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February 13, 2011

Myths and Facts About Eating Disorders

Filed under: Food,Health — Twistie @ 1:30 pm

Trigger Warning: If frank discussion of eating disorders and disordered eating may be triggering to you, this would be a good time to move along. Your well-being is way too important to ignore.

I well remember the first time I ran across the term anorexia nervosa. I was twelve years old and eagerly devouring the latest issue of American Girl magazine. It’s not the same magazine as American Girl is today. This was a magazine for Girl Scouts, not a line of dolls and books. The content ran the gamut from scouting-related news, games, and puzzles to feature articles on girls and women doing interesting things to campfire recipes to stories about girls’ health.

As I recall, I read and re-read the article about anorexia half a dozen times that week. I would have looked for more information, but I didn’t know where to start. My parents didn’t have a lot of health manuals around the house, and most of what they did have on the subject covered things like very basic anatomy or tips in my mother’s ladymags about getting your family through cold and flu season with minimum mucous. There wasn’t a peep about young girls becoming so obsessed with being thin that they starve themselves literally to death.

In fact, I wouldn’t find any more information than that one article for another three years… and when I did, it was a novel. I devoured it as ravenously as that article. And between the two, I learned quite a bit of misinformation.

You see, the American Girl article assumed that eating disorders are all about food and such pop culture images as Scarlett O’Hara. The novel placed the blame squarely on the family, particularly good old Mom, eternal doormat of psychiatric theory. Both suggested that once the cause had been identified, recovery was – while hardly pleasant – pretty much an assured thing. Oh, and it was a couple more years before I heard about bulimia at all, let alone binge eating disorder or EDNOS (eating disorder not otherwise specified).

Then a funny thing happened: someone I knew developed an eating disorder. A high school friend became bulimic during her first year at college. I knew this girl. I knew her family. She’d never been obsessed with pop culture, let alone that of the thirties. Her family was one of the kindest, closest-knit, most supportive ones I’ve ever known. She’d always had attention, love, plenty of friends. Clearly something wasn’t right about what little I knew about eating disorders.

In point of fact there is no one sure way of telling who will and who won’t develop an eating disorder, or which one they will develop. The risk factors include such varied elements as: genetics, a history of infant feeding problems, fad dieting, family pressure to be thin, childhood obesity or extreme thinness (Hmmm… I wonder if that might be related in any way to the three previous indicators), or a severe stressor involving friends or family in the year before the disorder begins. The word that seems to come up the most when I’m reading the life experiences of people who are in recovery from eating disorders is ‘control.’ My guess is that’s a pretty major key.

Once identified and diagnosed, the horror is far from over. Treatments are wildly expensive, and according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), permanently effective a whopping 50% of the time.  Inpatient programs can cost $30,00o and up a month. Not year, month. ANAD estimates the cost of outpatient care at $100,000 and up, but does not specify what time frame that covers. In the end, some 6% of people with eating disorders will die of complications related to their disorders. The causes of those deaths range from malnutrition to heart disease to serious liver and kidney damage.

Eating disorders have the highest death rate of any psychiatric illness. Just let that sink in for a minute.

Another myth I got from the first two sources of information I had on eating disorders was that only upper middle class teenaged white girls get them. This is patently untrue. The fact is that while it is most often diagnosed among girls, a growing number of boys are being identified, too. And yes, most people who develop anorexia and bulimia do so during adolescence, but there are outliers on both ends of the age scale who do so, too. As for race and socio-economic level, these are even worse predictors. Black or white,  rich or poor, it neither dooms nor protects you.

On top of that, a growing number of related disorders are being identified. Orthorexia, pregorexia, and diabulimia may not be officially recognized, but the research and literature are showing some shocking trends.

So how do we turn the mass of misinformation around? We educate ourselves. We learn what the latest research has to say and listen to the voices of recovery. We keep our ears, eyes, minds, and hearts open. And once we have educated ourselves, we talk.

Here are some good sources of factual information on eating disorders:

National Eating Disorders Association

Association of Anorexia Nervosa and Associated Disorders

Eating Disorders

Feed Me


  1. After reading this I went on to read the links that you provided as well, and I have to say, the information on orthorexia was something I’d thought of in the past. The dieting trends like Atkins or South Beach or whichever popular name comes to mind, make a type of food your “enemy”. We’ve allowed people to vilify bread or fat or any other number of foods. And at the end of the day it’s just FOOD. We aren’t victims of a type of food.

    This always brings to mind the seemingly innocent comments we make in regards to food. At Christmas time or at parties and such you always hear someone say something along the lines of, “I was so bad today, I had cheesecake at the party” or something equally inconsequential. Only it isn’t really inconsequential, this behavior – this simple thought – shows the trend of our vilification of food so clearly.

    Twistie, I’m so pleased with all of the research and work you are putting into this series. Thank you.

    Comment by mel — February 13, 2011 @ 3:17 pm

  2. My therapist defuses the “I was bad” thinking this way: “Did you kill little boys and bury them in your back yard? Did you fly an airplane into an office building full of people? THAT’s bad. Eating cookies is not even close to those on the continuum of ‘BAD’.”

    Comment by Orora — February 13, 2011 @ 9:47 pm

  3. Thank you so much for posting these. I have never had an eating disorder–I suffered, more likely, from a form of disordered eating brought on by a major depressive episode during which I lost my appetite and became very stubborn about food–but I know people who either have had an ED or have been accused of having one. I know too many people who are so concerned about cutting back/eating less/exercising more that it frightens me. A grown woman shouldn’t be worried about eating more than 1100 calories a day! When I wasn’t eating, there were days I probably didn’t have more than 500, and I always felt sick. I was miserable and not at all healthy. Since when does eating so little make you healthy?!

    This is why my sister and I have decided to not make food bad or good, but rather to be sensible. I’d rather weigh a few extra pounds and feel good than have horrific stomach cramps and tension headaches and be skinny. It’s such a terrible double-standard, and I refuse to contribute.

    Thank you again. I have learned more than I knew (one of my majors was psychology and I studied eating disorders quite a bit) and I hope others have as well.

    Comment by Heidi Aphrodite — February 14, 2011 @ 12:42 am

  4. Wait, so we’re not allowed to kill little boys and bury them in the back yard anymore?

    Comment by Miss Plumcake — February 14, 2011 @ 11:51 am

  5. Well, I should think not. I just put those roses in.

    Comment by daisyj — February 14, 2011 @ 1:28 pm

  6. Plummy, burying little boys in your back yard is an abomination. Throw them in the river, like God intended.

    Comment by Orora — February 16, 2011 @ 2:18 pm

  7. I would think little boys would be excellent fertilizer for roses. And probably tomatoes, too.

    Comment by The gold digger — February 16, 2011 @ 2:43 pm

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