As a therapist with personal and professional experience with disordered eating, I’ve encountered individuals from all walks of life who come to treatment at various stages in the recovery process — and I've noticed that there are a lot of misconceptions about eating disorders out there. By raising awareness about eatng disorders and all stage of recovery, we can inspire others to share their stories and seek the help they need.

In this article, we'll explore eating disorders, common misconceptions, and ways to get help at all stages of recovery.

What are eating disorders and how common are they?

We live in a society where there is no shortage of focus on food, weight, and shape. This hyperfocus on physical appearance is very much normalized via “thinspo” and “fitspo” accounts on social media and other web-based outlets. It is difficult to scroll through Instagram or TikTok without seeing the before and after photos of someone’s weight loss journey or hearing about a new beauty product.

For some, this preoccupation with body image may be fleeting, while for others, enduring and potentially fatal. According to a research, nearly 30 million people in the United States will suffer from an eating disorder in their lifetime. And people of color are half as likely to be diagnosed or receive treatment as their white counterparts.

I have heard countless clients articulate their apprehensions about pursuing formal care because their illness falls just beneath what would be considered clinically concerning, watching them justify their behaviors because such actions are promoted or reinforced by beauty as a social currency.

There are many types of eating disorders. Some are more common than others, and they all manifest differently. For instance, anorexia nervosa involves a pattern of restrictive eating and a fear of gaining weight, whereas bulimia nervosa is characterized by eating large quantities of food, followed by compensatory behaviors such as self-induced vomiting, laxatives, or excessive exercise. Also common is binge-eating disorder, which is similar to bulimia nervosa minus the use of compensatory actions to prevent weight gain.

Regardless of the form one’s illness adopts, eating disorders can lead to functional impairment as well as medical complications, even death, sometimes resulting in extensive hospital admissions. For many, the disease permeates multiple facets of life, ultimately leading to social isolation and self-loathing, particularly when left untreated.

Eating disorders have a significant impact on mental health

People with eating disorders are twice as likely to experience conditions like anxiety and depression compared to people in the wider community. Although it is unclear whether eating disorders precede these things, research shows that eating disorders are positively correlated with other mood and anxiety-related disorders. As a result, treating an eating disorder often entails multidimensional treatment that targets, not only a person’s problematic relationship with food and weight, but also other mental-health issues that may inform the primary presenting concern.

Busting misconceptions about eating disorders

It’s all about food

There is a misconception that eating disorders are all about food, and clients often express frustration about the fact that friends and loved ones will typically say, “why can’t you just eat?” But eating disorders are much more than that; they are a disease that takes hold of the individual with a really intense grasp.

For many people, struggles with disordered eating are a manifestation of something deeper, whether it is a sense of loss of control and therefore a need to regain control, or a way to disconnect from a distressing state. When someone restricts their caloric intake, their body is so focused on maintaining a place of medical homeostasis that the person doesn’t have any energy left over to pay attention to whatever external or internal stressor was occurring. In other words, it provides an escape and a sense of reprieve from suffering.

Eating disorders only affect women

Another misconception is that eating disorders are a female problem. This could not be further from the truth.

Eating disorders do not discriminate according to gender, sexual orientation, race or ethnicity. In fact, males represent 25% of individuals with anorexia. Because people believe that this is primarily a woman’s disease, many men either do not seek treatment due to the stigma associated with doing so, or are not screened sufficiently for symptoms.

If you aren’t malnourished you can’t be that sick

Although someone with an eating disorder can be underweight, the number on a scale is not necessarily an accurate portrayal of the severity of the disease. In fact, many people with eating disorders may appear physically healthy. Believing that you have to look a certain way in order to be sick perpetuates the idea, “I don’t look sick, so I can’t be that bad and therefore don’t need or deserve treatment.”

You never fully recover from an eating disorder

Full recovery is absolutely possible and worth the fight. Recovery takes patience, time, and self-compassion and that process looks differently for everyone. I think that believing you will always be sick perpetuates the illness.

Recovery at all stages

If you are new to recovery...

Eating disorders are mental health conditions that can also result in potential medical consequences. Eating disorders develop from the inside out, whereas the treatment process often occurs in the opposite direction. That is, disordered eating results first from internal psychological distress that later manifests externally as behavioral symptoms, which can go unnoticed until they begin to affect one’s physical health.  

However, it is difficult to treat the underlying distress without first addressing medical stabilization. Therefore, a treatment team should include a physician, a therapist, and a registered dietitian — ideally all of whom have received additional specialized training to effectively assess and diagnose eating disorder symptoms — to address both the internal and external factors.  

If you suspect you may be experiencing an eating disorder and have not yet started the treatment process, it is recommended that you contact your primary care doctor and receive a physical exam to evaluate your current vitals and recent changes in your weight or appetite. Depending on the severity of your symptoms, you may be referred for different levels of care anywhere from inpatient or residential to outpatient services. If you are already in therapy, it is important to be honest about your eating patterns in order to identify the "what” and the “why” when it comes to underlying psychological causes, which then determine the appropriate therapeutic interventions. Your doctor or therapist may then refer you to a registered dietitian who can identify the “how” and fill in the missing pieces when it comes to dietary intake. 

Because the topics of weight and food can be triggering and the treatment process can be overwhelming for many people, it’s important to be aware of the different ways to make the transition to recovery a little bit easier. First, you may request to receive “blind weights” during your appointments by stepping backwards onto the scale so that your providers can document the necessary information without you having to worry about the numbers involved. Second, recognize that eating disorder recovery is different from other forms of recovery because food is such a necessary part of our survival so it is impossible to completely avoid triggers and  “relapse” is very common. Trusting the process is a must when you begin your journey. Third, there are many free and low-cost resources available, including online support groups and smartphone apps, to supplement treatment and receive additional support. 

If you are recovered... 

If you’ve already been through the treatment process and have maintained your progress for a while, congratulate yourself for getting this far. While many argue that we are always in recovery, it’s certainly important to recognize the small and big successes along the way.  

At the same time, it’s also important to recognize that long-term recovery for eating disorders is achieved by managing not only the physical symptoms, but the behavioral and psychological symptoms involved as well. This means learning to cope with the underlying stressors long after weight, health, and nutrition are stabilized. More specifically, you and your therapist may continue to work on behavioral recovery by identifying triggers and positive alternative coping mechanisms for disordered eating urges. Your therapist may also help you work on psychological recovery by reframing the deep-seated rules and distortions you may have around food, weight, and body image. 

Lastly, mobilizing your support system is critical for long-term success in eating disorder recovery.  For many individuals with eating disorders, being in recovery requires setting necessary boundaries in their relationships in order to manage triggers and receive adequate support. Part of relapse prevention and safety planning is identifying those people in your life whom you will contact based on your needs and the level of intervention they can provide. For example, it’s a good idea to be aware of friends and family you can call when you need to distract yourself versus those you can call in the event of a relapse.  If you experience an emergency and are in need of immediate help, there are several crisis resources available on our website. 

What to do if you, or someone you know, is struggling

Regardless of whether someone is struggling from a clinically significant eating disorder or disordered eating tendencies, seeking professional treatment is an important first step. Left untreated, eating disorders can lead to life-long consequences.

Although some of these ramifications may be physically visible, the emotional suffering can feel insurmountable and take an equal, if not greater toll on an person's well-being. There is not a one-size-fits-all approach to treatment and it is important to remember that one person’s pursuit of recovery may look very different from another. That said, connecting with a clinical provider, whether a therapist or physician, is the first step toward regaining control over your life. The longer disordered eating patterns persist, the more ingrained they can become.

Watching a loved one struggle with an eating disorder can feel like a powerless situation, but there are many ways that you can take action and show your support. 

• First, you may contact the NEDA Helpline at 1-800-931-2237 or text “NEDA” to 741741 to speak with a trained volunteer who can provide short-term support and point you in the right direction for professional help.
• Second, educating yourself on the signs and symptoms can increase your understanding of eating disorders, including how to talk to someone with an eating disorder. Sharing empathetic responses can validate your loved one’s experiences.
• Third, there are several opportunities to get involved in the cause such as volunteering or participating in a NEDA walk in your local community.  

Regardless of your experience with eating disorders and the level of support you can provide, making an ongoing commitment to explore your own relationship with food and biases related to eating disorders can help to further increase self-awareness and reduce stigma. Taking that first step might be the scariest thing you do, but it will also be the most worthwhile act of self-love.