7 Common Misconceptions About Eating Disorders, And The Truth About How They Actually Work
It's the first day of February, which is National Eating Disorders Awareness Month. As an eating disorder survivor, I am keenly aware of the harmful misconceptions people hold about such disorders and how they can affect their victims. Throughout the years that I suffered from anorexia, I was told that I was selfish, that I was stupid, that I didn't have an eating disorder, that my unhealthy body looked great, and everything in between. It's very common for those who have suffered from an eating disorder to hear things from others that hinder recovery and exacerbate the illnesses — and these comments can do an incredible amount of harm.
When I first developed an eating disorder in my early teens, I sincerely thought I was just being health-conscious. I had heard and read nutritional advice that made food restriction sound healthy, even for a thin person. After I lost a medically dangerous amount of weight, my parents started taking me to specialists who tried to get me to eat more and gain weight — and I realized I couldn't. I had become addicted. Thus ensued two more years of starving, purging, and everything in the book that could help me resist the dietary regimes my parents, therapists, and doctors tried to impose on me.
All this is scary to relate because I can already hear the common responses I get. "What made you do that?" "You know men don't like stick figures." "You don't look like you have an eating disorder." Before you ever say any of these things again, please ask yourself whether you are speaking out of these misconceptions about eating disorders, and consider what they're actually like.
1. MYTH: Anorexia And Bulimia Are The Only Eating Disorders
The eating disorders most commonly portrayed in the media are anorexia nervosa, which involves restricting food intake to lose dangerous amounts of weight, and bulimia nervosa, which involves binging and then purging through self-induced vomiting, fasting, exercising, or a number of different methods. In reality, the most common eating disorder is Eating Disorder Not Otherwise Specified (EDNOS), recently renamed to Other Specified Feeding or Eating Disorder (OSFED).
People with this disorder often have some symptoms of anorexia or bulimia, but not all of them. Or they may have different food- or weight-related problems entirely. Don't assume that the nebulous label makes the disorder less serious; some studies have found EDNOS/OSFED to be the most life-threatening eating disorder there is.
Another eating disorder that's talked about less often is Binge Eating Disorder, which affects 3.5 percent of women and two percent of men in the United States. It involves periodic out-of-control binges followed by feelings of guilt and shame.
2. MYTH: If You Don't Have An Eating Disorder, Your Eating Is Not Disordered
About 30 million people in the United States experience eating disorders at some point in their lives, but even more experience disordered eating, which is defined as "a wide range of abnormal eating behaviors, many of which are shared with diagnosed eating disorders." "Abnormal" is a bit of a misnomer, however, because our society normalizes disordered eating habits like dieting and binging. In fact, over half of teenage girls have engaged in behaviors symptomatic of eating disorders, including skipping meals, using laxatives, or intentionally vomiting. And almost half of British women feel guilty after eating carbs, according to a survey by XLS-Medical Carb Blocker. Disordered eating may be defined as "abnormal," but as body image activist Melissa Fabello points out, it's the norm in our society.
If you make dietary choices based on a preordained set of rules rather than the messages your body is sending, Fabello explains, that is disordered. According to Kelsey Miller, author of Big Girl: How I Gave Up Dieting and Got a Life, having moral feelings like guilt about food (with the exception of vegetarianism or religious dietary restrictions) is also disordered. In short, eating based on anything other than what your body says it needs is disordered. Body acceptance, intuitive eating, and other goals of people in eating disorder recovery are actually areas where many people without eating disorders could improve as well.
3. MYTH: Eating Disorders Are A Choice
Mental illnesses are no more of a choice than physical illnesses. While people may choose to engage in behaviors like dieting that are gateways into eating disorders — and even then, as I've written about, we're often pressured into these gateway behaviors in the first place — nobody sits down and thinks "I'd like to have the compulsion to binge and purge" or "I'd like to have such a crippling fear of food that I need to be hospitalized so that people will make me eat." Trust me, if somebody told me during my teen years that I could take a magical pill to make myself view my body accurately and feel no need to restrict or purge, I would have gladly taken it.
People who believe eating disorders are a choice often don't understand the psychological distress that sufferers are under. It's not as if people with Binge Eating Disorder or bulimia think that binging sounds like a fun thing to do. They are addicts, and as with any addiction, abstaining can lead to withdrawal. Similarly, people with anorexia and other victims are typically under an unbearable amount of stress regarding their body image, and restricting or purging provide the escape they are desperate for. They don't feel as if they have a choice.
4. MYTH: People With Eating Disorders Are Vain
People who believe eating disorders are a choice often believe that people choose them because they're obsessed with their looks. Eating disorders do often involve an obsession with looks, but that is the disease, not the victim's personality. In fact, some of the kindest, most selfless people I know have had eating disorders. Our society teaches women to obsess over their appearances, so when we judge women for caring about how they look, we are blaming victims.
I was scolded by friends and family for being superficial and selfish. I was told it was ungrateful not to eat when there are starving children in Africa, that I was just looking for attention, and that it was unbelievable that someone as smart as me could do something so stupid. Again, I would have loved to stop being tortured by body hatred every minute of every day, but I didn't have the choice. Shaming people for mental illnesses only adds an extra burden to an already impossible time.
5. MYTH: People With Eating Disorders Are Trying To Be Sexy
People with eating disorders are often aspiring to achieve a body that society deems acceptable, but the disease is deeper than that. Years of individual and group therapy have taught me that if you have an eating disorder, there's almost no part of your life that it's not related to. For some people, disordered eating is a way of expressing themselves through food when people aren't listening to them. For others, it's a way of exerting control over their lives.
For many, eating disorders are a response to fear of sexuality. Marya Hornbacher gives a gripping account of how this can work in Wasted: A Memoir of Anorexia and Bulimia . Like a disproportionate number of eating disorder victims (as reported by a study in Hormones and Behavior ), she went through puberty early, and saw her body sexualized before she was ready. According to the National Eating Disorders Association, nearly a third of eating disorder victims have been sexually abused during childhood, which can have a similar effect. One theory for these correlations, presented in Hornbacher's personal account and many others, is that losing or gaining weight can make women feel less prone to being objectified.
That's why it is so disheartening for me to hear things like "real women have curves" and "my anaconda don't want none unless you've got buns, hun" used in attempt to improve women's body image. As long as we are sexualizing women, we are not combating eating disorders, because the sexualization of women contributes to eating disorders. Women are already familiar with the stereotype that "men like curves." But what men supposedly like has very, very little to do with why women binge, purge, or starve.
Even when people are using eating disorders to become thinner, they are really seeking out the qualities associated with thinness, like self-control and purity. Since many in our culture, especially women, have gotten the message that succumbing to physical desires like hunger makes us weak-willed, being seemingly exempt from hunger can evoke an addictive sense of superiority. It gave me a high to feel like I could miraculously escape the confines of biology, even though, in reality, nobody can do that. The disease was much more about these moral associations with thinness than about any beauty ideal.
6. MYTH: It's Obvious When Someone Has An Eating Disorder
I got the comment "You don't look like you have an eating disorder" several times from friends and acquaintances. These same words were uttered to survivor and author Jenni Schaefer by a doctor who specialized in eating disorders. She and I both met the weight requirements for anorexia when we were told this.
I think this often happens because we have an unrealistic idea of what a typical body looks like. We live in a society that considers average-sized women to be plus-sized, after all. It's no wonder we don't recognize the disease when we see it. But regardless of what you see when we look at someone who says they have an eating disorder, you should never, ever say that they don't look like they have one. This can exacerbate feelings of not being thin enough, and there is truly no such thing as "looking like you have an eating disorder." Eating disorders can make people gain weight, lose weight, or stay the same.
You also can't tell if someone has an eating disorder based on their eating habits. Binging is often done in secret, and even an person with anorexic eating habits might look normal to some people, given the dieting culture we live in. In my case, I actually ate three meals (albeit low-calorie ones) per day when I first met the criteria for anorexia. That still wasn't enough for me to maintain a healthy weight. Different people have different dietary requirements, so you could find two people who eat the exact same foods, and one might have an eating disorder while the other doesn't. You have to consider why they are eating those foods, and how these habits affect their physical and mental health. Similarly, two people could be the exact same size, and one could have an eating disorder while the other doesn't. So unless you are a professional who has done a thorough assessment, you cannot be the judge of whether someone has an eating disorder.
7. MYTH: Eating Disorders Are Rare
Nearly every time I tell another woman about what I've gone through, she confesses that something similar has happened to her. Consistent with this experience, a survey by SELF Magazine and the University of North Carolina at Chapel Hill found that 10 percent of women have eating disorders, and an additional 65 percent suffer from disordered eating. If you have been struggling with body image, food, or weight, you are not the odd one out. It might be scary to tell someone else, but you'll probably end up learning that you're in good company. It can be a huge relief, and a source of support, to speak with people who don't have all these misconceptions about eating disorders because they've experienced them firsthand. It can help you see that you're not vain, that you're not choosing this, and that you're not looking for attention. You are normal, and you are worthy of compassion.