believe you or someone you know exhibits the signs of an eating disorder, encourage he or she to seek guidance from a professional. For more information on eating disorders or risk factors check out NEDA, or consult with a doctor on HealthTap.
Author: Maggie Harriman