National Eating Disorders Awareness Week
National Eating Disorders Awareness Week is an annual campaign to increase public awareness around the deadly realities of eating disorders. Recent years have brought about hopeful changes in terms of the body liberation and acceptance movements. However, many myths regarding disordered eating and weight as it relates to health continue to persist. In the spirit of NEDA week, let’s debunk some of these myths now so that we may increase awareness, reduce stigma, and improve prevention and treatment efforts.
MYTH #1: Eating disorders are rare and only occur in young, white females.
Actually, eating disorders are highly prevalent and will affect approximately 10-13% of Americans in their lifetime.
This figure is even higher for subclinical eating disorders and doesn’t include those who never present to treatment. Recent research with diverse samples further indicates that these disorders do not discriminate and affect people of every age, race, gender, sexual orientation, and body size. For example, about a quarter of patients presenting with an eating disorder identify as “male.” Additionally, Black and Hispanic adolescents are 50% more likely than their White peers to engage in bulimic behaviors. Despite these statistics, non-White individuals are 50% less likely to be diagnosed with an eating disorder or receive appropriate treatment.
MYTH #2: Eating disorders aren’t that serious.
Eating disorders are incredibly serious psychological illnesses that negatively impact every single bodily system. Many of these effects can present rather quickly after symptom onset and some, like osteoporosis, are irreversible.
Eating disorders are characterized by high rates of physical, psychological, and functional impairment, as well as chronicity and relapse. These disorders are also a major cause of health-related disability among adolescent girls and young women and are associated with abnormally high rates of suicide and early mortality. In fact, anorexia nervosa is the second deadliest mental health disorder that was only recently surpassed by opiate abuse.
MYTH #3: Eating disorders are a choice and are only about vanity/appearance.
The truth is, eating disorders are serious mental health conditions like depression, bipolar disorder, and schizophrenia. These disorders are not a lifestyle choice and are about much more than physical appearance.
Biological, social, and psychological factors all play a role in the development of an eating disorder. Thus, although appearance concerns may partially explain the development of an eating disorder, we also know that there is a strong genetic component to these disorders, contributing between 28-74% of the risk. Psychological traits, such as perfectionism and difficulty regulating one’s emotions, also play significant roles in the development of eating disorders. Additionally, contributing social factors include exposure to the thin/muscular ideal, bullying, trauma, and unhealthy family relationships.
MYTH #4: Body mass index (BMI) is a good indicator of health.
This myth is deeply rooted in our society’s “weight-centered health paradigm” — a model promoted by public health officials and healthcare providers which equates health with weight. ￼
In reality, “health” is a multifaceted concept that involves a complex interplay of variables (e.g., physical, emotional, spiritual, social, environmental). This paradigm completely fails to account for the influence of other health-related factors. Despite the limitations of using weight as a single indicator of health, correlational evidence supporting the relationship between higher BMI and poor health outcomes led public health officials to declare “war on obesity” in the early 2000’s.
This effort was based on the notion that stigmatizing higher-weight bodies and applying social pressure to promote weight loss would motivate people to lose weight and improve population health. However, when we examine the relationship between BMI and life expectancy while controlling for other factors associated with health (e.g., age, gender, substance use), it turns out that the lowest incidence of death is found among individuals whom the medical community currently classifies as overweight or obese. So, if weight doesn’t kill us, then why does our society continue to fear mongering around weight and perpetuating the harmful effects of weight stigma? Someone from the dieting industry may be more suited to answer this question, considering this is currently a $72 billion dollar industry solely funded by our society’s fear of fatness.
MYTH #5: Dieting works.
“Dieting” refers to caloric restriction or limiting oneself to certain foods with the purpose of losing weight. The weight-centered health paradigm communicates that if we consume fewer calories by dieting, we should be able to lose weight and keep it off over time. Well, not exactly.
When we consult the literature examining the effects of dieting over time, what we find is that although many dieters lose a little bit of weight in the short-term, they tend to regain it all back (plus some) in the long-term. The problem is that dieting itself leads to a host of physiological changes that undermine long-term efforts to maintain weight loss (e.g., lowering our metabolic rate).
Another problem with dieting is that it leads to disordered eating attitudes and behaviors which can quickly progress into a full-blown eating disorder. Finally, you don’t have to rely on my advice around dieting — even diet companies admit their diets don’t work and have stated this publicly. So, there you have it folks — all the experts agree that diets just don’t work!
At this point you may be feeling confused, distrustful, and (hopefully) a little pissed off! You may also be asking yourself, “okay, so where do we go from here?” The first step is awareness. These myths are deeply ingrained in our collective psyche and their effects are insidious. I encourage you to filter the messages you receive around weight and health through a critical lens. The next step is turning that awareness into action. What this looks like will depend on your specific circumstances. Maybe it means correcting people who minimize the destructive consequences of disordered eating or simply noticing your mind’s tendency to categorize foods as “good” or “bad.”
Wherever you are at, I encourage you to take that next step in the direction of moving our collective consciousness toward a new reality where all humans can exist in their bodies without judgment and shame.
About the Author:
Dr. Tiffany Graves received her doctoral degree in clinical psychology from Xavier University. Prior to joining Galia Collaborative as a postdoctoral fellow, she worked at the Lindner Center of HOPE within the Harold C. Schott Foundation Eating Disorders Program. Dr. Graves completed her pre-doctoral internship in clinical psychology at the Charlie Norwood VA Medical Center/Medical College of Georgia Consortium where she gained extensive training and experience in the assessment and treatment of mental health issues disproportionately affecting women and members of the LGBTQIA+ community.
Dr. Graves is an affirmative care provider and is specialized in the treatment of eating disorders and body image issues, interpersonal and sexual trauma, borderline personality disorder, obsessive-compulsive personality disorder, perfectionism, and mood and anxiety disorders. She enjoys working with adolescents, families, and adults. Dr. Graves believes in working collaboratively with her clients to develop a comprehensive, empirically-supported treatment plan for addressing their areas of concern.
Dr. Graves primarily utilizes behavioral techniques with acceptance and mindfulness-based practices. She has extensive training in a variety of evidence-based treatments that emphasize these principles (i.e., Acceptance and Commitment Therapy [ACT], Dialectical Behavior Therapy [DBT], and Radically Open Dialectical Behavior Therapy [RO DBT]). She has additionally received specialized training in several empirically-supported trauma interventions including, Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and Written Exposure Therapy (WET).