When somebody says the term “eating disorder,” what comes to mind? While our culture does have a pervasive idea of what eating disorders are, it is sadly fraught with many misconceptions and stereotypes. Some of these can be harmful to anyone struggling with an eating disorder, because they mischaracterize the battle they are going through or minimize their condition to make it seem less of an issue than it is.
Worse still, some of these misconceptions make it very difficult to spot the symptoms or even diagnose somebody who has a condition that, if left unchecked, could become life-threatening. Therefore, it’s important to dispel these stereotypes and promote an accurate depiction of what eating disorders are.
(Please note: Addressing these misconceptions and clarifying the facts involves discussion of eating disorder behaviors, symptoms, and risks, which may be triggering for some readers who are struggling with an eating disorder or have struggled with one in the past.)
If you need help with an eating disorder, or know someone who is, help is available. Visit the National Eating Disorders Association website or contact NEDA’s Live Helpline at 1-800-931-2237. You can also receive 24/7 Crisis Support via text (send NEDA to 741-741).
People with eating disorders are always underweight
When you think of somebody with an eating disorder, the first image that comes to mind might be somebody who is dangerously thin. But on the contrary, many people struggling with eating disorders might be at a normal weight or even overweight, according to the Eating Disorders Recovery Center.
Low body weight is a symptom of anorexia nervosa, a common eating disorder in which a person eats very little food. However, if a person is struggling with eating disorders such as bulimia, binge eating disorder, or EDNOS (eating disorder not otherwise specified), then their physical appearance will likely be different from a person who is battling anorexia.
Unfortunately, the assumption that all people with eating disorders are underweight can be quite harmful. This can lead many patients to be either misdiagnosed or diagnosed too late when they should have been getting medical intervention earlier.
Men can’t have eating disorders
Many people think that eating disorders only happen to women and girls. But that’s not true, and there are significant numbers to show otherwise. In fact, men and boys make up about a third of people who have eating disorders, according to the National Eating Disorders Association. That amounts to about 10 million men in America.
Unfortunately, many of those men will go undiagnosed, either because health care professionals assume they don’t have an eating disorder or because they themselves refuse to seek treatment (or are afraid to seek treatment). They think that an eating disorder is a condition that only affects the opposite sex, or that the only men who have eating disorders are gay.
Men who are struggling with eating disorders will often take part in the same dangerous practices as their female counterparts, such as fasting, binging and purging, or abusing laxatives. The upside is that once men do seek help and/or receive proper diagnosis, they will do just as well with treatment as a female patient would.
If you’re functioning, you don’t have an eating disorder
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Along with the misconception that somebody with an eating disorder is always extremely underweight, there is also the incorrect notion that somebody with an eating disorder has trouble functioning — they’re constantly passing out from fatigue, for example, or malnutrition is making their hair fall out and their nails become brittle.
But just as there are functional alcoholics, there are also people with functional eating disorders — people who go about their daily lives just fine, but are still struggling with unhealthy eating habits as a result of mental illness. Romper breaks down the signs of a high-functioning eating disorder, noting that many people have a relationship with food that causes them high levels of stress. People might regularly cancel plans so they can go to the gym instead, or they cut out entire food groups from their diets.
If you have a compulsion to bring food with you to events where food is normally served (because you want total control over what you eat) or if you hide food wrappers in the trash because you’re ashamed of what or how much you ate, these could be red flags of an unhealthy relationship with food.
If you or someone you know needs help with mental health, please contact the Crisis Text Line by texting HOME to 741741, call the National Alliance on Mental Illness helpline at 1-800-950-NAMI (6264), or visit the National Institute of Mental Health website.
Eating disorders are all about vanity
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Many people strive to lose weight because they want to be more confident in their physical appearance, so there’s a misconception that all people with eating disorders are taking this idea to the extreme. After all, if they’re starving themselves to control their weight, it’s probably all about vanity, right?
Unfortunately, this is a misconception, and one that can be offensive to people who struggle with (or have struggled with) eating disorders, per Good Therapy. A person with an eating disorder isn’t obsessed with their looks; instead, they are trying to cope with negative emotions like anger or fear. They might be controlling their diet because they feel as if it is the only thing they have control over, or they could be looking at their body in a negative light because they find it easier to worry about that than their other problems.
A person with an eating disorder has strong willpower
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The average healthy person likes to enjoy their favorite foods from time to time. And it isn’t unusual (or even unhealthy) to overindulge on occasion. But when people see somebody who has an eating disorder turning down delicious food, they might think to themselves, “Wow, that person has great willpower.” But nothing could be further from the truth.
Somebody with anorexia doesn’t have strong willpower, and characterizing it as such can be triggering, per Recovery Warriors and the New York Times. A person with an eating disorder is often avoiding food out of fear or out of habit. If anything, people with eating disorders who are striving to get better are the ones who are displaying strength and willpower. They have to be strong to take care of themselves, even when their inclination is not to do so – and letting themselves have a nourishing meal or their favorite food takes tremendous commitment on their part.
Purging refers only to vomiting
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A person with bulimia engages in what’s often described as the binge-purge cycle, which is described by Johns Hopkins Medicine as consuming large amounts of food (more than a person would normally eat) in only a short time, often without feelings of control, then trying to offset the binge by purging the food (commonly through vomiting).
But vomiting is by no means the only type of purging that a person might engage in. They also might try to purge their digestive tract by abusing laxatives, diuretics, or enemas. While these are categorized by Johns Hopkins as “purging,” there are other behaviors a person with bulimia might engage in after a binge, such as an extended period of fasting or even excessive exercise. In other words, if somebody exercises an inordinate amount in order to “earn” food or “atone” for food, this could be a sign of disordered eating.
A person with bulimia could use more than one method, and this cycle of binging and purging could vary in its frequency, sometimes happening multiple times in a week (or even within a day).
If you see them eat, they don’t have an eating disorder
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Because people tend to simplify an eating disorder as just “not eating,” they might see a friend or loved one eat and assume that it means they don’t have an eating disorder. But not all eating disorders look the same, and as with other mental illnesses, a person with an eating disorder will go to great lengths to hide their struggle from others (via National Eating Disorders Association). They might hide these behaviors because they’re ashamed of their illness or afraid of intervention. Thus, they could be eating normally in front of other people, but engaging in unhealthy food behaviors when they are by themselves.
A person battling an eating disorder might insist that nothing is wrong with them — they might genuinely believe this (as they are unaware of how unhealthy their behaviors are), or they might be avoiding the treatment they need. Because people battling eating disorders can be so good at keeping up the appearance of normalcy, those closest to them can go a long time without noticing anything wrong — and will often be shocked at how bad the symptoms are once they become more apparent.
Their parents or family members are to blame for their eating disorder
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When a person struggles with an eating disorder, those on the outside might be looking for someone to blame. And unfortunately, the finger typically gets pointed at the person’s family. For instance, a young woman struggling with an eating disorder may lead people to assume that it’s because of her mother’s unrealistic expectations about her physical appearance. Another example: if a young man exhibits disordered eating habits to maintain a certain weight for his sport, others may blame his father for pressuring him to excel.
But these blame games are unfair, as the Eating Disorder Recovery Center explains, because eating disorders are more complex than that. University of Rochester Medicine echoes this notion, stating that many factors contribute to the development of an eating disorder. But take note: Parents are not to be blamed for eating disorders, but their support and assistance can be a determining factor in whether a person with an eating disorder gets the intervention they need and eventually recovers.
The media is to blame for eating disorders
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For some folks, the media is a convenient scapegoat for eating disorders. According to them, because movies, TV shows, magazines, and social media all set unrealistic body standards, it’s inevitable that a person constantly exposed to all of them would develop an eating disorder.
The only problem with this logic, as the Eating Disorder Recovery Center points out, is that while many people are exposed to these media platforms, not all of them develop eating disorders. That’s because eating disorders are complex, and typically not just due to a single root cause.
However, it’s true that the media can affect a person’s self-perception. As the National Eating Disorders Association says, media messaging can indeed be a factor in the development of eating disorders. For example, as early as elementary school, girls may be exposed to photos in magazines that can influence their idea of what their bodies should look like (and thus make them feel the need to lose weight).
Eating disorders only affect teenagers and young adults
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A lot of people assume that eating disorders only affect young people, primarily teens and twenty-somethings. Perhaps it’s because they think that by the time somebody is older, they will be more confident or won’t be as impressionable, so they won’t engage in disordered eating habits. That’s not always the case, though.
In fact, as Eating Disorder Hope explains, older people with eating disorders tend to exhibit many of the same symptoms as their younger counterparts, but they are less likely to be diagnosed because people don’t consider the elderly to be at risk. However, it’s worth noting that one reason young people are generally more susceptible to eating disorders is because their bodies are changing very drastically during this time in their lives (per Kelty Mental Health Resource Centre). This leads to a lot of discomfort and dissatisfaction, which can make some youths more inclined to engage in eating disorder behavior.
Everyone does [insert weight-loss method here], so it can’t be a sign of an eating disorder
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Maybe you’ve heard a list of eating disorder symptoms and you’ve thought, “Wait, that sounds pretty normal — I thought a lot of people do that. And they don’t all have eating disorders.” True, a lot of people count their calories or watch their intake of a specific nutrient, such as carbohydrates or fat, especially if they’re trying to lose weight. And there are folks who eat not because they’re hungry but just because they’re bored. But the difference between these habits and an actual eating disorder is when the thought process becomes all-consuming and distracting from a normal, happy life (per the National Eating Disorders Association).
It’s one thing to be conscious of the calories you are eating throughout the day, but it’s another thing entirely to be tracking calories with such scrutiny that it distracts you from the things you enjoy. With that said, only a percentage of people take their eating practices to this extent: According to one study cited by the National Eating Disorders Association, less than 1% of women and men struggle with anorexia during their lifetime. Meanwhile, the most common eating disorder, binge eating disorder, affects only 3.5% of women and 2% of men.
Some people with eating disorders aren’t sick enough
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Sometimes, it can be extremely difficult for friends and loved ones of somebody with an eating disorder to identify the illness and provide intervention. But even if a person received intervention and accepts that they have an eating disorder, they might continue to face invalidation as they seek help.
In other words, health workers might not perceive them as “sick enough” to get the care they need — and the person with the eating disorder could, in turn, start to believe their condition isn’t real, per the Central Coast Treatment Center. This problem can be exacerbated by other factors. Some insurance companies, for example, might not cover somebody’s eating disorder treatment if they don’t meet certain physical diagnostic criteria.
It’s important to remember that an eating disorder does not need to be extreme to warrant care and recovery. It’s better for a patient with an eating disorder to undergo treatment as soon as possible than to wait for the condition to get worse.
An eating disorder is something a person has control over
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For somebody who doesn’t have an eating disorder, the solution to such a problem may seem so simple. “All they have to do is eat,” you might think about somebody who is struggling. “They have to know that eating is healthy for them!” Unfortunately, an eating disorder isn’t something that a person has control over (via the National Eating Disorders Association).
An eating disorder is, after all, a mental illness, and patients who struggle with an eating disorder may also have other mental health problems (such as depression or obsessive-compulsive disorder). Mental illness can be triggered by socio-environmental factors, but there are often biological factors as well. When somebody with a genetic predisposition is exposed to social factors like teasing or media depictions of unrealistic body ideals, the result can be a mental illness that requires proper health care intervention for recovery.
A person can never recover from an eating disorder
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Fortunately, it is entirely possible for a person with an eating disorder to fully recover and develop a healthier relationship with food.
The National Eating Disorders Collaboration lists five components of eating disorder recovery: nutritional recovery, physical recovery, psychological recovery, functional recovery, and social recovery. People who receive treatment for eating disorders learn how to recognize and respect their body’s hunger and satiety cues, and they will regain strength, energy, and proper bodily function. They experience less stress, and start to rebuild their feelings of self-worth. They will also be able to repair relationships and return to activities they loved but couldn’t engage in because of their eating disorder.
Recovery will be a long process, and Monte Nido distinguishes between being “in recovery” and “fully recovered.” A person who is fully recovered isn’t just free from symptoms; they also accept their weight and body shape, and refrain from engaging in any destructive or harmful eating habits.
