5 things no one tells you about eating disorders
If you have history with an eating disorder, you know this: Eating disorders are neither simple nor straightforward. If you don’t have the history, it bears repeating: Eating disorders are complicated.
But for both camps, there is value in learning a few things about eating disorders that you might not have learned in health class or even through lived experience.
#1: Eating disorders thrive in secrecy
It’s not always easy to spot disordered eating habits, whether you’re the one engaging in the behaviors or you’re wondering if someone else is engaging. All could seem perfectly normal on the surface but beneath, the eating disorder is at work, shaming, berating, accosting, and calculating how the individual is going to compensate for whatever they have just done.
I’ve spoken with dozens of therapists and a handful of nutritionists since I started recovery in 2008, and it can take months to be able to divulge to them my real internal dialogue—both because it takes time to develop trust in the other person and because I don’t always know whether the thoughts originate from me or the eating disorder.
It can be daunting to deal with whatever comes up when you’re speaking with a professional. Some of the things I’ve said aloud to therapists and nutritionists have been nothing short of shocking once the words leave my lips. But each time you speak about it, you give life to the line between what’s you and what’s not.
#2: Eating disorders afflict all types of bodies
Eating disorders can develop in individuals of any and every age, weight, body type, gender identity, race, ethnicity, and socioeconomic status.
In 10th-grade sociology, we watched a made-for-TV movie about a young, white, cisgender female who would eat entire lasagnas and then disappear into the bathroom. Her upper-middle-class parents gave her a stern talking-to and sent her away to a treatment facility that most likely costs tens of thousands of dollars. This unrealistic portrayal of a serious disease like eating disorders is not only inaccurate, it’s insulting.
Media like this have taught us that people with eating disorders have a certain “look”, but the truth is it’s impossible to tell whether someone struggles with disordered eating just by looking at them. People with eating disorders can “look” perfectly healthy but, as mentioned in point #1, the disease is deceiving.
#3: Eating disorder symptoms can be slow and sneaky
Eating disorder symptoms are a lot like grief—they pop up when you least expect them. And when you think they’re really gone this time, they have a tendency to lie in wait for the next vulnerable moment to storm in and take your attention hostage.
At the genesis of my disordered eating journey, my intense—borderline obsessive—interest in fitness and nutrition surreptitiously morphed into an insatiable fixation with my appearance.
While my “interest” in health and exercise developed during my teen years, the heightened attention and disordered behaviors came much later. When the conditions are right (i.e., a heavy amount of physical, emotional, and/or mental stress), a seemingly innocent hobby can tip over to the dangerous side.
A relocation, a new work environment, a new relationship, a death in the family, or even just a slight change in lifestyle—both minor and major changes that cause even the tiniest disruption in daily routines are ripe conditions for disordered thoughts.
#4. Eating disorders are not always (in fact are rarely) about food
Despite the nomenclature and categorization in the DSM-5, eating disorders aren’t always about eating.
It’s easy to assume that the crux of eating disorders is eating. But in reality, food and exercise are just conduits through which individuals with eating disorders displace their discomfort, grief, sadness, and a host of other feelings.
According to the National Eating Disorders Association (NEDA), eating disorders are “bio-psycho-social diseases, which means that genetic, biological, environmental, and social elements all play a role.”
People with eating disorders are often dealing with deep internalized issues that are manifesting themselves through a fixation on food and their bodies. Simply "eating” won’t solve the problem.
Instead, they need psychological treatment to understand where these thoughts may be stemming from and, sometimes, medical nutrition therapy with a qualified nutritionist to learn how to create a healthy relationship with themselves and with food.
(Ideally, these clinicians have extensive backgrounds and training in eating disorders, but depending on where you live, this can be hard to find. See Resources for more information on where to find help.)
#5. Eating disorders can’t always be clearly defined
Eating disorders can’t always be categorized into neat tables and bulleted lists. It’s common for someone who exhibits disordered eating behaviors to fall under more than one eating disorder classification.
When I’m asked, “Which eating disorder do/did you have?” I answer, “All of them.”
Sure, sometimes my symptoms aligned those of anorexia nervosa, and other times they leaned more toward “exercise bulimia” (which isn’t even one of the DSM-5 categories). My very first eating disorder therapist diagnosed me with anorexia nervosa solely because she needed to codify my billing statement. But throughout the course of the disease and recovery, my symptoms could have fallen into any of the buckets defined by the DSM-5.
There isn’t always a bold line that separates one eating disorder from another. They often blur, which can make them difficult to diagnose.
Bonus: Recovery is possible
There’s a lot we still don’t know about eating disorders and mental health in general. But one truth we do know is that recovery is possible, and that’s something to celebrate.
Pause & Prompt
One misconception I’ve had (or heard) about eating disorders is…
