The Truth About Eating Disorders: Eating Disorder Awareness Week on Central Coast Voices
Earlier this month, my colleagues and I visited Kris Kington Barker at KCBX radio to raise awareness around body image issues and eating disorders. The truth is, eating disorders affect at least 30 million Americans while other food and body image issues affect millions more.
Today, I’m sharing some highlights from the podcast to bust eight common myths about this often-misunderstood disease.
1. Myth: You can always tell by looking at someone if they have an eating disorder.
Fact: It’s impossible to diagnose an eating disorder simply by looking at someone. There are patients who are emaciated and visibly malnourished—but even these symptoms can be caused by conditions other than Anorexia Nervosa. Similarly, obesity can be caused by conditions other than Binge Eating Disorder (BED). It’s not uncommon for someone to appear healthy—or even ultra-fit—while sliding under the radar with a disorder. We live in a culture obsessed with health and fitness, which creates an illusion that a “fit” aesthetic is superior, or even elite. However, this obsession with body image can quickly become dangerous, leading to unhealthy habits and eating disorders.
2. Myth: Each eating disorder has a set of specified symptoms.
Fact: Even though the criteria are specific for each type of eating disorder, the symptoms can change. The specific name of an eating disorder isn’t particularly important. The fact is, if you have an eating disorder, it deserves attention and treatment.
3. Myth: It’s about food or weight.
Fact: Food and weight are only the tip of the iceberg. Eating disorders function as a way of coping. People with eating disorders often experience co-occurring disorders such as anxiety, depression, OCD, personality disorders, substance use disorders, and PTSD. If you have an underlying disorder, such as an anxiety disorder, eating disorder behaviors—such as restricting, bingeing, purging, or over-exercising—become a way of managing underlying emotions. Obsessing overeating and exercise decisions takes up tremendous mental space. When this space is occupied, there’s less room for other negative and anxious thoughts.
4. Myth: Binge Eating Disorder poses less risk.
Fact: BED deserves as much attention as Anorexia and Bulimia Nervosa, especially considering it’s the most common among the 30 million Americans affected by eating disorders. It’s also the most common amongst males. Additionally, BED patients frequently face treatment discrimination. Insurance companies are far less likely to authorize treatment for someone struggling with BED than someone with Anorexia. To be authorized for intensive outpatient program (IOP) treatment, the patient must first fail outpatient treatment including a team specialized in eating disorder treatment. In many cases, BED patients carry as much extra weight—or more—than what an Anorexic patient has lost. Despite this, a patient with Anorexia is rarely forced to fail outpatient treatment prior to starting IOP treatment. These unfortunate circumstances are symptomatic of the weight discrimination that remains so prevalent in our society today.
5. Myth: Overeating and bingeing are conscious decisions.
Fact: Deprivation leads to overeating and bingeing. It can be physiological deprivation in the form of missing macronutrients that drives you to lose control with food, or psychological deprivation where specific well-liked foods are deemed off-limits that leads to losing control precisely with those foods. No matter what, it’s important to give yourself permission to eat.
6. Myth: People struggling with eating disorders can easily self-identify the symptoms.
Fact: Denial is part of an eating disorder. People affected don’t typically think they’re sick, or “sick enough.” This often causes them to remain in their disorder far longer than necessary, in a sense, to “qualify” and meet the criteria that allow them to “deserve” help. No matter what stage you’re at in your eating disorder, you absolutely deserve help.
7. Myth: Eating disorders are always related to low self-esteem associated with appearance.
Fact: Not all eating disorders are related to fear associated with appearances. For example, Avoidant Restrictive Food Intake Disorder (ARFID) doesn’t typically relate to common perceptions of poor self-image. People affected by ARFID restrict and avoid foods associated with adverse or fear-based experiences, such as vomiting or choking, sensory sensitivities that make certain textures and flavors intolerable, low appetite, and extreme pickiness. Once body image comes into play, such as with fear of weight gain or body image distortion, it’s considered “ARFID Plus,” which has similarities to Anorexia Nervosa.
8. Myth: Body Mass Index (BMI) is an accurate indicator of physical health.
Fact: BMI doesn’t consider a person’s body composition, gender, age, or ethnicity. Simply put, it’s not a good scientific indicator. Too often, this can trigger people—especially those with eating disorders—to strive toward a numerical value that may not be a valuable indicator of their health.
To combat body image issues and eating disorders, you can equip yourself with various tools, such as mindfulness and thought records learned through psychotherapy, meal plans from eating disorder dietitians, and social connection through support groups.
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Despite having the highest mortality rate of any mental illness, eating disorder recovery is possible. I am an example. Dozens of clients I have worked with are examples. Colleagues are examples. Perhaps you can be an example, too.
If you or someone you know is struggling with an eating disorder, know that you don’t have to fight the battle alone. Contact me.
To learn more about eating disorders and recovery, listen to the full podcast below.