Most people with eating disorders are NOT extremely thin
Photo by Houcine Ncib on Unsplash
I was a thin, white, female, anorexic adolescent. The poster child of an eating disorder. And then I was a normal weight, adult bulimic. Not exactly what you might picture a sick person to look like, and yet, significantly more common than the former.
Here is the truth: the vast majority of people who are suffering or have suffered from eating disorders are not underweight. What does this mean? And what does this feel like?
I developed a rather “textbook” case of anorexia when I was in high school. And because my family and friends noticed, they intervened, and I got help before it was too late.
My road to recovery, however, included a rather lengthy detour through the bizarre world that is bulimia. A world where preoccupation with food and my body still dominated my personal narrative, but where no one could see it.
And THIS. This was some special kind of torture.
Imagine having a massive wound on your arm. You missed a step on your way out the door, tumbled down the staircase, and opened your forearm on the sharp metal corner of the handrail. You’re bleeding. It’s pretty bad. And without help, you’re going to be in worse shape, real quick.
But you’re embarrassed. Who falls down the steps anymore? How klutzy! If you’d been brushed by a car, attacked by a dog, or even pushed down the steps, you’d feel justified in asking for help!
But you did it to yourself. You have no one to blame but you.
So you stay quiet about it. You cover it up with bandages whenever you go out. You try to smile, but you’re in some serious pain. Efforts to focus on anything else are pretty short-lived.
And meanwhile, no one is paying attention to the gaping wound on your arm. No one can see the bandages filling up with blood. People may even compliment your arms. Or (and this is the worst), they might suggest you take the stairs and not the elevator. If only they knew what just happened on the stairs!
This inconspicuous yet deeply wounded adult is actually much more typical among people suffering from eating disorders and disordered eating than the conspicuously thin, white, female adolescent portrayed in every “eating disorder” internet search or in popular media.
Indeed, studies show that less than 6% of people with eating disorders are medically diagnosed as underweight (1). In fact, having a larger body is both a risk factor for developing an eating disorder and a common outcome for people who struggle (2). On top of that, people in larger bodies are half as likely as those at a normal weight or underweight to be accurately diagnosed with an eating disorder (3).
Perhaps this is one reason why nearly 70% of the 30 million people (one third of which are men!) in the US who have eating disorder symptoms actually ever seek treatment (4). Imagine if there were a 50/50 chance that the doctor I see for my bleeding arm either does nothing or, worse yet, suggests I cut open the other one!
And yet this is our reality. This is the often unspoken truth about the prevalence of eating disorders.
And this is why here, we check all of our assumptions at the door. Your experiences around food and your body are your own and are worth honoring. All are welcome here.
Arcelus, Jon, Alex J. Mitchell, Jackie Wales, and Soren Nielsen. 2011. “Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.” Archives of General Psychiatry 68 (7): 724-731. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1107207.
Eating Disorder Recovery Center. 2020. “Eating Disorder Facts and Statistics.” Eating Recovery Center. https://www.eatingrecoverycenter.com/conditions/eating-disorders/facts-statistics.
Nagata, Jason M., Andrea K. Garber, Jennifer L. Tabler, Stuart B. Murray, and Kirsten Bibbins-Domingo. 2018. “Prevalence and correlates of disordered eating behaviors among young adults with overweight or obesity.” Journal of General Internal Medicine 33 (June): 1337-1343. https://doi.org/10.1007/s11606-018-4465-z.
National Eating Disorders Collaboration. 2017. “People Living in Larger Bodies & Eating Disorders.” NEDC. https://nedc.com.au/eating-disorders/eating-disorders-explained/people-living-in-larger-bodies-and-eating-disorders/