The mental health stigma. While this phrase might get thrown around a lot, there is not really a clear explanation of how and why it affects people. Although mental health is something that impacts our daily lives, there is so much fear around talking about it. But the shame, embarrassment, and misunderstanding that this stigma causes is extremely harmful for ANYONE coping with a mental illness. In light of National Eating Disorders Awareness week (Feb. 22-28), this article will highlight a few of the ways in which those with eating disorders are affected by the mental health stigma—and why it matters.
Overall, it is important to understand that eating disorders do not discriminate. They have the capability to affect anyone regardless of their race, gender, sexuality, body size, age, or any other category. It is also important to note that every human being is unique, so every individual’s recovery will take a different path. There is no “right way” to recover—but everyone deserves it.
1. It's not ALL About the Food.
This aspect of eating disorders might be quite confusing for people to understand. After all, they are called eating disorders, so how can they not be all about the food? On the surface, eating disorder behaviors might seem like they are about the food, but what most people don’t know is that EDs serve a variety of purposes. For some people, regulating their food intake very closely can make them feel like they are in control. For others, their ED may serve as a coping mechanism, helping them deal with trauma, anxiety, uncertainty, depression, etc. Because of the way in which society praises diet culture and the beauty standards that it promotes, some people feel as though they will finally experience acceptance if they do what society is telling them to do. But as stated previously, everyone’s experience with an ED is different, and the purposes that it serves can vary. However, the main takeaway from this section is that EDs are not just about the food. There is a deeper meaning behind the ED, and while they are self-destructive, someone’s ED exists to meet some sort of need that has gone unfulfilled.
It is also important to note that just because someone has an ED, that does not mean that they are judging others because of their appearance, eating habits, etc. Oftentimes, society portrays those with EDs as vain, self-absorbed, and constantly critical of others. This is simply not the reality. EDs are complex mental illnesses, and someone’s eating disorder is relevant to their mind only. Sure, people with EDs might find connections through their experiences, but at the end of the day, everyone’s journey is unique. Someone who has an ED does not see you any differently—their ED affects them and them only.
2. Sex, Gender Identity, Weight, Level of Treatment, or Certain Behaviors are not the Way to Gauge Whether Someone’s ED is More/Less Severe.
While it might seem like someone who is at an extremely low weight has an eating disorder that is more severe, this is simply not the case. Regardless of weight, level of treatment, or the frequency of ED behaviors, ALL eating disorders are serious. Everyone is deserving of recovery and all experiences are valid.
Think about it--if someone was diagnosed with leukemia and someone else was diagnosed with osteosarcoma, would you consider one of their cases more serious than the other? No. Because either way, both individuals need to receive treatment and deserve a chance at getting better. While cancer and eating disorders are obviously different illnesses, the comparison is still helpful in demonstrating that no one eating disorder is more serious than another.
In fact, many people often tend to label anorexia as the most “dangerous” and most prominent eating disorder, but that is mainly because eating disorders are presented that way in the media. Most ED films, documentaries, etc. will show a young, white, emaciated woman struggling with an eating disorder, but this stereotype could not be further from the truth. Despite this media portrayal of eating disorders, less than 6% of people with eating disorders are medically diagnosed as “underweight.”
Additionally, binge eating disorder (BED) is over three times more common than anorexia and bulimia combined. There is also a lack of awareness when it comes to men who suffer from eating disorders. Less than 1% of eating disorder research focuses on males, so most of the time, men and boys with eating disorders are misdiagnosed, not diagnosed at all, or are never really aware that they need help. Despite the fact that one out of three people with an eating disorder is a male, there is very little discussion of the manifestation of EDs in men. This is true for the media and in ED recovery spaces as well.
Therefore, not only are eating disorders underrepresented and avoided in many public spheres, but in the rare instances when they are discussed, they are misrepresented. This is extremely harmful for people suffering from eating disorders, because it is very easy for them to feel invalidated and misunderstood. Many people are actually deterred from treatment because they do not view themselves as “sick enough” to recover--even though ANYONE is sick enough to heal their relationship with food, their mind, and their body.
3. Eating Disorders Affect People in Larger Body Sizes!!!
In contrast to the media’s portrayal of eating disorders, they do not discriminate by body size, shape, or any other factors. For many people who are living with an eating disorder in a larger body, there are many barriers to treatment and recovery. Unfortunately, there is not a lot of awareness in the medical field about eating disorders and the fact that they can affect ANYONE. There are countless cases of medical professionals dismissing patients’ symptoms and behaviors because they are in a larger body. Due to the impact of diet culture and fatphobia that permeates everyday life, automatic assumptions are made about people in larger bodies. “That person must not know how to control themselves around food.” “That person must be so lazy and never exercise...etc.” There are even barriers present in some insurance companies, which might require a low weight in order to cover high level treatment costs. Therefore, not only is accessing treatment hard, but it also might be completely closed off for some people.
Another challenge for those in larger bodies is that they might even be praised for their eating disorder behaviors, especially if they consist of more restrictive eating habits. And even if individuals are restricting, professionals might doubt this if their weight does not decrease. The point is that everyone’s bodies are different, so the same ED behaviors that one person uses can manifest completely differently when someone else uses them. All of these factors make it even easier for people in larger bodies who have significant eating disorders that they are not sick at all. Because they do not fit the stereotypical image for what an eating disorder “should look like,” they convince themselves that their behaviors are “normal” or that there is not a problem.
4. People of Color Are Affected by Eating Disorders —Despite What the Media Might Tell You
Another problem with ED stereotypes is that they exclude people of color from their narratives. Similar to how people in larger bodies often have EDs that go ignored, undiagnosed, or minimized, so do people of color. Statistics show that black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior like binging and purging. Similarly, “people of color with self-acknowledged eating and weight concerns were significantly less likely than white participants to have been asked by a doctor about eating disorder symptoms, despite similar rates of eating disorder symptoms across ethnic groups.”
Additionally, black individuals have to face societal pressures and stressors that might infringe upon their recovery process, which makes raising awareness that much more important! Following BIPOC influencers that are pro-recovery, fat positive, and anti-diet is a great way to stay informed and help to spread awareness!
5. EDs are Very Prevalent in the LGBTQ+ Community
Another group that is commonly overlooked when it comes to EDs are those in the LGBTQ+ community. There are many unique stressors that people in the LGBTQ+ community endure, all of which put them at a higher risk for developing eating disorders. Fear of rejection because of their sexuality is a key contributor, as well as experiences of bullying, discrimination, violence, or PTSD.
Studies have shown that among men who have eating disorders, about 42% of identify as gay. Along with that, gay males were also 7x more likely to report binging and 12x more likely to report purging than heterosexual men. In regards to females in the LGBTQ+ community, those who identified as lesbian, bisexual, or mostly heterosexual were about twice as likely to report binge-eating at least once per month. These statistics might seem shocking, but they demonstrate how EDs have been misrepresented in so many ways.
6. For Some, EDs are A Way to Cope with Trauma/PTSD
What people might not realize is that for some, the ED can serve as a coping skill to deal with trauma and other PTSD symptoms. There are many types of trauma that can put people at risk for eating disorders, but some are neglect, sexual assault, physical abuse, and emotional abuse. Studies have also shown that PTSD and eating disorders have a lot in common, as sufferers often dissociate to avoid feeling painful emotions, and having unwanted thoughts.
Unfortunately, many treatment options have not really evolved to accommodate these individuals and their needs. PTSD, trauma, and eating disorders are all sensitive subjects, so cultivating a safe recovery space can be very challenging. While people might criticize people with EDs and assert that people are choosing to do this to themselves, that is simply not true. For many people, even those who have not experienced trauma, their eating disorder(s) serves a purpose. It can make people feel in control, especially if they are longing for the comfort of structure and routine.
7. Yes, EDs Affect the Disability Community Too!
Another group in the ED community that is underrepresented are those with disabilities. Disabilities can come in many different forms (physical, intellectual, etc.) and because of this, they impact people in unique ways. Some people with physical disabilities feel physically and emotionally disconnected from their bodies, which can lead to the use of ED behaviors to feel comforted and more in control. The National Eating Disorders Association (NEDA) also reports that “there is also evidence that patients with eating disorders who have mobility related disabilities may be especially sensitive to body size if relying on the care of others to help them move their bodies.” As seen through these examples, it is clear that physical disabilities can serve as risk factors for EDs, and they also pose unique challenges in the recovery process. Gastrointestinal conditions and other digestive difficulties (ex: irritable bowel syndrome) can sometimes lead to increased ED behaviors, as people might fear the pain that they will experience after eating and avoid foods as a result.
For those with intellectual disabilities, ED behaviors are traditionally tied to a need for routine, structure, and predictability. While statistics about EDs in the disability community are not quite as accessible, estimates suggest that 20% of people with eating disorders have autism. There have also been findings to suggest that people with autism spectrum disorder (ASD) “seem to be at greater risk for developing binge eating disorder (BED), pica, and avoidant/restrictive food intake disorder (ARFID).”
8. EVERYONE’S BODY IS DIFFERENT AND HAS DIFFERENT NEEDS!
The main takeaway from all of the aforementioned points is that EDs can affect literally everyone. It does not matter how old a person is, what gender they are, their race, their size, etc. Destigmatizing EDs and spreading the truth about them instead of promoting media stereotypes can help to save lives. If people feel more represented and seen in the recovery community, they might be able to recognize that they deserve recovery. There is no “mold” that someone has to fit into in order to be “eligible” for recovery.
It is also important to address the impact of diet culture and fatphobia in society. People in recovery from EDs often struggle because the world is full of so many people immersing themselves in diets, excessive exercising, and constantly labeling foods as “unhealthy” or “healthy.” All foods can fit! Bodies are very intelligent, and each body is unique and knows what it needs. There will be some days that a body craves sweets, and there might be others where it is in the mood for fruit or nutrient dense foods. Whatever your body wants on a given day is acceptable and OKAY! Society often tells us to defy what our bodies want in the pursuit of unachievable beauty standards, but ultimately, this will only lead to dissatisfaction and misery.
Every single body is different, and even if everyone ate the same amount and exercised the same amount, our bodies would STILL look different. A great analogy to think about is plants. If you consider two different plants, do you expect them to grow and look exactly the same? No. Do you expect them to need the same amount of water or sunlight? No. Some plants need water, some do not. Other plants need sunlight, and others prefer the dark. Like plants, every individual human being has different needs. Some might need to eat more to feel satisfied and nourished, and this has nothing to do with their body size— there are a variety of factors that contribute to food intake.
I would like to end with one closing thought. Food is something that EVERYONE, regardless of their body size, deserves. Food does not have to be “earned” or “burned off” — food is fuel. It also helps us connect with others, ourselves, and even memories from our past. It has no moral value, and having one food over another does not make a person superior. People deserve to live their lives as the best versions of themselves, and being nourished, both mentally and physically, is an important part of that.
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