8 Common Misconceptions about Eating Disorders

Amy Julian

With the great amount of attention given to weight in our society (turn to any magazine and find out which celebrities are “too fat” or “too skinny,” how to lose 5 pounds in a week, and ways to suppress your hunger) it’s easy to construe some misconceptions surrounding eating disorders. I spoke with students here at the University about their own beliefs and misconceptions surrounding the subject of eating disorders. Here are eight common misconceptions from UMB students, and the truth to dispel such myths.

Misconception #1: “People with eating disorders are doing it to get attention. It’s all about vanity to them.” This is probably one of the most common misconceptions out there in society today. Some may try to go on a diet to lose a few pounds, so in that sense one could argue that it is for “vanity” or attention. But the obsession quickly shifts from the need for attention or to look good into a compulsion of behaviors. In reality, those who are entrenched in their eating disorders don’t really notice the world around them, often isolate themselves from friends or family, and so they have no one to “look good for.” It is common, however, that a number of sufferers from eating disorders are looking to promote and receive praise for their behaviors by turning to online communities and websites that give them the camaraderie of other eating disordered individuals. It is these people, who do not realize the severe consequences of their actions that tend to create this misconception and revel in their eating disorder. However, for the majority of those suffering, it transcends far beyond the beauty aspect into a way to cope with stress, depression, expectations, and trauma.

Misconception #2: “Eating ‘cures’ Anorexia.”If this were only the case, the inpatient facilities tailored to treating eating disordered individuals would not have such a high rate of returning patients. If eating truly cured an eating disorder there would be far more programs specialized in force-feeding anorexia sufferers to get them out of their disorder. While an anorexic may eat, making it seem that he or she is “OK,” it is the feelings associated with eating (before, during, and after) that truly mark where a person is in recovery. One who suffers from anorexia could eat a cheeseburger, but if the anxiety surrounding it is so great, and he or she compensates by restricting subsequent meals or over-exercising because of the larger calorie content of such a food, this can hardly be called “cured.” A fear of fat and gaining weight is a symptom of anorexia, and it does not diminish (it may actually increase) with the simple act of eating.

Misconception #3: “People who overeat are lazy.”I once knew a woman who was a binge-eater who was the mother of two, active in her children’s PTA and sports teams and enjoyed going out to movies and socializing. Hardly lazy. People who binge eat (with or without purging) often do so because they are overwhelmed by emotion and feel emptiness in their lives that they feel can only be filled with food. It’s sad that our society puts so much criticism upon those who are overweight and obese without understanding the mechanisms that may be in play. Perhaps they are stressed, so they overeat. Perhaps they are unfulfilled with their relationship (or lack of). Perhaps it’s work-related. Whatever the cause, emotional and binge eating is a serious medical and psychological condition and does not reflect a person’s self-worth.

Misconception #4:”If a person is of ‘normal weight’ and not skin and bones, they aren’t anorexic.”Possibly the most harmful of all of the misconceptions, being at a normal weight and appearing to be healthy does not mean a person is not battling and engaging in anorexic behavior. Often with anorexia if a person has dieted for a prolonged period of time and lost weight, their metabolism may have been slowed down due to the body’s self-preservation mode. While metabolism may be restored, it is possible that the body will not allow a person to lose any more weight past a certain point because it recognizes how it has felt at that point (Ruhs, 2007). Weight is only one symptom of an eating disorder, and if a person exhibits other symptoms of anorexia (preoccupation with food, intense fear of weight gain, feeling fat despite being underweight for their height, etc.) there is still an underlying problem. The reason this is so harmful is that many people assume that because they are at a somewhat normal weight, they do not need to receive treatment. Even doctors and programs, though it is changing steadily, overlook patients who do not fall under 85 percent of their “healthy” weight. (A person who is only 87 percent of their normal, healthy weight may be overlooked and therefore try to lose more weight to prove he or she is truly sick enough to receive treatment.) Just because a person appears “healthy” does not mean they are. In fact, a large number of studies show that the majority of deaths from heart failure associated with anorexia and bulimia occur when the patient is in recovery and at a more stable weight (somethingfishy.net).

Misconception #5: “All obese people binge and vice versa”Obesity is a multi-faceted disease which should get a lot of attention because of the fatal side effects on one’s health. While obesity is considered by many health professionals to be an eating disorder, it is not true that all people who are obese binge. Some have genetic predispositions to obesity, so this predisposition combined with a lack of exercise and poor food choices may lead to obesity. Binge eating is characterized by uncontrolled eating of large quantities in a short period of time. Many people who struggle with obesity may be naturally heavier or may make poor dietary and fitness choices. And the converse of that: not all people who binge are obese. Bulimia involves binging (followed by purging via laxatives, diuretics, exercise, or restricting) and those who engage in bulimic behaviors tend to range from underweight to normal weight to overweight (based upon the Body Mass Index calculation).

Misconception # 6: “Men who have eating disorders must be gay.” Having an eating disorder in no way reflects upon your sexuality. Men are just as prone to life’s stresses and traumas as are women, and genetics do not discriminate between the sexes. That said, any man, gay, straight, trans-gendered can have an eating disorder. Many men, especially heterosexual men, often are ashamed to admit they have an eating disorder. Some men (mostly heterosexual) who engage in body-building often have a disorder called “reverse anorexia” in which the person tries to add weight and obsesses about food choices, calories, and exercising. While not as publicized, this “reverse anorexia” can be deadly, as seen in recent years following the deaths of many professional sports stars. Gay men and straight men are susceptable to life’s pressures, though perhaps in different ways. Therefore, having an eating disorder does not mean you are gay, and should not keep you from seeking help.

Misconception #7:”Medication will cure an eating disorder.”While medications are extremely helpful in treating co-morbid disorders such as depression, Obsessive Compulsive Disorder, anxiety, bipolar disorder, and others, no medication truly “cures” an eating disorder. Medications often help to take the edge off of obsessive thinking and alleviate some of the associated depression often occurring with the disorders. However, numerous studies have shown that medication in conjunction with various forms of therapy, nutritional counseling, and other approaches yields a better prognosis than simply medication alone. Not everybody responds to medications the same and what works for one person may not work for everyone, which is why it is important to take a holistic approach to treatment of any eating disorder.

Misconception # 8: “People with an eating disorder can control or ‘turn off’ their disorder when they want to.”This misconception often gives way to much frustration to those with a loved one who suffers from an eating disorder. The misconception that one can control or snap out of their disorder often adds friction to many relationships and ultimately leads to further isolation of the eating disordered individual. While those suffering from an eating disorder do ultimately control their behavior (as we all do), there lies within them a force that becomes so great that the person often feels they are compelled to go about their behaviors in order to quiet the “eating disorder voice.” Now, I use the word “voice” with much caution, as it automatically implies that those with eating disorders are delusional, hear voices and must be psychotic. This is not the case. I simply refer to this “voice” as a way to separate the eating disorder identity from the true identity of the sufferer. People often feel that when their loved one does not stop their behaviors, it is a direct way for the sufferer to spite the supporter. As a matter of fact, many women who suffer from eating disorders say that they wish they could stop, but often times it feels automatic, like they are on “auto-pilot” and don’t realize they are doing the behavior until they complete it. Sure, I suppose someone who suffers from bulimia could make a conscious decision not to go to the bathroom after a meal, but the anxiety that arises from sitting with oneself is far too great and can be alleviated by purging, therefore reinforcing the importance of the behavior and further cementing it into a person’s automatic behaviors.

If you are guilty of any of these misconceptions, try and remember that eating disorders are medical and psychological diseases, and many people do not seek treatment because they fear of being judged. Help dispel these myths and learn that eating disorders are serious illnesses that, if left untreated (or under-treated), can be fatal.