7 eating disorder truths that may surprise you

Content warning: This blog post is about eating disorders. Please take care while reading. Or skip it altogether. If you or someone you know needs emergency support, help is available. For free, private support, call the National Alliance for Eating Disorders helpline at 1-866-662-1235.

In recent years, more people have started to embrace the idea of body positivity. That we should love our bodies just as they are. For what they can do, instead of how they look. And there’s also been progress in how our society discusses and addresses mental health.

Yet, at the same time, there remains a serious health issue where these trends intersect. And that’s eating disorders.

Over the past few decades, the number of Americans living with some form of eating disorder has grown.¹ The most recent estimate is around 30 million people.²

Researchers know that a mix of cultural, psychological and biological factors often drive eating disorders.¹ But they’re still working to explain what’s behind this current rise. So far, the data points to stress, anxiety and an increase in screen time.³

“When life feels out of whack, deciding what and when you eat can feel like an easy way to take back control,” says Giselle Alexander, LCSW, a licensed therapist and AbleTo program advisor. “But that thinking can slide into taking extreme measures. And when you pair that with the filtered images and health misinformation that’s all over social media, it can warp what someone thinks is healthy. Too many accounts with big followings and little expertise are sharing advice that isn’t grounded in science. And it makes it harder for people to separate health fact from fiction.”

Changing how we approach eating disorders starts with understanding what’s true and what’s not. Below, we’ll debunk common myths about eating disorders. We’ll also share tips for getting support.

7 common myths about eating disorders

When it comes to eating disorders, separating fact from fiction could save a life. Here are 7 of the most common misconceptions that may be deterring you, or someone you love, from getting help.

People with eating disorders always look thin and frail
“Physical traits like weight, body mass index and muscle tone don’t tell the whole story,” says Alexander. That means someone’s appearance isn’t always a good gauge of whether they have an eating disorder.

For example, obese people might struggle with binge eating disorder.⁴ That’s chronic bouts of consuming too much food. And elite athletes have what most of us think of as fit, strong bodies. But they also have a higher risk of an eating disorder compared to non-athletes.⁵

“Look for signs of rigid thinking and behavior around food or exercise,” she says. “Someone might be really strict about what they eat. Or how often they work out. They might not stray from those rules for any reason.”

Only young, white women get eating disorders
It’s true that eating disorders occur most often in women. But they’re not the only group. In fact, these disorders span a wide range of ages, ethnicities and gender identities.⁶

“Our culture still prizes beauty standards that focus on thinness, youth and Caucasian features,” says Alexander. “But eating disorders cut across a range of subcultures and populations. People may still go to extreme lengths to conform to their community’s ideals.”

Research compiled by the National Association of Anorexia Nervosa and Associated Disorders (ANAD) shows just how widespread eating disorders are.⁷

A few key takeaways:

• Rates of eating disorders in Black, Indigenous and people of color (BIPOC) communities are similar to those in white communities. But they’re much less likely to get a diagnosis or pursue treatment.
• Those who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual or 2-spirit (LGBTQIA2S+) also face a higher risk of eating disorders than their heterosexual peers.
• Eating disorders are more common among transgender college students than cisgender ones.

Eating disorders are a choice or a phase
For many people, an eating disorder is a way of responding to stress or a lack of control in other areas of their lives, explains Alexander. “Maybe work has become really intense. Or there’s something going on with their family that they can’t fix,” she says. “But they can decide what they eat and whether they purge. They can decide how much or how often they work out. Whatever it is, the person can’t help but be stuck in these behaviors.”

Beauty standards are the main cause of eating disorders
When someone has an eating disorder, there’s usually more going on beyond wanting to fit into a certain size. Or look a certain way.

“These disorders often stem from deeper psychological issues,” says Alexander. “Maybe it’s stress. Or a need for control. Or even a response to trauma.”

Family members or other key figures in someone’s life can also play a role. That’s especially true for young people. “The way primary caregivers talk about things like food, fitness and body image impact how you view those things, too,” says Alexander.

Anorexia and bulimia are the only types of eating disorders
When people think of eating disorders, two main types often come to mind. The first is anorexia nervosa. That’s when someone refuses to eat, displays an extreme fear of weight gain, has a warped view of their body and misses at least three periods in a row.⁸

The second is bulimia nervosa. That’s marked by cycles of binge eating and purging.⁹ But there are several other eating disorders that are less well-known but just as serious.

The 5 types recognized by the American Psychiatric Association are¹⁰:

• Binge Eating Disorder: eating large amounts of food in a short period of time without getting rid of the food in some way after
• Avoidant Restrictive Food Intake Disorder: picky eating taken to such an extreme extent that it results in nutritional deficits
• Pica: a drive to eat things that are not food, such as dirt or paper
• Rumination Disorder: when someone regularly brings up food they’ve already swallowed, chews it again, and either swallows it or spits it out
• Specified Feeding and Eating Disorder: eating issues that affect someone’s daily life, but don’t meet all the official criteria for a specific disorder

Beyond those diagnoses, there are other forms of disordered eating. That means eating patterns that fall outside the range of what doctors would consider normal, healthy behaviors.¹¹ One form Alexander calls out is orthorexia, when someone obsesses over only eating “pure” or “clean” food. Research suggests the condition is on the rise.¹²

You can never fully recover from an eating disorder
Recovery from eating disorders can be complex. And different definitions of the term in studies make it tricky to get a clear picture of what it entails. People living with eating disorders can heal both their bodies and their minds. But they need caring, holistic support.

“Relapses are common. So it takes good, specialized services to make progress,” says Alexander. “Cognitive behavioral therapy (CBT) can help with connecting the emotions, thoughts and actions that feed harmful habits. And nutrition support is key to tend to the physical side of recovery.”

Every body is beautiful

Knowing the truth behind eating disorders helps us spot signs early on. Then we can support people in our lives who may be affected. And if we’re the ones with an eating disorder, we can begin to change how we view ourselves.

Think you or someone you know has an eating disorder? There are several organizations that can help. ANAD, the National Alliance for Eating Disorders and the National Eating Disorders Association can connect you to support groups, screenings and treatment options. AbleTo does not treat eating disorders. But the support team can refer you to the right kind of care.