Debunking myths about eating disorders

On Nutrition

It’s Eating Disorders Awareness Week, which is the perfect time to debunk a few persistent myths about eating disorders. And I’m going to jump right in.

Myth: Eating disorders aren’t that serious. Eating disorders are the second most fatal mental illness after opioid use disorder. Many deaths are due to medical complications such as heart failure, but some are due to suicide. More than 10,000 people in the U.S. die from eating disorders each year, which is equal to one death every 52 minutes.

Myth: You can tell who has an eating disorder by looking at them. When you think of someone with an eating disorder, do you think of a young, white, middle-to-upper class, very underweight female? If so, you’re not alone. However, fewer than 6% of people with eating disorders are medically underweight. Plus, eating disorders affect people of all genders, races and sexual orientations, and can affect both 5-year-olds and 80-year-olds.

Unfortunately, myths about who develops eating disorders and what eating disorders look like contributes to the fact that most people with eating disorders never get properly diagnosed, and only 10% ever receive treatment. People in larger bodies — especially if they are also Black, Indigenous or a person of color — with “atypical” anorexia (which really isn’t atypical because most people with anorexia aren’t underweight) may be misdiagnosed with binge eating disorder or prescribed weight loss. Someone with a “normal” weight may be dismissed and told, “You look fine.”

Myth: It’s just about eating more … or less. Eating disorders aren’t about the food, even though food is obviously involved. You can’t just push someone with anorexia to eat more, or someone with binge eating disorder to get more willpower. Eating disorders are mental health conditions that have serious physical health consequences and often coexist with other mental health conditions, such as obsessive-compulsive disorder, anxiety or mood disorders, or substance use disorders.

Myth: Treatment is available for people who seek it. If only. There are far too many barriers to treatment to list here, even for people who have been accurately diagnosed and want help. Insurance doesn’t always cover treatment, or at least not the level and duration of treatment that someone needs to recover. Even with insurance coverage, high-deductible plans can be a financial barrier, as can the need to work to afford housing or child care. Some people don’t live near a treatment center and can’t financially or logistically uproot themselves to go to where the treatment centers are. Virtual treatment options are improving, but some people may not have access to the technology and the privacy to make this work. Project HEAL (theprojectheal.org) covers treatment barriers in detail on its website.

Two things you can do to help (and not harm)

One. Don’t comment on people’s weight, weight loss or their “discipline.” I’ve heard story after story from people who were at the height of their eating disorder when they were complimented on their weight loss by doctors, nurses, family members, friends, co-workers — even encouraged to continue losing more — with comments like, “You’re so good … I wish I had your discipline.”

Two. Don’t assume people know they have an eating disorder, or want to confide in you if they do. However, staying silent when you have concerns isn’t an ideal option. If you want to reach out to someone you suspect has an eating disorder, search for “how to talk to someone with an eating disorder” online and look at resources from eating disorder centers and organizations.