Eating disorder myths
Eating disorders are complex physical and mental illnesses. Most of us have been told or shown inaccurate messages about eating disorders. Here are a few myths that I have come across as a therapist specializing in eating disorders, and the realities of eating disorders.
MYTH: Only vain people have eating disorders.
This myth pre-dates my experience, but I have had clients who have grown up where this was the go-to idea. Eating disorders are, ironically, rarely related to vanity. Many people who develop eating disorders are seeking acceptance for who they are, or avoiding negative judgment for things that they cannot change, such as genetics. Eating disorders can also develop when needs are not met, be they physical or emotional.
MYTH: Only W.A.S.P.’s (White Anglo-Saxon Protestants) with money have eating disorders.
Eating disorders don’t discriminate. Genetics, socioeconomic status, and learned behaviors all play a role in the development of eating disorders. If you come from a Hispanic, Mediterranean, or African background you have a higher risk of developing an eating disorder. This dates back to the colonization of countries and is explained in depth in the book “Fearing the Black Body: The Racial Origins of Fatphobia.” One thing the book does well is expanding on how our current (and historic) views of beauty within Western culture idolize Anglo appearances but fear or villainize traits associated with other ethnicities and cultures (e.g., wide hips, curly hair, etc).
MYTH: In-Patient Treatment is a Cure-All.
In-patient treatment is primarily geared towards medical stability. Yes, you might learn coping skills. However, there is a higher chance that you will learn to play the system to get out of treatment and back to your regular life. Unfortunately, in-patient treatment doesn’t prepare you for the realities of regular life. Food is a part of life. American culture is obsessed with, and morbidly afraid of, people’s bodies. In-patient can be a wonderful break from this harsh reality, but it does not always provide patients with the skills needed to thrive in their day-to-day lives.
MYTH: Just eat. Just stop eating. Just don’t purge.
Oh my gosh, I wish I had thought of that! (cue eye roll) If it were this easy I would not have a job (or years of personal struggle). It is rarely this easy. Eating can become inundated with labels like “good” and “bad”, “healthy” or “unhealthy”. Forget about what happens when you feel the effects of appearance changes. This is the type of advice I count among, “Well-meaning but ignorant.”
MYTH: I’m a normal weight. I can’t have an eating disorder.
Eating disorders are one part weight and many parts behavior. Most people view eating disorders as a 1:1 ratio (1 part weight, 1 part behavior). In reality, this is far from the truth. Eating disorders all have elements of control, guilt, and shame in addition to fearing body weight. Thanks to updates in the DSM-5 and DSM-5-TR, people can receive help based on more than just a low BMI (which is BS). As a clinician, I view the weight as one piece of the puzzle. Medical stability is important, but it is only one facet of the puzzle that is an eating disorder.
Sources:
Barakat, S., McLean, S.A., Bryant, E. et al. Risk factors for eating disorders: findings from a rapid review. J Eat Disord 11, 8 (2023). https://doi.org/10.1186/s40337-022-00717-4
Huckins, L. M., Signer, R., Johnson, J., Wu, Y. K., Mitchell, K. S., & Bulik, C. M. (2024). What Next for Eating Disorder Genetics? Replacing Myths With Facts to Sharpen Our Understanding. Focus, 22(3), 418-429.
Strings, S. (2019). Fearing the black body: The racial origins of fat phobia. In Fearing the Black Body. New York University Press.