Eating Disorder Myths
Before you read on, consider what you believe to be true about eating disorders. Why is this the narrative that exists in your head? For many people, it’s because of popular culture representation of eating disorders as well as common assumptions we make about the relationship between food and ourselves.
- What’s the most common eating disorder in the United States?
- What’s the most fatal psychiatric disorder?
- What does a person with an eating disorder look like?
- Who has an eating disorder?
National Eating Disorders Awareness Week 2022 runs from February 21 to February 27. This is an annual campaign to educate the general public about eating disorders. In a sense, this can be an opportunity to create empathy, compassion, and support for those who suffer from eating disorders. In other ways, it is a reminder than people you may think are “the general public” may in fact be the very folks we therapists who work with eating disorders need to support. Let’s start with a ground rule. We know — and we want everyone to know— that eating disorders are very real, very devastating illnesses. We also know that recovery is possible. When we talk about the devastating realities of eating disorders, or ED, it comes from a place of hope and healing. Read on for just a small introduction into some of the eating disorder myths weeks like NEDAwareness Week serve to dispel.
Important Facts About Eating Disorders
Untrue: Anorexia is the most common eating disorder in the United States.
Binge-eating disorder is most common in the United States. While anorexia nervosa affects a large number of people around the world, binge eating disorder is actually the most common eating disorder for Americans. About 1.25% of adult women and 0.42% of adult men have binge eating disorder, and a much larger percentage of teens and adults have episodes of binge eating or loss-of-control eating that is not frequent enough to meet the criteria for binge eating disorder. The average age at which binge eating disorder first occurs is 25 years
Untrue: The most fatal psychiatric disorder is depression.
Anorexia is the deadliest psychiatric disorder. We will say it again: hope is not futile, and recovery is possible. However, as folks who work with eating disorders, it is crucial that we communicate the seriousness of awareness, action, and treatment. Eating disorders are deadly. In fact, people with anorexia are six times more likely to die than other people their age. The data around eating disorder mortality is also part of why early recognition and intervention are crucial. Age at diagnosis plays a major role in the risk of death from anorexia. The risk of death increases an additional
- 3 times when diagnosed before age 15.
- 10 times when diagnosed at ages 15 to 19.
- 18 times old when diagnosed at ages 20 to 29.
- 6 times when diagnosed at ages 30 and older.
Bulimia and other specified feeding or eating disorders (OSFED) have mortality rates that approach the high rates seen in anorexia nervosa. In one study, roughly 1 in 20 people with ED died as a result of their illness. Abuse of laxatives or diuretics, or forcing vomiting, significantly increases risk of sudden death from heart attacks due to electrolyte imbalances, and excessive exercise also can increase the risk of death by placing immense stress on the body.
Untrue: You can tell by looking at someone if they have an eating disorder.
Many people mistakenly believe that all people with eating disorders look “skinny” or that the severity of one’s disease is directly proportional to whether or not they look healthy. In fact, less than 6 percent of people with eating disorders are medically diagnosed as “underweight.”
Not only is having a larger body size a risk factor for developing an eating disorder related to body image, thanks for societal stressors and increased pressure from family, friends, peers, and media, but making assumptions about the correlation between body size and ED diagnosis is a dangerous barrier to appropriate treatment. People in larger bodies are half as likely to be diagnosed with an eating disorder as those who are at a “normal weight” or who are “underweight” — yes, that means even medical and mental health professionals are allowing misconceptions about ED to put up a roadblock.
The physical risks of eating disorders are not tied just to low body weight. According to NEDA, even those who “look and feel deceptively well,” with normal EKGs may have cardiac irregularities, variations with pulse and blood pressure, and be at risk for sudden death.
Untrue: Eating disorders are a white woman’s disease.
Men and POC are already disproportionately affected by stigma and ignorance when it comes to mental health, and POC and LGBTQIA+ people are generally underserved when it comes to health care in general. Toxic masculinity, false assumptions about cultural body image perceptions, and a preponderance of trauma-related risk factors create a double whammy of danger when it comes to ED in underserved populations.
Sometimes, this stigma is a direct reflection of practitioners’ ignorance and assumptions about their patients, causing them to turn a blind eye. In other cases, this blind eye is underscored by patients’ own difficulties in recognizing their need for help. POC with self-acknowledged eating and weight concerns are significantly less likely to have been asked by a doctor about eating disorder symptoms than white people, despite similar rates of eating disorder symptoms across ethnic groups. Gender plays a role, too. Men generally have a much harder time acknowledging any mental health need in response to cultural and social stigma around ideas of weakness. In fact disordered eating behaviors — such as fad diets and excessive exercise — may be cheered on by their family, friends, and even medical providers.
Consider some of these truth-bombs:
- Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior, such as binging and purging
- Transgender individuals experience eating disorders at rates significantly higher than cisgender individuals.
- Over one million boys and men suffer from eating disorders at any given time, aking up about a quarter of the population with ED.
What Can We Do About Eating Disorders?
Eating disorders are everyone’s responsibility. We can make a change in the way we contribute as individuals to body image issues, disordered eating, and eating disorders. The best-known environmental contributor to ED is the sociocultural idealization of thinness. Even emphasizing body positivity still focuses on bodies as measures of self-worth. Instead, consider exploring ideas around body neutrality (more about that in an upcoming blog).
However, for many, the eating disorder has nothing to do with appearance. Approximately one in four people with an eating disorder has symptoms of post-traumatic stress disorder (PTSD). However, eating disorders are NOT just about wanting to look a certain way — in fact, that’s perhaps one of the largest myths of them all.
Eating disorders deeply impact the lives of people who suffer them as well as their family and friends in a world that fetishizes having a difficult relationship with food. Educating yourself about eating disorders, their causes, and what it means to heal is the best weapon we have in the fight against this complicated and often misunderstood disease. Feel free to reach out to us with your questions, or check out our book recommendations, including positive stories of survival from a variety of people who have battled ED.
Heather Murphy, owner of The Feelings Healers, majored in psychology with a minor in theology at the University of St. Thomas. Afterward, she began working at The Menninger Clinic with patients at the inpatient level in a multidisciplinary team approach and then interning as a Primary Therapist at the Houston Eating Disorders Center with Dr. Terry Fassihi. As an LPC-S, she works with ED and complex trauma, including providing EMDR services.