They can all be life-threatening, yet anorexia, bulimia, binge-eating, and similar disorders are often misunderstood. Here we bust the myths surrounding these serious mental illnesses
Eating disorders have the highest mortality rate among psychiatric disorders, with anorexia leading with the highest number of deaths among adolescents. The UK’s foremost charity for eating disorders, Beat, believes that around 1.25 million people in the UK are sufferers, and research from the NHS information centre shows that up to 6.4% of adults display signs of an eating disorder.
Rising numbers of inpatient hospital admissions for eating disorders reveal the crisis unfolding before our eyes, and yet so many myths and damaging stereotypes still surround this serious mental illness.
As an eating disorder survivor myself, I want to bust 10 of the myths surrounding eating disorders, to break down the stigma and misconceptions, to ensure people can get the support they so desperately need.
1. You have to be thin to have an eating disorder
This is perhaps the most pervasive myth surrounding eating disorders. Sensationalist reports in the media often pick the most extreme cases of anorexia nervosa, and show unnecessary images of emaciated people – often young women. We see this so often that many people assume you have to be very thin to have an eating disorder. Yet anorexia only accounts for around 8% of eating disorders. Bulimia accounts for around 19% of eating disorders, binge-eating disorder (BED) for 22%, and the most common eating disorders, OSFED (other specified feeding or eating disorder, formerly known as EDNOS – eating disorder not otherwise specified) accounts for around 47% of cases.
There is no weight criteria or guideline for any eating disorder other than anorexia, and most people with eating disorders are at a normal weight or above. This doesn’t mean that their eating disorders aren’t serious: there are severe medical complications with all eating disorders, regardless of weight. We also have to remember that eating disorders are mental illnesses, and what is going on in people’s heads is not necessarily reflected on the outside.
2. The only eating disorder fat people can have is BED
This is an utter fabrication, created and perpetuated by our fatphobic society, which sees fat people as over-eaters, when the truth is a lot more complex. Many fat people suffer from restrictive eating disorders, and many thin people suffer from BED. No eating disorder has a ‘look’.
3. Anorexia is the only serious eating disorder
This is perhaps one of the most harmful myths, as it means that many people who are very ill are often overlooked by those around them, and can be deterred from seeking or getting help, due to the belief that they are not sick enough. Bulimia is associated with severe medical complications, such as dehydration (which can lead to kidney failure), absent or irregular periods, digestive and bowel issues, severe tooth decay and gum disease, fits and muscle spasms, and heart problems (such as irregular heartbeats or heart failure).
OSFED also comes with the risk of dangerous medical complications, such as electrolyte and chemical imbalances, organ failure, osteoporosis, malnutrition, heart disease, and type II diabetes mellitus, and/or gallbladder disease.
All eating disorders can be life-threatening, not only through medical complications, but also because there is an increased risk of suicide.
4. Gaining weight means someone has recovered or is better
Often when people see someone who has an eating disorder gain weight, they think that they are better, but eating disorders are primarily a mental illness, with often serious secondary physical symptoms.
Those with eating disorders can have fluctuations in weight due to recovery attempts, or due to changeable eating disorder behaviours. It could be that the person gaining weight is in recovery, or has been re-fed in hospital.
But while they may be healthier physically, it doesn’t necessarily mean that much has changed mentally. Just because someone looks well, doesn’t mean that their eating disorder isn’t screaming at them inside their head.
Eating disorders do not discriminate: they affect people of all ages, sexual orientations, ethnicities, socio-economic statuses, and genders
5. It’s all about weight
On the surface, people with eating disorders fixate on weight, and the disgust they feel about their bodies, but below that are a multitude of driving forces.
Trauma can be a catalyst, as can a build-up of smaller negative events or factors. Eating disorders are often about those who have them feeling in control: of their bodies, of their choices, of their lives. It can be about numbing the pain of trauma. It can be about taking up less space, about disappearing. It can be about remaining childlike, to avoid adulthood for a variety of reasons. It can be about becoming unattractive after sexual assault or rape. The triggers for an eating disorder are extremely varied and personal, and go far beyond weight.
6. It’s a choice
Eating disorders are severe mental illnesses, and no one chooses to have one. Research suggests that there is a genetic factor in the development of eating disorders, and it appears that a combination of genetic predisposition and environmental factors create the perfect storm for an eating disorder to emerge. With the extensive suffering that they bring to those with eating disorders, and their families and friends, it is absurd to think that anyone would ever choose to have one.
7. It’s for attention
Most people with eating disorders go to great lengths to hide their illness, and those who don’t shouldn’t be discouraged from being open by being labelled ‘attention-seeking’. Those who are talking about their eating disorders have a greater chance of seeking help than those who keep it secret. Eating disorders are not a phase, or a lifestyle choice, and often people who experience them feel a great amount of shame.
8. Men don’t get eating disorders
Many people see eating disorders as something that affects young white women, but eating disorders do not discriminate: they affect people of all ages, sexual orientations, ethnicities, socio-economic statuses, and genders. In fact, 25% of people with eating disorders are male, although this could be higher because the stigma means that many men go undiagnosed. Men may tend to be more secretive because of the fear of not being taken seriously, being laughed at, or being seen as weak. No one with an eating disorder should be made to feel ashamed for having one.
9. It’s a diet gone wrong
Although dieting can sometimes trigger an eating disorder, eating disorders are not just “a diet gone wrong”. While dieting can negatively impact both physical and mental health, it’s different from having an eating disorder.
10. You can’t recover
Because of the genetic factor, people might think that this could make recovery impossible. This isn’t the case, and although genes do play a part, they are only one factor in the mix. Research suggests that 46% of anorexia patients fully recover, while 33% improve. Research into bulimia suggests that 45% make a full recovery, with 27% improving considerably.
After suffering for almost a decade, I made my first tentative steps towards recovery in 2012. I have been in remission for more than five years now. Recovery from an eating disorder is absolutely possible, and although it’s a difficult journey, it’s 100% worth it.
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For more information on support for eating disorders visit counselling-directory.org.uk