What Do Eating Disorders Look Like?

Eating disorders impact people of every ethnicity, age, socioeconomic status, gender, and body size, but still, there are many misconceptions about what eating disorders look like. Because of these myths, too many people remain undiagnosed and without treatment. 

Am I Thin Enough?

Of course, we all know intellectually that how someone looks on the outside does not reflect their mental state, but we’re still vulnerable to stereotypes around eating disorders and stuck on this idea that an eating disorder “should” be associated with an emaciated or underweight appearance. I can’t tell you how many times I’ve heard people invalidate their own struggle by saying that they’re not thin enough to have a real eating disorder. I often share that they’re in excellent company because the vast majority of the clients we treat at Columbus Park are in normal weighted or higher weighted bodies.  People often forget that an eating disorder is officially a mental illness – not a physical one. Sometimes with this form of mental illness, there can be physical or visible signs of the problem, but much more often, there are no outward or visible signs at all. Consider this fact: Around 30 million people in the United States population will experience an eating disorder in their lifetime, and, of those diagnosed, less than 6 percent will be medically underweight. In other words, 94 percent of people with eating disorders are in totally average or larger-sized bodies. Sadly, many will end up undiagnosed and untreated directly because of misconceptions about what an eating disorder looks like and about when disordered eating qualifies as a problem that warrants treatment.  

Let’s Talk Gender

In the United States, 10 million men will experience some form of disordered eating in their lifetime. Furthermore, males represent 25 percent of individuals with anorexia nervosa. According to the research, males are at a higher risk of dying from the condition, in part because they’re often diagnosed later. Eating disorders being overlooked and neglected in men is largely due to lack of education about the prevalence of eating disorders in men. Eating disorders are not just conditions of white, heterosexual women as many still assume. In fact, subclinical eating disorders (disordered eating that does not quite meet criteria for a full-blown clinical condition) are almost as common in males as in females.  Further reinforcing that eating disorders are not just a female concern, let’s talk about the LGBTQ+ population. LGBTQ+ people face a number of unique challenges that increase their vulnerability to developing eating disorders. Factors like internalized negative messaging, trauma, discrimination, bullying, and violence increase chances of developing negative self-image and/or extreme weight control measures. Transgender individuals experience eating disorders at rates significantly higher than cisgender individuals. According to a recent report by the National Eating Disorder Association (NEDA), more than half of LGBTQ+ youth between the ages of 13 and 24 have been diagnosed with an eating disorder at some point in their lifetime. Half. These statistics are mind-numbing.  

What Does Race or Ethnicity Have to Do with It?

Thanks to the great effort of some very passionate advocates in the field, we hope that people are beginning to understand that eating disorders are not just a white people problem. When it comes to ethnicity, the research is clear that eating disorders affect people from varying demographics and ethnicities at comparable rates. Unfortunately, though, people in minority populations are much less likely to get help for their eating disorders.  

• Studies have shown trends of higher incidence of binge eating disorder in all minority groups.  
• Research also tells us that rates of eating disorders and body image concerns amongst Latinas are comparable to or greater than non-Latina white individuals. 
• Asian Americans seem to have specific risks for eating disorders, with a trend towards higher incidence of anorexia in the Asian American population.
• One study looked at Native American teenage girls and boys in grades 7-12, finding that 3 percent of the girls and 30.5 percent of the boys had dieted within the past year. Of this group, 28 percent of girls and 21 percent of boys endorsed purging behavior. These statistics are dramatic.
• A study looking at girls aged 11 to 14 found that African American girls scored higher than white girls on all of the eating disorder measures except for drive for thinness and body dissatisfaction. And studies tell us that black teens are 50 percent more likely than their white counterparts to engage in bulimic behaviors like binge eating and purging.

And What About Money?

There is a longstanding belief, in both the professional and mainstream populations, that eating disorders are primarily conditions occurring in individuals of higher socioeconomic status (SES). This stereotype has likely led to major disparities in how eating disorders are identified and treated. For instance, eating disorders occurring in people of lower SES backgrounds are often overlooked and neglected. A systematic review of the research on SES and eating disorders found that there does not appear to be evidence of a relationship between eating disorders and higher SES and that eating disorders are present across the full range of SES backgrounds. Many other surveys and studies echo these findings.

Can You Be Too Old for An Eating Disorder?

Eating disorders are often associated with teens and young adults, but the reality is that older age is not a barrier for disordered eating. The National Comorbidity Survey Replication (NCS-R) identifies age 18 as the median age of onset for bulimia and anorexia and 21 as the median age of onset for Binge Eating Disorder (BED). So yes, eating disorders do tend to come up first in young adulthood, but if a condition goes untreated, it will persist throughout adulthood and into the later years of life. Tragically, many people with eating disorders experience symptoms for decades. A large segment of this chronically ill population will never seek treatment, as the familiar behaviors of the eating disorder simply become part of life. Further, many find that treatment centers focus on the needs of adolescents and younger adults, making older adults feel on the periphery – another factor discouraging outreach for support.   

The Bottom Line

If you think that you don’t “look” like you should have an eating disorder or if you think you don’t live within a community where an eating disorder should be of concern, please think again. The bottom line is that, if your sense of peace and well-being is disrupted by thoughts and worries about food or your weight, you should seek treatment. And even if you’re not sure that you actually meet the criteria for an eating disorder, seek support anyway! You can never treat the problem too soon or too early. If you can interrupt an eating disorder early, before the behaviors sink in and become habitual, you have a better chance for a swift and sustainable recovery. Please don’t fall into the dangerous trap that you don’t fit the mold.  There is no template for what an eating disorder should look like. We’re all vulnerable. Treatment can help. Call Columbus Park today at 646-414-1446 for a free phone screen.  We can help you clarify your needs, provide direct support, or identify alternative resources for help.