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Six Common Myths and Misconceptions about Eating Disorders

By Meghan Vivo

We live in a society that is obsessed with food and weight. Eat too much and you’re ostracized for being overweight or obese, and branded “lazy” or “undisciplined.” Eat too little and you’re shunned for having an eating disorder and being “weak” or “vain.” 

There are countless misconceptions and myths surrounding disordered eating patterns. Here are a few of the most common misunderstandings, along with the truth from experts in the eating disorder treatment field to dispel those myths. 

Myth #1: People with eating disorders just want attention. 

Although some eating disorders stem from a desire to look better or lose weight, the desire for attention or a super-thin physique can quickly turn into obsessive or compulsive behaviors that extend far beyond their initial source. Research is beginning to show that eating disorders have a strong genetic component, which can predispose even the least vain among us to develop one of these life-threatening disorders. For most eating disorder sufferers, the issue transcends beauty and becomes a way to cope with feelings of stress, grief, depression, or trauma. 

“Eating disorders are not about looks or food,” says Maggie Baumann, MA, a therapist at The Victorian of Newport Beach, a world-renowned eating disorder and co-existing substance abuse treatment center in California. “They are complex mind-body disorders that require multidisciplinary treatment from a team of caring eating disorder specialists.” 

People also erroneously believe that eating disorder sufferers only care about themselves. Barbara Cole, MFT, Psy.D., clinical director at The Victorian of Newport Beach, writes in her book The Eating Disorder Solution, “One of the more interesting features of people who develop eating disorders is that at the core of their nature or personality, prior to their True Self being overtaken by the eating disorder, they are usually a great deal more altruistic than others.” 

Although an eating disorder sufferer may seem self-consumed or vain, most have a deep desire to care for and protect others, even at their own expense. Dr. Cole has found that this sense of altruism can be of critical importance in the process of recovery. 

Myth #2: Eating disorders are about food. 

Eating disorders seem so simple to the outside observer who says, “just eat already,” or in the case of binge eating or compulsive overeating, “go on a diet.” Many people mistakenly believe that an eating disorder can be “turned off” or “snapped out of” at will. 

In reality, the eating disorder “voice” and compulsion to binge, restrict, or purge is so strong, many sufferers require professional treatment to get well and reconnect with their true identity. Effective treatment of eating disorders involves not only “re-feeding” and learning about proper nutrition and exercise, but also processing difficult emotions, past experiences, and body image concerns. 

Recovery is both a physical and emotional process. Sufferers may confront medical complications like digestive distress, heart palpitations, chronic fatigue, muscle weakness, osteoporosis, hernias, and other problems while simultaneously participating in intensive therapy that addresses the disordered eating as well as any co-occurring emotional or behavioral issues such as depression and anxiety. 

“In addition to dealing with pervasive low self-esteem, inadequate coping mechanisms, and a fear of failure, eating disorder sufferers face a host of medical problems,” explains certified eating disorder specialist Elaine Alexander, MA, LMFT, the Vice President of Eating Disorders for CRC Health Group (a leading provider of specialized behavioral health care services in the U.S.). “There are neuro-chemical aspects of eating disorders; for example, the hypothalamus can malfunction, the heart and brain can atrophy, and the digestive system can collapse. The result is thought processes and coping skills resembling a 7-year-old’s. Once these conditions arise, the disease is beyond the individual sufferer’s control. It’s not as simple as choosing to eat well again.” 

Myth #3: Normal-weight or overweight people can’t have eating disorders. 

Very low weight is indeed a sign of anorexia, but anorexics can also be just five to 15 pounds underweight and still be in grave danger. Bulimics tend to be of average or above average weight and compulsive overeaters are typically overweight rather than underweight. Because every individual is different, it is impossible to determine the existence of an eating disorder based on appearance or weight alone. 

Similarly, just because a person appears to be eating normally or gaining weight doesn’t mean they are healthy or that the eating disorder is cured. In her book, Dr. Cole explains, “The disappearance of eating disordered actions is no indication that an eating disorder is entirely gone. Instead, when e/d thoughts are present but actions are absent, it means that the e/d simply found another outlet for its hateful messages and will still attach negative behaviors to its thoughts at some point.” 

Weight is just one symptom of an eating disorder, and if a person continues to struggle with preoccupation with food, poor self-image, or other symptoms, the person’s well-being is still in jeopardy. 

Myth #4: People with eating disorders don’t want help. 

Resistance is indeed a hallmark of eating disorders. The eating disorder thought process drives the sufferer to push people away, to stubbornly resist offers of help and construe them as criticism, and to isolate oneself and suffer in silence. This is what the eating disorder wants, not what the individual wants. 

In actuality, resistance is a distress call. Dr. Cole writes, “If you or someone close to a person with an eating disorder is noticing an increasing degree of ‘stubbornness’ or rigidity together with physical and behavior symptoms that point toward difficulties surrounding food, it is best to intervene sooner rather than later to try to bring help to this person.” 

Even if the eating disorder sufferer believes or claims she could stop binging, purging, or restricting if she wanted to, these life-threatening disorders are not merely a phase that can be controlled or outgrown. They are serious mental disorders that require professional treatment and counseling. 

A study published in the American Journal of Psychiatry indicates that those who unwillingly enter treatment for an eating disorder fare just as well as their more willing counterparts. Even if your friend or loved one resists treatment now, don’t give up. Your commitment and persistence will pay off when you’ve helped save a life. 

Myth #5: Eating disorders only affect white adolescent girls. 

While eating disorders most commonly begin in a person’s teens or twenties (approximately 86 percent of sufferers are under the age of 20) and predominantly affect females, they can develop in any person at any time. Increasing numbers of adult women in their thirties, forties, and fifties are seeking help for eating disorders that they have been harboring for years or that they relapsed back into in later adulthood. 

“The eating disorder sufferer doesn’t necessarily fit the mold of a super-skinny teen. It’s not just teenagers and 20-somethings struggling with these disorders,” notes Baumann. “Treatment needs to be available for everyone no matter what their age. You’re never ‘too old’ or ‘not sick enough’ to need treatment for an eating disorder.” 

Eating disorders affect boys and men as well. In fact, the number of males with eating disorders has doubled during the past decade, now accounting for at least 10 percent of all eating disorder sufferers. Men are affected by media images, social pressures to be thinner or more muscular, life stressors, and past trauma just like women. Contrary to another common misconception, not all men who have eating disorders are gay. These disorders affect females and males; young and old; gay, straight, and trans-gendered; of all ethnicities and walks of life. 

Myth #6: Eating disorders are not curable. 

This couldn’t be farther from the truth. With appropriate treatment at the right level of care, studies show 60 percent of those receiving treatment for an eating disorder experience full recovery and up to 80 percent experience at least partial recovery. 

Because outpatient therapy generally doesn’t offer enough structure, in most cases, residential or inpatient treatment is necessary. The women receiving treatment at The Victorian spend time with Dr. Cole each week discussing her book and learning about the healing process. The ladies also learn to prepare their own food with the support and supervision of staff, and follow a meal plan they create in concert with a nutritionist. 

Recovery can be a slow process that takes several years and can involve multiple relapses. Dr. Cole describes these lapses and fluctuations as “the norm rather than the exception” in the process of recovery. After primary treatment ends at The Victorian, clients are encouraged to participate in an extended care program, which allows them to remain in treatment while working, going to school, and accepting more responsibility for taking care of themselves. 

With non-confrontational, nurturing, and gentle support, the staff at The Victorian helps eating disorder sufferers hear the voice of their true self, challenge self-defeating thoughts and black-or-white thinking, and live with integrity and accountability. 

“The right treatment can fill the hole in the eating disorder sufferer’s soul and return her to health,” says Dr. Cole. “Many of our former clients stay in touch through our alumni community, some graduate with advanced degrees in psychology and other fields, and some come back to help other women suffering from these disorders. They have fabulous careers and lives, and are now living in accordance with who they really are.” 

Re-Evaluating Our Beliefs 

Eating disorders are medical and psychological diseases – in fact, they are the most fatal mental health disorders in existence. If left untreated, these curable disorders can become a life sentence. If you are guilty of any of these misconceptions, remember to have compassion for those suffering from eating disorders and other conditions, and work to serve as a positive influence in their lives. 

Many people suffer in silence and avoid seeking eating disorder treatment for fear of being judged. Eating disorder sufferers are not callous, self-absorbed individuals to be judged and rejected. They are “high-functioning, charming, intelligent, wonderful individuals whose best traits have been covered up by their disorder,” says Dr. Cole, and they are worthy of your attention and support.