Myths About Eating Disorder

The following is a list of common myths about eating disorders. Many of these statements are taken from our message board where members were asked to name the most annoying myths about eating disorders.

 

“Stupid myth #1: you’re not sick until you’re emaciated.”

In reality, only a very small percentage of people with eating disorders EVER reach the state of emaciation often portrayed in the media. The common belief that a person is only really sick if they’re abnormally thin only compounds the feeling of normal- or over-weight ED’d people that they’re not “good” at being “sick enough”, which usually prevents them from seeking treatment and causes them to intensify their self-destructive behaviors. The 60-pound anorectic that is often highlighted in the media is actually a rarity, representing only a very tiny percentage of actual people with eating disorders. Of course, the media wants to show something dramatic, and the majority of people with eating disorders that are of relatively normal weights just aren’t “shocking” enough to draw in all the people that want to see a train wreck. Drama sells. It’s not reality.

At the same time, a person can be malnourished regardless of their current weight. For example, an extremely obese person may be malnourished because they only eat junk food and are missing important nutrients, a normal-weight person may be malnourished if they cut out all protein sources, or a bulimic of any weight can have very low levels of specific nutrients that are often lost during purging, either through vomiting or laxative abuse. Anyone who has ever been to an inpatient eating disorder unit can tell you that there are people of ALL sizes and weights who need treatment. The idea that you’re not sick until you look like a walking skeleton is completely false, and potentially dangerous!

 

“Another myth that bothers me is how every person you meet thinks that the answer to all your problems is a goddamn cheeseburger.”

“You dont need therapy to recover from an eating disorder, you just need to eat/stop purging”

“People always assume recovery is about just eating right, when the underlying cause of having an eating disorder and having so called “bad eating habits” is the mental and emotional disorder. You cant fix your eating unless you fix whats going on inside of us.”

Eating disorders are MENTAL illnesses. They are caused many factors, including: depression, family stress, self-esteem, internalized anger, societal pressure, media images, lack of knowledge about nutrition, etc. Also, restrictive eating and bulimia have similar effects on the brain as addictions. In short, the brain basically becomes “addicted” to the caloric deficit. Increasing eating behaviors actually causes a variation of withdrawal, which results in intense anxiety, depression, irritability, potential dehydration and electrolyte disturbances (“refeeding syndrome”), and potential suicidal ideation. Telling a person to “just eat” is similar to telling a heroin addict to “just suck it up” when going through withdrawals — they need support!!

 

“The one that bugs me is that ‘all bulimics are fat’.”

“I am an overweight bulimic, who runs into, ‘all bulimics are normal weight or thin.’ People think I am COE and I’m not.”

“If you’re overweight and you have an eating disorder, it MUST be COE/BED.” People always looked so shocked when I followed up, “I have an eating disorder” with “it’s bulimia.”

(COE = Compulsive Over-Eating; BED = Binge Eating Disorder) Bulimics come in all ranges of sizes from emaciated to very overweight. Purging does not rid the body of all calories consumed, and variations in individual metabolism and eating habits causes people to reach different weights.

 

“Or better yet — all bulimics wanted to be anorexic but couldn’t stop eating. (You know, because it’s not like bingeing itself gives you any kind of high, or that purging gives you a high, or anything…….. *rolls eyes*)”

This is not true. The acts of bingeing and/or purging are not always caused by starvation (although it IS true that starvation often leads to bingeing- in ANY person with or without an eating disorder). Bingeing has been linked to changing levels of tryptophan and serotonin in the brain, and purging has similar effects. Both can cause a “high” that can be quite addicting. While eating disordered people who primarily restrict may desire to maintain a constant level of mental “numbness,” bulimics tend to seek out regular “highs.” At the same time, many anorectics do not binge, but they purge normal meals. In short, the statement above is just not correct.

 

“Or if you overindulge on day that you’re automatically COE or BED. Talk about being unfair to the people who fit that clinical diagnosis.”

“Or if your weight goes up a pound, you’re getting ‘better’, and if it goes down you’re getting ‘worse’……….yet the same people who say that will be the first to admit that your weight will normally fluctuate when you’re freaking out about gaining anything at all!

“Or if you vary from your meal plan a little bit, either over or under then you’ve relapsed!”

NORMAL eating involves overindulging at times as well as under-eating at times. Weight in ANY person can normally vary from 3-5 pounds on any given day due to changes in stomach contents and water weight. A person’s weight is actually likely to fluctuate even MORE dramatically when they are undernourished, due to issues with electrolytes, glycogen depletion, protein deficieny, and dehydration. A “relapse” is much more dramatic than just having a “rough day, eating-wise.” There is so much more to an eating disorder than just eating habits!!!!

 

“Anorectics never eat at all.”

“She’s not anorexic, she eats sooooooo much. All that candy and cookies and baked goods. And she doesn’t gain an ounce! She just has a fast metabolism, I guess. No way she has an eating disorder!”

Anorectics DO eat. They just eat smaller portions, lower-calorie foods, or strange food combinations. Some may eat three candy bars in the morning and nothing else all day. Others may eat lettuce and mustard every two hours. It depends on the person. Pure cessation of eating is extremely, extremely rare, and would result in death from malnutrition in a matter of weeks.

 

“How ’bout: ‘Hooray! Thank god! We got our daughter enrolled in a treatment program!!! Our problems are over! They will “fix” her!!! Yay! It feels so good to know we’ve got nothing to worry about! She’ll come out bigger and our lives will be back to normal forever!!!!’”

“I HATE how insurance companies especially think that once you reach a certain goal weight, or if you’re already there, then you’re “all better” and no longer need treatment.”

Now, let’s think for a minute: A person with an eating disorder gets FORCED to eat every day for weeks until their “worst fear” actually happens — they gain weight. Then, they are released from the hospital immediately after gaining large amounts of weigh. Then, following their release, they are sent right back into the same social/familial/life situation that they were in before (the situation they were in that they were using ED behaviors to cope with), only now they have had their primary coping mechanism taken away . Dysfunctional as it may be, an ED DOES provide a form of comfort to the person. Of course it is NOT an IDEAL form of coping, but one cannot deny that a person often uses their ED to shield themselves from painful stressors in their life. It’s no wonder that relapse rates are very high.

Also, research has shown that weight gained during early recovery tends to be gained mostly around the middle of the body. Later on, the weight will eventually drift to other parts of the body and the person will again regain a “normal” shape. But for an eating disordered person who ALREADY fixates on their stomach, hips, butt, or thighs, this initial body shape is extremely disturbing, and they often feel compelled to regain a ‘normal’ body shape through eating-disordered behaviors.

There IS some research that has shown that malnutrition and starvation itself can actually exacerbate eating-disordered thinking and cause a person to focus on food, calories, and weight almost constantly. Therefore, weight restoration can help to ease some of that constant obsessive thinking. Based on my own personal experience though, and the experience of others I have known, I personally believe that it takes much longer for the thoughts to subside (after weight restoration) than most ED treatment programs last.

Another problem is that once a weight-restored ED patient is released, they often have a sense that they “lost their identity.” In other words, weeks or months prior, they had been living as “the sick person” or “that really thin girl.” When their weight is restored, they often struggle to find a new identity. To some, that is such a disconcerting experience that they choose to return to their eating disordered habits. Most ED’d people have an extreme fear of being judged by others. They especially fear others thinking they are “greedy” or “lazy” or that they sit an eat all day long. Many ED’d people fear that their new larger body sends a message to others that they “got greedy and lazy” or that they “let themselves go.”

Another issue of weight restoration is that supportive people in the ED’d person’s environment often make the erroneous assumption that “Weight Gain = ED Cured”. Since that is NOT true, many ED patients fear that weight gain will result in a loss of support from family and friends, and that physical health will result in cessation of treatment well before they reach a state of mental health.

 

“Or how about just denying a problem exist ever at all?”

“When I first started to try and get help at a normal weight all my doctor said was that it was normal for an 18 year old girl to b/p every now and then and as long as I wasn’t underweight there was no problem.”

Intentionally stuffing yourself and causing yourself to vomit is NEVER normal. Denial of a person’s illness can be extremely damaging. Ignoring the problem will NOT make it go away. In fact, if a person feels that her illness is being ignored, they will most likely INCREASE the severity of their behaviors in order to “deserve” treatment and support. In the words of an ED sufferer from our message boards: “There is nothing worse than when you are constantly beating up on your body on a daily basis and the people around you are telling you that nothing is wrong, that you don’t have a problem, and that you ‘aren’t really very sick. You start to feel that maybe you’re just not beating up on it ‘enough’, so you need to do more in order to feel like your problem is real.”

 

“I hate: ‘Oh you’re 14… how can you have a SERIOUS eating disorder?’ I get this from a lot of fellow eating disordered people, which is even sadder.”

The most ironic thing about that comment is that it’s widely accepted that those who develop their EDs at a younger age are much harder to treat and have more difficulty getting to recovery! Also, most eating disorders tend to develop during a person’s teens and twenties.

 

“but you can’t really have an eating disorder if you admit it, all eating-disordered people are in denial”

Just plain “not true.” A true myth.

 

“What about ‘purging is only throwing up’.”

Laxative abuse and diuretic abuse and excessive exercise are all forms of purging and can be equally dangerous.

The definition of purging is ridding the body of food eaten by extreme measures, such as inducing vomiting, laxative abuse, or fasting after a large meal. ANY of those behaviors can be dangerous. Laxative abuse can lead to dehydration, electrolyte imbalance, loss of normal intestinal bacteria that aids in digestion & absorption of nutrients, dependence on laxatives to produce future bowel movements, and other long-term damage to the intestines.

 

“Or the one that gets me the most: the whole frame of mind that you didn’t choose to have an ED. What did you just wake up one day and realize you’d been binging and purging against your will for the past 2 years? No, you have a brain. You have free will. You made a very conscious choice somewhere along the line that you were going to do this.”

“Of course, the other myth is that if you started of your own free will, you can stop that way, too. The thing is, by the time you don’t WANT to do it anymore, it’s about then that the ED takes over and it’s no longer a ‘choice’.”

In the beginning, there is a choice — just like drugs are a choice and alcohol is a choice. Unfortunately, when it finally stops being “fun” and “comforting,” you’re horribly addicted and you end up continuing with the behaviors just to feel ok. Withdrawal sucks.

This leads into the discussion of whether or not an eating disorder is caused by genetics, environment, society, personal experience, or some combination of all of those. There is still considerable controversy over what actually causes an individual to indulge in ED behaviors in the first place. Genetics studies seem to suggest a possible genetic predisposition. Studies of society and culture seem to suggest that a person’s environment can trigger those with a genetic vulnerability to actually begin their eating disorder. Studies of starvation (e.g., the Keyes study) seem to suggest that starvation itself can induce eating disorders, suggesting that dieting can lead to the eventual development of an eating disorder.

 

“oh, she’s too old to have an eating disorder.”

Anorexia and bulimia are NOT just “for teens!” Eating disorders happen in people of ALL ages! Sure, less older people are in ED treatment centers, but that is often due to other constraints that prevent them from seeking help, such as children/families, work responsibilities, finances, or even because they are afraid that they won’t be ‘accepted’ into treatment because they are too old!

 

Eating disorders, addictions, suicide and SI are just pleas for attention. If you don’t pay people who have them any mind, the disorders will go away.

First, if someone was going to lengths that extreme in order to get attention, perhaps it’s because they have a very true need that is NOT currently being met. The thing is, eating disorders have many causes. They can be loneliness or isolation, or the mistaken belief that no one will care about them until they are sufficiently beaten up and mistreated in every possible way. It is a common trait of eating-disordered people that they often have difficulty speaking up and asking for support in a healthy manner. If someone is acting out in such a dramatic way, it is a safe bet that they NEED attention, desperately. Ignoring that person would only worsen the behaviors and cause them to feel that their beliefs that ‘no one cares’ or that they are not ‘worth it’ are being proven.

 

“ED is merely a desire to be thin, or a desire to be pretty. Sometimes, it is the opposite. Emaciation is not beauty.”

There is a very important distinction between “vanity” and the goals of someone with an eating disorder. Someone who wants to be thin for the sheer enjoyment of being “beautiful” or “perfect” can be considered “vain.” However, an eating disordered person is often motivated by the FEAR of being something AWFUL. They are not trying to reach a state of “perfect.” Rather, they are trying to reach a state where there is nothing about them that makes them vulnerable to ridicule or harsh judgment by others. They are trying to reach a state of “normal,” because they feel that they are flawed to begin with. They want to “fix” their “flaws” because they feel that having flaws is a horrible, terrible thing to do.

At the same time, sometimes people with EDs can find comfort in making themselves UNattractive to the opposite sex. This is especially common in people who have experienced sexual abuse or assault. By making themselves unattractive, they feel that they become less of a target to the opposite sex, and therefore less likely to be raped and re-victimized.

 

“Oh yeah…they say that you’re out to get your treatment team, and you just want to manipulate people, including your tx team, your parents, your friends, your family…just to get your way.”

This is definitely a myth. When a person with an ED tries to manipulate their program, it’s usually because they were forced into recovery before they were ready to accept it. Most people who ask for help are NOT in that category!

Many people with eating disorders feel alienated from their treatment team or their family when they are accused of being “manipulative,” and as a result, they often feel unsupported and lose faith in the program. They might choose not to speak up when they have a question or concern, for fear of being accused of trying to ‘manipulate’ the situation. Ultimately, treatment works best when it is a TEAM effort, with both the treatment providers and the patient being actively involved, and based on open communication and trust.

 

“If you have an eating disorder you are an expert on every eating disorder. Also if you have an eating disorder you can sympathize with everyone having body issues and can consequently fix them.”

For some reason, “normal” people seem to think that people with eating disorders are good sources of diet advice. Anyone who has ever had an eating disorder has likely been asked by many people about “their secrets,” or “how they stop being hungry,” or “how did you lose the weight so fast?” PLEASE, FOR THE LOVE OF GOD, NEVER DO THIS!!!!!!!! First, if people with ED’s were such experts in diet and nutrition advice, they would NOT need to resort to extreme behaviors to maintain their weight. Second, if a person is trying desperately to recover from their ED, they do NOT need to be constantly bombarded by talk about “dieting” and “weight loss” and “cutting calories.” They need to be surrounded by talk about healthy food choices and body acceptance.

 

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