Eating Disorders Are Not Always What You Think They Are

What Are Eating Disorders?

Many people think of adolescent girls, gymnasts, or models when they think of eating disorders, and with good reason. Certain industries or developmental periods of life expose people to eating disordered behaviors and/or make people more susceptible to them. However, eating disorders can occur in anyone, in any setting, and during any period of life. Eating disorders are a vast range of problematic eating behaviors and rituals that pose a  threat to a person's physical and mental health. At times, eating disorders can be life threatening and can require medical hospitalization. They are very serious disorders and require immediate attention as they can spiral out of control quickly. Unfortunately there are a lot of misconceptions around eating disorders that can interfere with people getting help when needed. In general, more education around eating disorders is necessary.

What Are Some Common Misconceptions?

1. People Who Have Eating Disorders Are Really Thin. This is perhaps the most common misconception of eating disorders. Many people have heard about Anorexia Nervosa, which is only one type of eating disorder. A person who has anorexia restricts their eating in an attempt to be extremely thin. People with anorexia can become dangerously underweight, women can lose their periods, and as a result of severe malnutrition can go into cardiac arrest, can have multiple other medical complications, and can even die from it. However, there are other eating disorders as well. There is Bulimia, where people desire to be very thin and restrict their eating at times but it is not sustainable and engage in eating large amounts of food in a small amount of time (binge) as a result. This creates a lot of anxiety for the person who is obsessed with thinness and the person therefore engages in a behavior to try and undo the binge, such as self-induced vomiting, excessive exercise, or laxative or diuretic use. People who have bulimia are often average weight or overweight. There are also people who have Binge Eating Disorder. This group of people engage in binge eating but do not try to undo it immediately after. This group tends to be overweight, and they may or may not be overly preoccupied with thinness.  Additionally, some people with eating disorders can have very muscular bodies. For example, eating disorders is very common in wrestlers, dancers, and gymnasts who may be engaging in eating disordered behavior and appear to look very healthy. 

2. Eating Disorders Are Women-Specific Disorders. Historically, people used to believe that eating disorders were only found in women. However, this is not true. Part of the problem, among many, is the way professionals thought about eating disorders. For example, until the latest edition of the diagnostic and statistical manual, one of the main criteria for a diagnosis for Anorexia was loss of menstrual cycle. Clearly that sets the tone for Anorexia as a "female disorder" and overlooks how this disorder could present in males. There are a lot of boys and men who need to maintain certain weight to be on specific sports teams, and unfortunately these weight pressures can contribute to eating disordered behavior, such as self-induced purging or excessive exercise. 

3. Extreme Dieting and Eating Disorders Are the Same Thing.  Sometimes people make jokes about their friends or themselves as "having an eating disorder" when they are watching what they eat or going on a diet. These jokes are not funny and can really minimize the seriousness of any eating disorder. Regular dieting, even if extreme such as a cleanse or diet that requires cutting certain foods out, is different from an eating disorder. Eating disorders are not just about food, what food you eat, or how much. Eating disorders come with a set of very problematic thoughts about one's body, self-worth, self-esteem, and maladaptive assumptions about others' judgments about your body, as well as rigid rituals around body and eating. There are many people who will diet in their life and that will not lead to an eating disorder. However, for a person with a history of an eating disorder, or for who eating disorders run in their family, or if they have some predisposition to eating disorders, then extreme dieting can be a dangerous slippery slope. 

4. It Is A Phase and Will Pass. It is not a phase, and not only will it not pass, it will likely get worse. If you or someone you love is restricting their eating to the point of becoming extremely underweight, is obsessed with calorie counting, constantly weighs themselves, has rituals around how they cut or eat their food, binge eats, self-induces vomiting, obsessively exercises, misuses diet pills, or talks about their body very negatively, then it is imperative to seek help immediately. The hard part is that oftentimes, people who have eating disorders do not want help, so a gentle approach is necessary. The most important thing to do first is seek the attention of a primary care physician, ideally one with experience with eating disorders, to make sure the person is physically ok. Assuming no further medical attention is needed, such as hospitalization, the person will need a team of a dietician and a psychotherapist, and sometimes a psychiatrist. If dealt with early on the eating disorder can successfully be treated on an outpatient basis. The longer the time passes before help if received the more likely a hospitalization may be required.  

There is hope with help! 

If you find yourself struggling with signs of an eating disorder, or have a loved one who engages in eating disordered behavior and are struggling to manage your feelings around this, feel free to reach out for a consultation. If you have general questions about therapy, you may find the FAQ page useful.