The most common mental illness is eating disorders. This misunderstood condition prevents people from receiving the help they deserve. In honor of Eating Disorder Awareness Week, I bust four common eating disorder myths. These myths prevent people from seeking help.
Eating Disorder Awareness Week (EDAW) is a time for raising awareness about the second-deadliest mental illness after opioid addiction. As a newly practicing dietitian, I compare what I thought I understood about eating disorders to what I understand now after years of practice (and I still don’t fully know because we are all learning). It’s not surprising that eating disorders are a common misconception among the public.
Unfortunately, even though it’s gotten much more accessible, I still see a lot during EDAW that promotes the same eating disorders myths, which prevents people who don’t fit into the traditional mold from receiving care. The focus on young, thin white women with anorexia, at the expense of a broader range of people suffering from eating disorders and different eating disorders, perpetuates the myth that eating disorders are “looked upon.” This leads to many people being denied the help they deserve.
This week I would like to dispel four of the most popular eating disorder myths.
Myths about Eating Disorders
A person with an eating disorder appears thin.
Most people associate an eating disorder with a thin, emaciated young woman who appears to be malnourished. When I was a teenager, I saw these “shocking” images on after-school shows. Although someone with an eating problem can appear extremely thin, with protruding bones, this is not true for all eating disorders or even the majority of eating disorders.
You can see from the research that only 6 % of those diagnosed with eating disorders are underweight. This includes anorexia, where “atypical anorexia” (i.e., higher weight anorexia is at the very least three and a half times more likely to occur than anorexia, which is traditionally defined as someone with a weight below 85% normal. This number may be lower than you think since people with atypical eating disorders are less likely to get a diagnosis. The prevalence of anorexia by 20 years old is 28 % compared to 1%.
While most people associate eating disorders with anorexia, there are other types of EDs, including bulimia and ARFID (avoidant-restrictive food intake disorder). There are many people who struggle with a variety of symptoms which change over time. They don’t always fit into a neatly defined diagnostic box. Binge eating disorder is the most common form of eating disorder. It affects both people with and without excess weight. is far from the truth when it comes to binge eating disorders (BED). BED is often rooted in restriction. This can lead to a restrict – binge cycle. Binge eating disorder can be misunderstood as a lack of willpower. This leads many to seek treatment through weight loss programs or bariatric surgeries. Binge-eating is common in people who are seeking weight loss treatments, with 9-29% of them reporting the behavior. The rates for clinical binge-eating disorder are higher among bariatric patients; up to 47% meet the criteria for diagnosis.
This myth is a huge barrier to those seeking treatment for eating disorders. If someone is thin and doesn’t appear emaciated, they may be told that they’re not sick enough. For those who are overweight, eating disorders can be completely overlooked or viewed as “successful” weight loss. If you want to learn more about higher-weight anorexia, I recommend that you read the article in The New York Times. It features some of my dear friends who bravely spoke up.
Eating disorders can be rare.
Over 30 million people develop an eating disorder in their lifetime. This is just the number of people with eating disorders who can be diagnosed – those who struggle with food and meet diagnostic criteria. There is a wide range of disordered eaters, including many who don’t fit the diagnostic criteria. Research suggests that the majority of people will struggle with disordered food at some point during their lives. Even if someone does not meet the diagnostic criteria for disordered eating, it doesn’t mean that they don’t need support or aren’t suffering.
Many eating disorder dietitians have the frustrating experience of speaking out to their colleagues about harmful practices which put people at high risk of eating disorders. Our concerns are then dismissed under the assumption that our concerns are exaggerated. The assumption is that the risks associated with “obesity,” as defined by BMI, outweigh those of eating disorders. When you are working with eating disorders, you will see red flags all over the place. Even if dietitians claim they don’t deal with eating disorders, they still work with them!
Women are the only ones who suffer from eating disorders.
Eating disorders affect both men and women. As many as 40% of those with eating disorders are men. However, early warning signs are often missed because the eating disorder myth is that it’s a girl thing. Men’s eating disorders are usually diagnosed only when they become severe because they were previously unnoticed. Men’s eating disorders are also normalized similarly to women’s but with a slightly different approach. Eating disorders may be seen as an attempt to gain weight with diets such as paleo, keto, or biohacking.