Most people think about anorexia nervosa and bulimia nervosa when they hear the term eating disorder. But there are actually more types of eating disorders. There are also many misconceptions about eating disorders. As someone who works with youth and young adults with eating disorders on a daily basis, I’d like to clear up some of those misconceptions. Here are several of them and the truth behind each.
Misconception #1: When you have an eating disorder, you never get better.
Not true. There is treatment for eating disorders and it can be effective. Individuals can fully recover from eating disorders and lead normal, healthy lives if they receive treatment.
It is crucial to get treatment early because the less time a person has an eating disorder, the better their chances of recovery. Many people believe that traditional therapy is required to help someone with an eating disorder feel better about eating. However, the opposite is true. Food is medicine. Eating more and improving physical health is the first step toward feeling better about eating. This is because being malnourished has negative effects on the brain that can make traditional mental health therapies less effective.
In our Eating Disorders Program, we use a family-based approach, where family members are supported to help the youth eat in a healthy way. Once renourished, other evidence-based therapies are used to help youth cope with stressors that make eating difficult.
Misconception #2: Eating disorders are a girl thing.
Not true. Eating disorders can happen to anyone. They do not discriminate by race, ethnicity, age, gender, sexual orientation, or socioeconomic status.
Although many people think that eating disorders only happen to girls, it is believed that up to 25% of eating disorders occur in males. Individuals who don’t fall into the stereotype of who gets eating disorders face greater stigma, lower rates of diagnosis, and treatment barriers that can complicate recovery.
Misconception #3: You have to be underweight to have an eating disorder.
Not true. Around 40% of youth who are medically hospitalized at Cincinnati Children’s for complications of an eating disorder are of normal weight. Someone’s weight is not an accurate reflection of their health. Youth of all shapes and sizes can be “healthy” or “unhealthy.” A youth’s eating behaviors and attitudes are as- or more- important in assessing for an eating disorder. Further, instead of someone’s weight, recent changes in weight are a better indicator of a potential problem. It’s important to not make assumptions when it comes to these conditions.
Misconception #4: Eating disorders are all about weight.
Not true. Eating disorders are not a choice and are not about vanity. Research tells us that biology plays a large role in someone’s chances of developing an eating disorder. For most people, an eating disorder starts after changing their diet and/or exercise in hopes that it will help them. However, for people with a greater biological risk of developing an eating disorder, dieting and weight loss can accidentally spiral into a severe eating disorder.
Eating and the possibility of weight gain can cause paralyzing anxiety that results in eating even less. Significant weight loss can also lead to mental health and physical problems, like severe anxiety and depression, difficulties concentrating, making decisions, reasoning, and paying attention. Body systems can also be severely affected, including the brain, heart, kidneys, bones and muscles.
When seeking treatment for an eating disorder, it’s important to find providers who practice evidence-based interventions. Among youth, family-based treatment has the most support and it’s the intervention that our team uses here.
If you are concerned about your child’s eating behaviors, please talk to your pediatrician. They can refer you to an eating disorder specialist if needed.
Listen to this episode of the Cincinnati Children’s Young and Healthy podcast to hear Dr. Abigail Matthews talk more about eating disorders and the trends her team saw in eating disorder hospitalizations during the 2020 COVID-19 lockdowns.