February 27th-March 4th is eating disorder awareness week. Eating disorders affect at least 9% of the population worldwide. While about 9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime, only about 30% of individuals receive treatment (NEDA, 2022). While eating disorders are serious prevalent disorders, stigma and misinformation contribute to the invisibility of individuals with these concerns inhibiting help-seeking behaviors. Therefore, it is important to consider some of the common myths and facts about these disorders so that you and your loved ones can get the help you need.
Myth 1: Eating disorders are a choice
Fact: Eating disorders are not choices but complex medical and psychiatric illnesses. Furthermore, eating disorders are not desirable or indicative of moral superiority (“self-control”/ “willpower”) or moral inferiority/failure. Eating Disorders are biopsychosocial diseases meaning that genetic, biological, environmental, and social elements all play a role (ANAD, 2021).
Myth 2: Eating disorders only affect young girls
Fact: Eating disorders affect people of all ages, races, ethnicities, sexual orientations, religions, and genders. There is a stereotype surrounding who is affected by these illnesses, i.e., they only affect young white middle to upper-class women. Thus, many individuals with eating disorders do not see themselves reflected in stereotyped portrayals of eating disorders in the media. For this and other reasons, they may fail to recognize that they need help. In particular, media representations rarely depict individuals with eating disorders who are: in larger or mid-size bodies, male, suffering from disorders other than anorexia and bulimia, BIPOC, LGBTQ+, living with a disability, and neurodiverse (Sonneville & Kipson, 2017). Overall, the lack of representation contributes to the invisibility and stigma of eating disorders.
Myth 3: To have an eating disorder, you must either have bulimia or anorexia
Fact: Anorexia nervosa is characterized by a significant and persistent reduction in food intake leading to extremely low body weight in the context of age, sex, and physical health; a relentless pursuit of thinness; a distortion of body image and intense fear of gaining weight; and extremely disturbed eating behavior. Many people with anorexia see themselves as overweight, even when they are starved or severely malnourished (NIH, 2022). Bulimia nervosa is characterized by binge eating (eating large amounts of food in a short time, along with the sense of a loss of control) followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives, or diuretics), fasting, or excessive exercise. Unlike anorexia nervosa, people with bulimia can fall within the normal range for their weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape (NIH, 2022). While bulimia and anorexia tend to be portrayed more often in the media, there are many other types of eating disorders, all of which are just as serious as bulimia and anorexia and which we are still understanding in terms of diagnosis and treatment. Some other common eating disorders include orthorexia, atypical anorexia, purging disorders, diabulimia, and binge-eating disorder. Orthorexia is used to describe individuals who demonstrate obsessions with proper “healthful eating.” For people with orthorexia, these fixations damage their well-being. Atypical anorexia nervosa is when all the criteria for anorexia nervosa are met, except that despite significant weight loss, the individual's weight is within or above the normal range (ANAD, 2021). Patients with atypical anorexia can suffer the same health consequences as those with anorexia. Purging disorder is recurrent purging behavior to influence weight or shape (e.g., self-induced vomiting; misuse of laxatives, diuretics, or other medications) in the absence of binge eating (ANAD, 2021). Diabulimia is a media-coined term that refers to eating disorders in which a person with diabetes, typically type 1, purposefully restricts insulin to lose weight. Research estimates that nearly one-quarter of women with type 1 diabetes will develop an eating disorder. Binge eating disorder is characterized by recurrent binge eating episodes during which a person feels a loss of control and marked distress over his or her eating (ANAD, 2021). Unlike bulimia nervosa, binge eating episodes are not followed by purging, excessive exercise, or fasting. As a result, people with binge eating disorders often are overweight or obese(NIH, 2022). Binge-eating disorder is the most common eating disorder in the United States and 40% of individuals with binge-eating disorder are male (NIH, 2022).
Myth 4: You must be underweight to have an eating disorder and if you are not emaciated, it is not that serious
Fact: Most people with an eating disorder are not underweight. In fact, less than 6% of people with eating disorders are medically diagnosed as “underweight” (NEDA, 2022). Additionally, while most people with eating disorders are portrayed by the media as emaciated, you cannot tell whether someone has an eating disorder just by looking at them. Furthermore, the mortality and morbidity for individuals with eating disorders are not predicated on how “thin” one is (ANAD, 2021).
Myth 5: Eating disorders are not that serious
Fact: Eating disorders have the highest mortality rate of any psychiatric illness (NEDA, 2022). Potential health consequences include heart attack, kidney failure, osteoporosis, and electrolyte imbalance. People with eating disorders often also have intense emotional distress and a severely impacted quality of life (NIH, 2022).
Myth 6: Recovery is impossible so why bother?
Fact: Recovery is possible! As a biopsychosocial disease, eating disorders are best treated with a multidisciplinary team to help cover each of these domains, i.e., working with therapists, doctors, and nutritionists to promote healing (NEDA, 2021). Remember that while recovery is possible, it is not always linear. Relapse is common and not an indication of failure
February 27th-March 4th is eating disorder awareness week. Take this time to support yourself and loved ones who may be at risk or dealing with an eating disorder. Here are some resources to help:
nedawareness.org
By: Brianna Greenberg
Mental Health Counseling Intern
References
National Association of Anorexia Nervosa and Associated Disorders, ANAD. (01, January
2021). Eating Disorder Recovery. The National Association of Anorexia Nervosa and Associated Disorders, ANAD. https://anad.org/
National Eating Disorder Association, NEDA. (01, January 2022). The National Eating Disorder
Association. NEDA. https://www.nationaleatingdisorders.org/help-support/contact-helpline
National Institute of Health, NIH. (01, January 2022). Eating Disorders. The National Institute
of Health. https://www.nimh.nih.gov/health/topics/eating-disorders
Sonneville, K.R. & Kipson, S.K. (2017). Eating disorder symptoms among undergraduate and
graduate students at 12 U.S. colleges and universities. Eating Behaviors, 24, 81-88. Doi: 10.1016/j.eatbeh.2016.12.003.