By Rebel Buersmeyer
Eating disorders have the second highest mortality rate of all mental health disorders, only surpassed by opioid addiction (1). Over 10,000 deaths each year are the direct result of eating disorders, that is one eating disorder death every 52 minutes (2). 81% of 10-year-old children are afraid of being fat, with 1 in 4 having attempted to lose weight (3). These alarming statistics are only just a few picked out to highlight the eating disorder epidemic.
Eating disorders tend to be wildly misunderstood. As opposed to disorders such as depression and anxiety, eating disorders are often thought of as life choices and behaviors people should be able to control. Unfortunately, these misconceptions can be dangerous for those suffering with eating disorders. With the diet culture and the lack of eating disorder education, many suffering from this illness will not seek treatment. Common fallacies preventing a person from seeking help denial or failure to recognize the severity of the illness and stigma and shame. As Eating Disorders Awareness Week approaches, I hope to provide some awareness and debunk a couple of the most common myths about eating disorders.
Eating disorders are just about food.
Behaviors around food tend to be a symptom to something more complicated, similar to a cough being a symptom of a virus. According to the National Institute of Mental Health, “eating disorders are complex illnesses caused by an interaction of genetic, biological, behavioral, psychological, and social factors (4).” Genetics play an important role in eating disorder development; however, they do not alone predict an eating disorder. Other examples of biological factors include hormones, certain brain circuits, and gut bacteria. In addition, a number of studies indicate some personality characteristics that contribute to eating disorders including perfectionism, anxiety, and depression. Those who experience difficulty regulating and expressing emotions, generally feel a lack of control, have low self-esteem, and are highly self-critical may also have a higher risk. Interpersonal/ sociological factors also have roots in eating disorders. These are factors that are present in the person’s environment. They may include family functioning styles, identity concerns, media driven ideals, or adverse experiences such as being bullied, death of loved ones, and traumatic life events and these are just starters.
Eating disorders are caused by the media.
Fun fact, eating disorders have been described as far back as the 1 st century when wealthy Romans would overindulge in food and drink, relieve themselves by vomiting, and return to continue their feast. It is also indicated that in ancient times, purging was utilized to prevent food borne diseases and in subsequent centuries, women would starve themselves, believing their desire for food was a sin. In 1689, Robert Morton first labeled anorexia, known then as nervous consumption; and the concept of binge eating disorders, first termed as Night Eating Syndrome, developed in 1959. Although, the development of eating disorders has changed over the years, eating disorders continue to be a complex and serious illness that has biological, genetic, and psychological roots. Media may have a direct impact on how people perceive themselves and others and media may contribute to the pressures that people must look a certain way, but media does not cause eating disorders.
You can tell if a person has an eating disorder by looking at them.
The media often portrays people with eating disorders as thin, frail, and/ or emaciated. While some people do experience weight loss as a result of an eating disorder, fewer than 6% of those with eating disorders are medically classified as underweight, as is most commonly seen in Anorexia Nervosa (5). Others may gain weight or remain the same weight; and eating disorders are present in all BMI categories. The diagnosis and treatment of eating disorders is not based on BMI or weight. In fact, of the eight DSM-5 feeding and eating disorder diagnoses, Anorexia Nervosa and Avoidant Restrictive Food Intake Disorder (ARFID) are the only diagnoses that contain criteria of weight loss and none of the diagnoses have criteria of weight gain. Furthermore, noticeable physical changes may be the result of other illnesses, circumstances, or stress. Essentially, eating disorders are mental illness, not weight disorders.
Parents are to blame for their child’s eating disorder.
It was once believed parents, especially mothers, were the cause for their child’s disorder. In the 1970’s a non-research-based book was written, theorizing that controlling mothers cause anorexia and the idea quickly spread. Research has since discredited this notion, discovering that eating disorders develop in a wide range of family dynamics. No specific parenting style or pattern of family functioning has been found to contribute to the development of eating disorders. Parental involvement has actually been consistently found to increase the chance of recovery, whether though Family-Based Treatment, providing support, or being involved in various ways.
Recovery from an eating disorder is rare.
Truth be known, recovery from eating disorders is entirely possible. While the road to recovery may not be an easy journey, with a thorough assessment and proper treatment, the prognosis for recovery from this illness is likely. To assist a person in recovery, it is important to have a team of eating disorder specialists consisting of at a minimum a physician, therapist, and dietitian, as well as a strong support system. It is noteworthy to keep in mind that eating disorders affect individuals differently, therefore, each person’s journey will be unique. Due to the complexity of eating disorders, recovery most likely will not be linear, it may take months or even years. Although recovery can be challenging, it is possible. Eating disorders do not discriminate, they affect people of every age, race, size, gender identity, sexual orientation, and background. They are serious illnesses, can be fatal, can cause severe disturbances to a person’s eating behaviors; and they tend to have a significant impact on a person’s relationships, mental health, life functioning, and overall well-being.
With eating disorders affecting millions of Americans and their families each year, it is likely you know someone struggling with an eating disorder or eating disorder symptoms or maybe you are struggling yourself. The more we learn about eating disorders, the more we can destigmatize the illness, and the earlier people can get help. Early intervention is key. Early intervention improves the speed of recovery, reduces symptoms to a greater degree, and improves the likelihood of long-term recovery. Awareness and education can lead to prevention and early diagnosis and treatment of this illness.
Eating Disorders Awareness Week, February 27 – March 5, is an annual campaign to educate the public about the realities of eating disorders. This year’s theme, It’s Time for Change invites everyone to begin starting conversations around the difficult topic of eating disorders, begin breaking the stigma and shame around eating disorders, and begin to debunk the myths of eating disorders. To learn more about Eating Disorders Awareness Week, visit www.nationaleatingdisorders.org.
About the Author: Rebel Buersmeyer is a licensed therapist and co-owner of Family Solutions Counseling. She is the 2023 president of Oklahoma Eating Disorder Association and specializes in the treatment of eating disorders and is trained in Eye Movement Desensitization and Processing (EMDR) therapy.
- Arcelus, Jon et al. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of general psychiatry 68(7), 724-31. https://doi.org/10.1001/archgenpsychiatry.2011.74
- Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. June 2020. Available at: https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.
- McNutt, S. W. et al. (1997). A longitudinal study of the dietary practices of black and white girls 9 and 10 years old at enrollment: the NHLBI Growth and Health Study. The Journal of Adolescent Health, 20(1), 27 – 37. https://doi.org/10.1016/S1054-139X(96)00176-0
- Frank, Guido K.W. et al. (2019). The Neurobiology of Eating Disorders. Child Adolescent Psychiatric Clinics of North America, 28(4), 629-640. https://doi.org/10.1016/j.chc.2019.05.007
- Flament, Martine F. et al. (2015). Weight Status and DSM-5 Diagnoses of Eating Disorder in Adolescents from the Community. Journal of the American Academy of Child and Adolescent Psychiatry, 54(5), 403-411. https://doi.org/10.1016/j.jaac.2015.01.020