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Eating disorders: Are they what we thought?

Eating disorders: Are they what we thought?

National Eating Disorders Awareness week has arrived and this year it is themed “Come as you are” which is about opening up the eating disorders conversation and raising our awareness away from the stereotypical image of an eating disorder sufferer.

Eating disorders aren’t all about low body weight, I was surprised when I learned that the majority of people with eating disorders aren’t underweight; which is an assumption many of us have (thanks to the media). Eating disorders can carry a stigma which acts as a barrier to people getting help, so raising awareness is really important because it reduces the shame that fuels the stigma. This seems like the ideal time to discuss popular misconceptions and give some tips for helping someone who is struggling with an eating disorder.

Common misconceptions and why they aren’t true


“Eating disorders are about vanity”

Eating disorders are a mental illness and often linked with low self-esteem and emotional distress, sufferers are the very opposite of vain and can struggle with feeling “good enough”. Some anorexia sufferers report that having anorexia made them feel they had finally found something they were good at (being anorexic). This is a sad fact and it reflects how desperately low people can feel about themselves.

“People with eating disorders are attention seeking”

Eating disorders are self-punishing and can emotionally isolate the sufferer from the people in their life. People with eating disorders are more likely to feel ashamed and socially withdraw. They may go to great lengths to hide their eating disorder rather than use it to get attention.

“Eating disorders are a symptom of modern life”

Eating disorders can be traced back as early as 1689 and are known to have been widespread amongst woman in Victorian times. Research started to step up in the 1970s and we now know that what causes eating disorders is slightly different for everyone but involves a combination of genetics, experiences and personality traits.

“People with eating disorders are extremely thin”

This is only the case for sufferers of anorexia nervosa, where food intake is restricted and the body weight can drop dangerously low. However, in cases of bulimia, binge eating disorder and EDNOS (eating disorder not otherwise specified) people will often be of healthy body weight and sufferers of binge eating disorder can often be overweight. Most people with an eating disorder will not appear emaciated, so if we use that as our only yardstick we will be missing out on a lot of red flags.

“Only teenage girls have eating disorders”

Eating disorders do not discriminate on gender, sexuality, ethnic origin, socioeconomic or celebrity status. In the past, eating disorders in women, and in particular female celebrities, has been given a lot of media attention. As a result, we see eating disorders as a female issue. Male sufferers have been exposed to a double stigma because of this; firstly for having an eating disorder and secondly for having a “female illness”. The impact of this is that men wait an average of seven years before seeking treatment. The good news is that the shift has started and things are slowly improving.

Did you know?

  • Eating disorders are a mental illness with a physical impact, not a lifestyle choice.
  • Anorexia nervosa is the most fatal but the least common eating disorder.
  • Eating disorders in people aged between 45 and 65 are continually increasing.
  • 70 million people worldwide have an eating disorder
  • Eating disorders last between 5 and 8 years on average.

How can friends and family help?

  • Involve them; Eating disorders can lead people to withdraw socially, keep inviting them out and involving them even if they never say yes. It gives the person evidence that they are loved and wanted.

  • Listen; Try to understand without judgment, avoid the temptation to criticise or tell them off.

  • No tough love; Support them to seek professional help, but try not to pressure them or give ultimatums.

  • Avoid body focus; Avoid commenting on their weight and appearance, even if it’s complimentary. People with eating disorders can have a disproportionate idea of how important their appearance is in how valuable they are as a person. Instead, show them you value who they are inside.

  • See beyond the food issue; Try to understand that the eating disorder could represent emotional distress being expressed in the person’s actions and behaviour. The food and the relationship with their body might be being used as an emotional language to communicate distress when the person feels unable to express what is happening for them inside.

  • No blame or shame; Avoid accusing or making them feel ashamed about their eating disorder behaviours. This is an illness and not something anyone would choose to endure.

Specialised counselling can form a vital part of eating disorder treatment and can support recovery. CBT-e is an approach designed around eating disorders and is widely used. However, in younger sufferers, family therapy is also recommended. Speaking to a counsellor can also help those caring for a person with an eating disorder because it can have a significant impact on the sufferers family and relationships.