Eating disorders are complex medical/psychiatric illnesses. Eating disorders are classified as mental illnesses in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV), are considered to often have a biologic basis, and co-occur with other mental illnesses such as depression, anxiety, or obsessive-compulsive disorder.
Myth #2: Eating disorders are uncommon
They are common. Anorexia nervosa, bulimia nervosa, binge eating disorder, and subclinical, but very concerning eating disorders and disordered eating behaviors affect many young people in the United States and worldwide. Among U.S. females in their teens and 20s, the prevalence of clinical and dangerous, but not full-blown anorexia may be as high as 15%. Anorexia nervosa ranks as the third-most-common, chronic illness among adolescent U.S. females. Even though it is the rarest, and most severe of eating disorders, it affects approximately 1-in-200 young girls. Recent studies suggest that up to 7% of U.S. females have had bulimia at some time in their lives. At any given time an estimated 5% of the U.S. population has undiagnosed bulimia. Current findings suggest that binge eating disorder affects 0.7% to 4% of the general population.
Myth #3: Eating disorders are a choice
People do not choose to have eating disorders. They develop over time and require appropriate treatment to address the complex medical/psychiatric symptoms and underlying issues.
Myth #4: Eating disorders occur only in females
Eating disorders do occur in males. Few solid statistics are available on the prevalence of eating disorders in males, but the disorders are believed to be more common than currently reflected in statistics because of under-diagnosis. An estimated one-fourth of anorexia diagnoses in children are in males. The National Collegiate Athletic Association carried out studies on the incidence of eating-disordered behavior among athletes in the 1990s, and reported that of those athletes who reported having an eating disorder, 7% were male. For binge eating disorder, preliminary research suggests equal prevalence among males and females.
Incidence in males may be underreported because females are more likely to seek help, and health practitioners are more likely to consider an eating disorder diagnosis in females.
Differences in symptoms exist between males and females: females are more likely to focus on weight loss; males are more likely to focus on muscle mass. Although issues such as altering diet to increase muscle mass, over-exercise, or steroid misuse are not yet criteria for eating disorders, a growing body of research indicates that these factors are associated with many, but not all, males with eating disorders.
Myth #5: Men who suffer from eating disorders tend to be gay
Although gay men are at increased risk for eating disorders compared to other men; straight men get eating disorders too.
Myth #6: Anorexia nervosa is the only serious eating disorder
All eating disorders can have damaging physical and psychological consequences. Although excess weight loss is a feature of anorexia nervosa, effects of other eating disorders can also be serious or life threatening. A person with bulimia can be at high risk for death because of purging and its impact on the heart and electrolyte imbalances. Laxative use and excessive exercise can increase risk of death in individuals who are actively bulimic.
Myth #7: Dieting is normal adolescent behavior
While fad dieting or body image concerns have become “normal” features of adolescent life in Western cultures, dieting or frequent/ extreme dieting can be a risk factor for developing an eating disorder. It is especially a risk factor for young people with family histories of eating disorders and depression, anxiety, or obsessive-compulsive disorder. A focus on health, well-being, and healthy body image and acceptance is preferable. Any dieting should be monitored. Ironically, dieting has also been found to predict excessive weight gain and obesity in adolescents.
Myth #8: Eating disorders are about appearance and beauty
Eating disorders are a mental illness and have little to do with food, eating, appearance, or beauty. This is indicated by the continuation of the illness long after a person has reached his or her initial ‘target’ weight. Eating disorders are usually related to emotional issues such as control and low self-esteem and often exist as part of a dual diagnosis of major depression, anxiety, or obsessive-compulsive disorder.
Myth #9: Only people of high socioeconomic status get eating disorders
People in all socioeconomic levels have eating disorders. The disorders have been identified across all socioeconomic groups, age groups, both sexes, and in many countries in Europe, Asia, Africa, and North and South America.
Myth #10: Recovery from eating disorders is rare
Recovery can take months or years, but many people eventually recover after treatment. Recovery rates vary widely among individuals and the different eating disorders. Early intervention with appropriate care can improve the outcome regardless of the eating disorder. Although anorexia nervosa is associated with the highest death rate of all psychiatric disorders, research suggests that about half of people with anorexia nervosa recover, about 20% continue to experience issues with food, and about 20% die in the long term due to medical or psychological complications.
Myth #11: Eating disorders are an attempt to seek attention
The causes of eating disorders are complex and typically include socioeconomic, environmental, cultural, and biologic factors. People who experience eating disorders often go to great lengths to conceal it due to feelings of shame or a desire to persist in behavior perceived to afford the sufferer control in life. Eating disorders are often symptomatic of deeper psychological issues such as low self-esteem and the desire to feel in control. The behaviors associated with eating disorders may sometimes be interpreted as “attention seeking;” however, they indicate that the affected person has very serious struggles and needs help.
Myth #12: Purging will help lose weight
Purging does not result in ridding the body of ingested food. Half of what is consumed during a binge typically remains in the body after self-induced vomiting. Laxatives result in weight loss through fluids/water and the effect is temporary. For these reasons, many people with bulimia are average or above-average weight.
Myth #13: You’re not sick until you’re emaciated
Only a small percentage of people with eating disorders reach the state of emaciation often portrayed in the media. The common belief that a person is only truly ill if he or she becomes abnormally thin compounds the affected individuals’ perceptions of body image and of not being good at being “sick enough.” This can interfere with seeking treatment and can trigger intensification of self-destructive eating disorder behaviors.
Myth #14: Kids under age 15 are too young to have eating disorders
Although it is true that the average age at onset for anorexia nervosa is 17 years and bulimia nervosa is usually diagnosed in mid-to-late teens or early 20s, eating disorders have been diagnosed in children as young as seven or eight years of age.
Myth #15: Achieving normal weight means the anorexia is cured
Weight recovery is essential to enabling a person with anorexia to participate meaningfully in further treatment, such as psychological therapy. Recovering to normal weight does not in and of itself signify a cure, because eating disorders are complex medical/psychiatric illnesses.
*All information obtained from ANAD.org and NationalEatingDisorders.org.
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