FeminismSkepticism

National Eating Disorder Awareness Week: Myths

This week is National Eating Disorder Awareness Week, an annual event put on by NEDA to educate the general public about eating disorders and to help dispel misconceptions. The theme of this year’s week is “I didn’t know” and in keeping with that theme we’re going to kick off this week with some myths about eating disorders and the real information you need to know. If you have any questions about eating disorders or are curious about what it’s like to have one, please sound off in the comments and I’ll do my best to jump in. So without further ado, some common myths about eating disorders and the real facts behind them.

1. Eating disorders are just a phase or a fad diet. They’re not really serious. If we can just convince people they look fine and they should eat, they can get over it.

Eating disorders are extremely serious. If you want evidence of that, just remember that they have the highest mortality rate of any mental illness. In addition, they tend to be lasting, damaging illnesses that can seriously impact someone’s life for years. There is a high rate of relapse in eating disorders, and the duration of the illness is often quite long (definitely longer than the teenage phase of stereotypes). While it’s true that the focus of an eating disorder is often on body shape, the underlying concerns of those with eating disorders are far from shallow and cannot be dispelled simply by convincing someone that they are attractive or that they need to eat.

2. There are only two eating disorders: anorexia and bulimia.

One of the serious problems with this myth is that it propagates the idea that all of those with eating disorders are thin or average sized. In reality, eating disorders cover a wide variety of symptoms. Binge eating disorder was recently added to the DSM and while the numbers on it are still new, it appears to be incredibly common. In addition to these three there is also Eating Disorder Not Otherwise Specified, which covers all of those individuals with disordered eating whose behaviors don’t fit into the strict constraints of the anorexia or bulimia diagnoses (as an example, anorexia has a weight requirement or an amenorrhea requirement. For those who don’t fit that requirement but do have all the other symptoms of anorexia, EDNOS would be the appropriate diagnosis). In addition, anorexia is not the only serious eating disorder. All eating disorders have high mortality rates and can wreak havoc on the body.

3. Only white, rich, cis girls get eating disorders.

This myth seems to stem from the idea that eating disorders are some sort of pastime for people who have nothing better to do with their lives, and who are vapid and shallow. Statistically this does not bear out though. Eating disorders are more common in women, but men do get them. Older women get them. Queer and trans people get them. People who aren’t white get them. People not in the US get them. They’re really not interested in discriminating. What is true is that eating disorders tend to get diagnosed more frequently in young white women because that is the perception of what an eating disorder is.In reality, anyone can use food to manage their emotions and in doing so develop an eating disorder.

4. Eating disorders are a new phenomenon caused by the media.

It is true that the terms used to label eating disorders are fairly new.The word anorexia has only existed since the late 1800s as an example. However we do have instances of individuals starving themselves going back as far as we have records. Often these had the same types of symptoms as eating disorders today: perfectionism, hyperactivity, depression, melancholy. In the past the explanation was religion, but the underlying behaviors appear to be quite similar. Additionally, we have good evidence that up to 50% of the cause of eating disorders is genetic (thanks to twin studies). Individuals who don’t consume much media also get eating disorders, including those in communities cut off from mainstream media. The etiology of eating disorders is extremely complex and we don’t fully understand it, but we do know that genetics and a stressful or invalidating environment appear to be the two key factors in developing one.

5. You can tell if someone has an eating disorder by looking.

I understand the appeal of this myth. I think everyone likes to play the game of sidewalk diagnosis. I can’t deny that I do it sometimes too (although after living with an eating disorder for 6ish years I tend to look for a certain dead look in the eyes rather than a specific body type). It’s nice to stick labels on people. Unfortunately, eating disorders come in a wide variety of types and flavors, which means that any body type can house an eating disorder. People who are drastically underweight can have eating disorders, people who are drastically overweight can have eating disorders, and everyone in between can have them. While the way we eat can affect our bodies, it does not determine our body type. Some individuals remain thin no matter what they eat (you all know them), and similarly some individuals simply can’t lose weight beyond a certain point no matter what they do to their bodies. Even if someone is engaging in eating disordered activities, this may not show on their body. Don’t make assumptions and don’t diagnose unless you’re a therapist and have actually spent some time with this person and their mental health.

Olivia

Olivia is a giant pile of nerd who tends to freak out about linguistic prescriptivism, gender roles, and discrimination against the mentally ill. By day she writes things for the Autism Society of Minnesota, and by night she writes things everywhere else. Check out her ongoing screeds against jerkbrains at www.taikonenfea.wordpress.com

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19 Comments

  1. #1 seems to be endemic across a lot of mental illnesses. Yes, the solution seems simple when you put it like ‘address self image and motivate healthy eating problems’, but how one does that and gets it to stick* is not easy at all. Just because one can state a goal does not make the goal immediately attainable.

    * And some of that sticking is realizing that you will probably always have a predisposition towards it, at least if eating disorders are analogous to anxiety and depression.

    1. It’s absolutely true that there are predispositions for eating disorders that last a lifetime, in addition to the fact that comorbidity is extremely common with eating disorders so you often have the predisposition for depression or anxiety along with an eating disorder, or else a personality disorder (which is persistent throughout life). Definitely makes it difficult.

  2. “This myth seems to stem from the idea that eating disorders are some sort of pastime for people who have nothing better to do with their lives, and who are vapid and shallow.” Oh my, I this is so mean and hurtful and dismissive. Kinda like blaming a person for having the eating disorder. OUCH. A close family member to me had issues with anorexia. It had nothing to do with being shallow, but more likely the horrible depression and abuse she suffered and lack of control she had in her life as a child.

    1. I think I might be misreading you (if I am, please disregard), but it sounds like you think “eating disorders are some sort of pastime for people who have nothing better to do with their lives, and who are vapid and shallow” is Olivia’s opinion. It’s not. She’s saying that’s the popular myth.

  3. Olivia: “Don’t make assumptions and don’t diagnose unless you’re a therapist and have actually spent some time with this person and their mental health.”

    That in itself is damn good advice right there. Diagnosis and treatment is a job for a highly skilled professional and accredited team.

    1. I will specify that I’m not talking about self-diagnosis because there are a lot of political issues at play to getting an official diagnosis from a psych professional and I don’t want to stop any individual from finding a term that helps them cope. But yes, diagnosing others is a job for people who actually have training in diagnosing.

      1. I’m sure there are a lot of political issues to getting an official diagnosis. Could you expand on this point? I imagine for instance that mandatory treatment under some circumstances may be one consequence. Is that the sort of thing you medant?

        1. That wasn’t exactly what I was referring to, although that’s a big deal as well. Mostly I was referring to the fact that if you aren’t straight, white, cis, and fairly well off it’s incredibly hard to access a mental health professional who will take your issues seriously and diagnose appropriately. Psych care is expensive and hard to access for lots of people, and many symptoms are interpreted differently when they present in different demographics.
          In terms of eating disorders, it’s much harder to get a diagnosis as a man or a person of color for example than as a white female. So especially for those who are already in difficult situations, it’s even harder to get the support and treatment they need and self-diagnosis can be helpful in finding community and coping skills.

  4. Good post with valuable information about some myths and stereotypes of eating disorders.

    I’m just a little skeptical of the claim about genetics though.

    Looking at the link you gave, they do not provide any citations for their claims. Further, all of those claims are based on statistical modeling, not on actual genetic evidence, which is a start, but does not constitute “good evidence” of a genetic basis–it represents preliminary data that needs to be looked at empirically and not just mathematically. There is not a claim on there that genetics may be up to 50% of the cause of eating disorders. The article says that it is thought to increase the likelihood of anorexia by 28 to 58 percent and 54 to 83 percent for bulimia (pretty large margins of error). But, since we don’t have the studies to look at where those numbers come from, it is not possible to tell what methods were used to arrive at those conclusions and whether they are actually sound conclusions or not.

    I’m always weary of this kind of thing because, historically, mathematical modeling like this has been used in lieu of empirical genetics evidence to make lots of claims ranging from plain wrong to nefarious. They say they are doing a genetic study now, but I’m confused as to what they’re going to be looking for, since they say they don’t know which genes may play a role in eating disorders. So, are they just going to compare genomes?? I mean, that’s kind of useless if you don’t know which genes do what as far as eating disorders go.

  5. Hey Will those are really good points and I’m going to honest I think I was just being lazy in my linking. Here are some more sites with evidence of a genetic role in eating disorders:
    http://www.usnews.com/news/articles/2013/10/08/researchers-find-genes-linked-to-high-risk-of-eating-disorders
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010958/
    http://www.psychologytoday.com/blog/mr-personality/201204/are-eating-disorders-heritable
    http://bjp.rcpsych.org/content/185/5/363.full (this one in particular mentions approximately half and half contributions of environment and genes)
    I hope these provide some more evidence that we’ve located some of the genes that are linked to eating disorders and that while we don’t have an exact approximation of how big a role genetics play we do know that it’s a significant amount.

    1. I looked at the two “scientific” studies and they are pretty much crap. They don’t look at actual genes. The estimates of “heredity” from twin studies are only about association, not causation. It is probably mostly not “genetic”, by which I mean that is is very likely that any human with any genetic background can/will get an eating disorder under the right (wrong) conditions. That on some level genes don’t matter. They don’t matter for treatment (you can’t change your genes), but lots of people like to think that such things are “genetic”, so they can imagine that by not having such a “disorder”, they have superior genes, and so have superior gene privilege.

      Eating disorders are the mental health disorder with essentially the worst prognosis. People with eating disorders will very likely have their life shortened by it, so it really needs to be taken seriously.

      1. You`re right it is almost impossible to single out a specific causative factor because researchers can`t exactly try to induce an eating disorder.

        You`re also right that genes probably don`t cause eating disorders but these studies are more likely about predisposition. Those with these predispositions would be more likely to have an eating disorder.

        I do have to disagree about whether it affects treatment. If something is entirely learned or environmental then treatment would focus on.changing self perception or environment. If something is genetic we may have to spend more time on coping strategies like how to deak with perfectionism or black and white thinking. Iy would also affect.prevention campaigns.

        Additionally, i`ve mostly seen the genetic argument as one that validatea the severity and reality of eating disorders, as a way to fight “it`s all in your head”.

  6. I think they are more about correlations of noise in the genome with noise in how people behave. Eating disorders are not rare, and everyone has a big genome with lots of variation. There is lots of “noise” in both systems, so there is lots of “noise” that is likely to correlate.

    Everything about behavior is “all in your head”. That doesn’t make it not real or not a problem or not something to be taken seriously.

    The treatment strategies that should be used are the ones that have been shown to work in well-run clinical trials. Nothing about physiology is well enough understood to decide what will work without studying it.

  7. A lot of the problem with eating disorders is because of…media stereotypes. Those perfect popular girls in middle school who everyone is jealous of? Yeah, sour grapes says that she *must* have an eating disorder. (And celebrities talking about naturopathic ‘detox diets’ further makes it seem that disordered eating is a hobby.)

    But it’s a mental illness, and a deadly one.

    (And I know some of the comorbidities probably have a hereditary element, such as anxiety and depression.)

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