Eating Disorders: Myth vs Reality

Let me define an eating disorder for you:

“A psychological condition centred around abnormal or detrimental eating patterns”

Despite definitions like this and further information surrounding eating disorders being easily accessible, there are still false perceptions present which are having negative effects on eating disorder awareness.

I want to put to rest these myths and perceptions in hope to increase awareness for those in need. Please please read through this whole post and feel free to contact any helplines that I have linked at the end if you feel like you or another need someone to talk to.

Myth 1: Anorexia and Bulimia are the only eating disorders

In a society obsessed with criteria and categories, it is easy to focus on the well-known eating disorders and dismiss someone’s issues if they do not fit in a particular diagnostic box. Eating disorders, as with any mental illness, are not as easy as ‘black or white’, or ‘anorexia or bulimia’. There is a large grey area that people should be more aware of so that sufferers not ticking all the boxes can still access appropriate treatment.

This grey area may be easier to explain numerically. BEAT, Britain’s largest eating disorder charity, predicts that 40% of people with an eating disorder have bulimia, 10% have anorexia, and 50% have OSFED[1]. Please click below to read more about what the different eating disorders are and their signs.
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Myth 2: Eating disorders only occur in young women

Stereotypes are often exaggerations of the truth, and here is no exception. The stigma that eating disorders occur in young women is somewhat accurate; in fact, they are considered ‘high-risk’ compared to other societal groups. This is supported by statistics showing that 89% of people with eating disorders are female [1], and the illness often begins between the ages of 12 and 18, with 14 to 16 being the most common [2].

Despite this, and emphasised in myth 1, mental illness is a grey area – even though eating disorders are more common in young women, it is predicted that 11% of sufferers are men [1], and there is evidence of eating disorders in children as young as 8 and in the elderly [3].

To summarise, eating disorders can occur in anyone, regardless of gender, age, race, ethnicity, upbringing etc etc.

Myth 3: You have got to be thin to have an eating disorder

“If you can’t see it, it is not there” 

The above quote and associated myth is a perception heightened by media coverage focusing on anorexia and malnourishment. The perception impacts negatively on eating disorder awareness by narrowing the public’s focus to the physical manifestations of eating disorders rather than the mental symptoms, meaning that sufferers that are not underweight are often disregarded as having an eating disorder.

The truth of the matter is this: 80-85% of people with an eating disorder are not underweight [4]. There is an increasing link between obesity and eating disorders, with binge eating disorder [5] and night eating syndrome [6] being the most common named disorders associated with obesity, and they both involve distress around food. Equally, eating disorders can occur when someone is of a normal weight and BMI. So, again, the weight of eating disorder sufferers is not black or white, underweight or overweight – sufferers can be any weight or body shape.

It is important to understand this myth because the mental symptoms occur before the physical ones. Treatment still needs to be engaged with if someone is displaying psychological and behavioural signs of an eating disorder, without the physical ones.

Myth 4: Purging only involves vomiting

Purging is a primary indicator of bulimia or other related eating disorders. It is a common misconception that vomiting is the only purging method; there are unfortunately multiple ways that someone can purge.

Purging is the act of physically removing food/ calories out of the body and this can involve[7]:

  • Self-induced vomiting.
  • Misuse of medication which can include laxatives, diuretics, enemas, appetite suppressants, thyroid preparations, insulin etc.
  • Fasting
  • Excessive exercising

Not only the lack of public knowledge about the different methods, but also the lack of knowledge about how dangerous they are, is worrying. With fasting and excessive exercise being a purging method, the binge-purge cycles may be much more common than you may think. Being aware of the different ways someone can purge is important for accurate identification, treatment and recovery.

Myth 5: Eating disorder behaviour focuses solely on food and body image

Eating disorders are often linked to other mental health disorders, with anxiety, depression, and OCD being common secondary illnesses that can develop with an eating disorder. I will be looking into this further in future posts.

Linked below are some helplines which can be used if needed:

https://www.mind.org.uk/#

https://www.mentalhealth.org.uk/

https://www.samaritans.org/

https://www.ocdaction.org.uk/

http://depressionuk.org/

Myth 6: Parents and the media are to blame

Nature or nurture? The above myth solely blames the environment that the sufferer has/ is experiencing. In reality, eating disorders are multifactorial – meaning that both nature and nurture can play a part in their development.

Nature – There is research showing that eating disorders are several times more common amongst biological relatives of people that have already had eating disorders [8], and that identical twins are much more likely to share a disorder than non-identical [4]. This, and a vast amount of other research, supports the theory that genetics contribute to eating disorder development.

Nurture – Every person has developed under different circumstances and has experienced different things. This considered, every eating disorder sufferer will have different environmental factors which have assisted their illness’s development. Some of the potential risk factors can include but aren’t limited to [9]: exposure to trauma such as abuse, death or bullying; a predisposition for obesity or leanness; and particular personality traits. 

Despite the extensive research carried out to find the causes of eating disorders, the recovery for sufferers is more important. Read on to find out how you seek help and treatment for eating disorder recovery.

Myth 7: There is nothing that can be done

There are a multitude of things that can be done.

For all other myths around eating disorders, I have collected credible, evidence-based sources and pooled them together to create my posts and increase eating disorder awareness. For the above myth, I want to link sources that have been made by experienced health professionals as I think that they would be more useful.

If you are concerned about yourself, a friend or a family member I would urge you to look at the below sources:

BEAT is the British Eating Disorder Association:

https://www.beateatingdisorders.org.uk/

The NHS website is also useful:

https://www.nhs.uk/pages/home.aspx

If you are worried and are not from the UK, please give me a message and I can direct you to the correct association.

Alternatively, you could go and visit your local GP.

Like any disease or illness, it is much better if the signs are spotted and appropriate medical care is initiated during the earlier stages. I cannot stress enough how important it is that you are aware of the potential signs of eating disorders, and how treatment can be sought after. Please spread awareness and the helplines above. This should be talked about more.

[1] BEAT (n.d.) Statistics for Journalists. Available at: https://www.beateatingdisorders.org.uk/media-centre/eating-disorder-statistics (Accessed: 6 August 2018).

[2] Hsu, L.K. (1990) Eating Disorders. New York: Guilford.

[3] Lask, B. and Bryant-Waugh, R. (1992) ‘Childhood onset of anorexia nervosa and related eating disorders’, Journal of Child Psychology and Psychiatry, 3, pp. 281-300.

[4] Fairburn, C.G. and Harrison, P.J. (2003) ‘Eating Disorders’, The Lancet, 361(9355), pp. 407-416.

[5] Grilo, C.M. (2002) ‘Binge Eating Disorder’, in Fairburn, C.G. and Brownell, K.D. (eds.) Eating Disorders and Obesity. New York: The Guilford Press, pp. 178-182.

[6] Stunkard, A.J. (2002) ‘Night Eating Syndrome’, in Fairburn, C.G. and Brownell, K.D. (eds.) Eating Disorders and Obesity. New York: The Guilford Press, pp. 183-191.

[7] World Health Organisation (1993) ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organisation.

[8] Strober, M. and Bulik, C.M. (2002) ‘Genetic Epidemiology of Eating Disorders’, in Fairburn, C.G. and Brownell, K.D. (eds.) Eating Disorders and Obesity. New York: The Guilford Press, pp. 238-242.

[9] Schmidt, U. (2002) ‘Risk Factors for Eating Disorders’, in Fairburn, C.G. and Brownell, K.D. (eds.) Eating Disorders and Obesity. New York: The Guilford Press, pp. 247-250.

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