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What you should know about eating disorders: common misconceptions

Eating disorders are not about vanity.
Eating disorders are not about vanity.

This week is National Eating Disorder Awareness week. Eating disorders afflict an estimated 23 million individuals, both male and female, in the U.S. The National Eating Disorders Association (NEDA) hopes to bring awareness to the complex and serious problem of eating disorders, including anorexia, bulimia, binge eating. There are several misconceptions surrounding eating disorders. Some of the common ones include:

1. You can easily spot an eating disorder.

Eating disorders are very secretive disorders. There may not be outward signs of eating disorders except at the “extremes” of the problem, when people may gain or lose a significant amount of weight. And the amount that a person weighs does not reflect how much they eat. Many overweight people eat very restrictively.

2. People with eating disorders look in the mirror and see “fat.”

Although this is often the case, it’s generally not an overall body image distortion. Fear of weight gain is a factor in anorexia and bulimia. Generally people with anorexia and bulimia focus on one or two “hated” body parts. The belief, however, is that they are “too big,” “fat,” or “take up too much space.”

3. Eating disorders are a white, upper-middle class, young, female disorder.

Although eating disorders are most often reported in this population, they span a range of ages, genders, and social classes. Young men are increasingly seeking treatment for their eating disorders (10%), and often “look” like their female counterparts. There is also a large population of young men struggling with eating disorders. Many of these young men also have sexual identity issues.

4. Despite the hype, eating disorders aren’t really dangerous.

Eating disorders are dangerous. Medical complications include electrolyte imbalance, loss of tooth enamel, infertility, damage to internal organs and even death. Without treatment 20% of those with eating disorders die.

5. Anorexics, bulimics, and compulsive eaters are distinctly different in terms of personality and symptom profile.

Many with eating disorders switch problems, often beginning with anorexia but graduating to bulimia or compulsive eating. There is rarely a “pure” eating disorder.

6. It’s all about control — a lack of control with bulimics and compulsive eaters and over control with anorexics.

That’s only one dynamic, it’s a combination of environment and genetics. Our current thoughts is: biology is the gun, environment pulls the trigger. Some underlying factors include inability to express feelings, abuse, and family stresses.

7. It’s a disease of vanity. If only society did not put so much pressure on kids to be thin.

It’s not a disease of vanity. It would be nice if we got rid of all the stresses to be thin, but this viewpoint minimizes the complexities of eating disorders and allows us to dismiss them. It’s a coping mechanism that has outlived its usefulness.

8. Those with eating disorders are perfectionists — top students and high achievers.

People with eating disorders often have similar personality characteristics, and achievement orientation is one. This is not always the case. Many with eating disorders do poorly in school, have learning disabilities, etc. On size does not fit all.

9. It is easy to stop anorexic and bulimic behavior.

It is usually impossible to stop these behaviors by oneself. Just eating isn’t the answer. Treatment is essential and includes weight restoration, individual counseling to develop healthy ways of taking control of one's life, family counseling to change old patterns and create healthier new ones and nutritional counseling.

10. People with eating disorders rarely ever recover.

With treatment, about sixty percent (60%) of people with eating disorders recover. They maintain healthy weight. They eat a varied diet of normal foods and do not choose exclusively low-cal and non-fat items. There are people who struggle with these issues life long and others who maintain partial recovery.

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