1. They aren’t just about body image.
Negative body image is undeniably a factor in the emergence of eating disorders, but it isn’t the only one. Many people who struggle with anorexia and/or bulimia also present psychiatric conditions like depression, anxiety disorders, and OCD, and the habits — restricting, binging, and purging — often develop as dangerous coping mechanisms. So, it isn’t just an extreme attempt at weight loss; it’s a legitimate, diagnosable (and therefore treatable) psychiatric disorder.
2. They aren’t adolescent disorders.
A 2012 study published in the International Journal of Eating Disorders found eating disorder symptoms in 13% of the women surveyed, all over the age of 50, with as many as 66% of those women reporting unhappiness with their overall appearance. Eating disorders are indiscriminate when it comes to age, but since they’re often associated with pre-teen and teenaged girls, they can instill a sense of shame and contradiction in older women who struggle with them — especially those who identify as strong feminists.
3. They aren’t women’s disorders.
A 2007 study suggests that men make up 25% of individuals with bulimia and anorexia, and 36% of those with binge-eating disorder. Because men are less likely to seek treatment, they tend to be underrepresented statistically. Lawyer and advocate Brian Cuban, who is a survivor of bulimia, talks about this misconception in the video above.
4. They aren’t white disorders.
There’s an idea that women of color don’t struggle with eating disorders, because the equating of thinness with beauty is, historically and culturally, a white practice. But this just isn’t the case. “What we’ve seen is that African-American girls are now becoming increasingly more likely to suffer from disordered eating, and this seems to be a sort of post-integration experience,” Melissa Harris-Perry says in this NPBC video. “More and more young black girls are going to school in environments that give them sort of very strong messages about normative body types that African-American girls have a difficult time fitting into.”
5. They aren’t punchlines.
Joking about eating disorders allowed all of these misconceptions (that eating disorders aren’t that serious, that they’re a conscious choice, that only vain young girls live with them, etc.) to continue unchecked. It makes a target of the person struggling with an eating disorder, and can actually trigger the very habits the joke is mocking.
Comedian Margaret Cho describes her experience of having an eating disorder as “whole years that [she] missed.” It’s an apt description, and sometimes a surprising one to those who might think it’s an issue that crops up only around meals. These anxieties have a way of swallowing up time, whether it’s in the hours lost to thoughts dominated by food, or years lost in waiting for a goal — a size, a weight — that will never be reached.
7. They include more than anorexia, bulimia, and binge-eating.
There is an entire spectrum of habits and characteristics that don’t neatly fall into these diagnoses, but which can be referred to as disordered eating. They can include things like compulsive exercising, fixating on specific foods, or combined characteristics of multiple disorders. Just because a person hasn’t met all of the diagnostic criteria for a specific disorder doesn’t mean he or she has a healthy relationship with food.
8. People with eating disorders aren’t easy to identify.
So we’ve established that you don’t have to be a young white girl to have an eating disorder, but you also don’t have to be significantly underweight. Outward appearance is rarely a reliable signal of the severity of the disease. Some of the most dangerous consequences of anorexia, bulimia, and binge-eating are imperceptible, like muscle loss, electrolyte imbalances, irregular heartbeats, osteoporosis, ulcers, high blood pressure, and even diabetes.
9. People with eating disorders can’t just “snap out of it.”
Recovery isn’t a matter of simply choosing to eat healthily. Because each eating disorder is a specific and complex illness — which can be traced back to psychological, cultural, and physiological factors — treatment methods have to be similarly comprehensive. The most effective treatment programs include psychotherapy, nutrition counseling, support groups, and, when necessary, psychiatric medication.
10. Chances are, people with eating disorders don’t see themselves the way you see them.
It’s called Body Dysmorphic Disorder (BDD), and there’s a big overlap between those who suffer from it and those with eating disorders. People with BDD perceive an exaggerated or imagined physical flaw in themselves, and can become consumed by it to the point that it disrupts their daily functioning. This is why, for many with eating disorders, there is no such thing as thin enough.
11. They’re serious and life-threatening problems.
Eating disorders have the highest mortality rate of any psychiatric disorder, and up to 24 million people — male and female, of all ages — have eating disorders in just the U.S.
12. Recovery is possible.
Despite the severity of all eating disorders, recovery is possible with proper treatment. What that recovery looks like will vary case by case, but for many it can include maintaining a healthy weight, restoring positive body image, and living a full and long life.
Men make up an estimated 36% of individuals who have binge-eating disorder. A previous version of this story stated the wrong percentage.
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