Eating Disorder Myths and Reality

Eating Disorder Myths and Reality

When I think back to high school and my first years of college, I regret the time I lost to a common obsession: Not an hour went by without thoughts of food—what I ate, what I would eat, what I wouldn’t eat—and my body—how big it was, how much it weighed, how it looked, how I wanted it to look. I didn’t talk with anyone about these thoughts because I thought they were inevitable. I didn’t think I had a serious problem because every girl seemed to share my obsession. That’s how it was, I thought, and there was nothing anyone could do about it. Sure I binged sometimes, but that was just a lack of self-control. Sure I went on extreme diets, but that was just to make up for the binges.

Because my behavior didn’t fit my understanding of an eating disorder, I didn’t ask for help until my third year of college when my eating had become so erratic my body started to shut down. To my surprise, I discovered through treatment that I didn’t have to live with self-loathing thoughts and self-punishing behavior. I found respect for my body and freedom from obsession. I might have found freedom years earlier if I hadn’t waited for the situation to become life-threatening before asking for help—if I’d understood how food and body obsession were already robbing me of a full life.

What you think you know about eating disorders might not be true. At best, misconceptions may be hurtful to individuals struggling with disordered eating. At worst, they may keep you or someone you know from getting needed help. Consider these six common eating disorder myths, and how a better understanding can bring hope and healing.

Myth #1: Eating disorders are primarily about food.

Just eat. This may be your intuitive response to someone who refuses food—or to someone who’s bingeing, just stop eating. These are among the least helpful comments you can make to someone with an eating disorder. Eating disorders have complex causes and cannot be willed away. If you are struggling with disordered eating, don’t deceive yourself into thinking you just need more willpower. Don’t beat yourself up when willpower fails. Find someone who can help.

Check out the National Eating Disorders Association (NEDA) website for more information about the causes and treatment of eating disorders.

Myth #2: Eating disorders are a “white girl’s disease.”

Eating disorders affect individuals of all ethnic backgrounds and ages, and males have eating disorders too. The national Eating Disorders Coalition reports an increase in the prevalence of eating disorders among all ethnic and cultural groups. Disordered eating can begin in elementary school and is becoming more common among older women. And according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), males account for 10 to 15 percent of those diagnosed with eating disorders. Don’t dismiss your own or someone else’s struggle because it doesn’t match the picture you expect to see. Eating disorders are real and their consequences are serious no matter who experiences them.

For further reading, see NEDA’s collection of articles about eating disorders among diverse populations.

Myth #3: Body size is the best indicator of an eating disorder.

People of all shapes and sizes have eating disorders. While a low body weight is among the diagnostic criteria for anorexia, individuals with binge eating disorder are often obese, and those with bulimia can be underweight, overweight, or in between. What’s more, it’s difficult to judge weight by appearance. An emaciated look is cause for concern, but distress over food is a more consistent indicator that help is needed.

Read more about the signs and symptoms of eating disorders at the Eating Disorder Hope website.

Myth #4: People with eating disorders don’t want help.

While resistance to treatment is not uncommon, studies have found that as many as 80 percent of referred patients agree to receive help and remain in treatment through its completion. Other studies have found that individuals who received life-saving eating disorder treatment without their initial consent later expressed goodwill toward care providers. Don’t assume someone with an eating disorder will refuse your help. If they do initially refuse, don’t assume that nothing can be done. offers tips on helping someone with an eating disorder.

Myth #5: Eating disorders aren’t dangerous.

Don’t write off troublesome eating behavior as “no big deal.” Despite what you might read on pro-ana or pro-mia websites, there is no healthy way to embrace an eating disorder. Eating disorders are always damaging to your physical and mental health, and they can become fatal. For example, ANAD reports that young women with anorexia are 12 times more likely to die before age 24 than young women without anorexia. Take disordered eating seriously and ask for help. The earlier a person seeks treatment, the higher the likelihood of success.

Myth #6: You can never recover from an eating disorder.

According to statistics reported on the website, 60 percent of those who receive eating disorder treatment experience full recovery, and another 20 percent experience partial recovery. Recovery can be a slow process, lasting several years and involving relapses and restarts. If you or someone you love is recovering from an eating disorder, have patience and hope. Find a provider and type of treatment that works for you. Recovery is possible and, with appropriate treatment, likely.

Read more about recovering from an eating disorder.


Eating Disorders Coalition:

Eating Disorder Hope:

National Association of Anorexia Nervosa and Associated Disorders:

National Eating Disorders Association:

Coping with Anxiety

I had my first panic attack in seventh grade, while taking a science test. One minute, I was scribbling an answer to an essay question. The next minute, my heart was pounding, my skin was clammy, and I felt dizzy and numb. My teacher sent me to the nurse’s office, and I made up the test the next day. It wasn’t until several years and a dozen panic attacks later that I understood my symptoms as a physical experience of anxiety.

Anxiety – an uncomfortable feeling of fear or concern – is a common and normal human experience. In fact, anxiety is beneficial when it keeps us from taking unnecessary risks or motivates us to prepare for a challenge. But anxiety becomes a problem when it interferes with daily life. Chronic worry, avoidance behaviors, and frequent panic attacks can all be symptoms of problematic anxiety.

Fortunately, people of all ages can learn to manage anxiety. The remainder of this post will offer tips on coping with anxiety, followed by a discussion of when and how to ask for help.

Managing Anxiety

The following suggestions for managing anxiety are adapted from the Anxiety and Depression Association of America website:

  • Take a break. Practice deep breathing, learn a relaxation technique, pray or meditate, listen to music, enjoy nature, read a book, write in a journal. Try something that calms you and gives you time away from your problem.
  • Take care of your physical self. Get enough sleep and exercise. Fuel your body with healthy foods. Avoid caffeine and sugar.
  • Adjust your outlook. Have realistic expectations. Aim for good, not perfect. Accept that you can’t control everything. Try replacing negative thoughts with positive. Embrace humor.
  • Learn what triggers your anxiety. Prepare for challenges instead of avoiding them. Facing your fears takes away their power.
  • Building healthy relationships. Find a group activity you enjoy. Help others and let them help you. Share your feelings with someone you trust.

When and How to Ask for Professional Help

Sometimes individual coping strategies are not enough. The National Institute of Mental Health estimates that about 8 percent of teens have diagnosable anxiety disorders and could benefit from treatment. Individuals with untreated anxiety disorders are at increased risk for depression, substance abuse, disordered eating, and other issues. (For example, I learned to cope with my panic attacks while in treatment for depression.) Anxiety treatment has a high rate of success and can include therapy, medication, or both. According to the American Psychological Association, the following are signs that it’s time to ask for help:

  • You experience extreme fear or worry that does not let up.
  • Anxiety is interfering with your daily life.
  • You have trouble concentrating because of your worries.
  • You have frequent panic attacks.
  • You often avoid situations due to unrealistic fears.
  • You repeatedly perform routines or rituals to try to rid yourself of anxiety.

A parent, school counselor, or other trusted adult can support you in seeking professional help for anxiety. You can also find support and links to resources through NAMI Washington, Psychology Today’s therapist directory, or King County’s Teen Link help line (1-866-833-6546).

To meet some real teens who have received successful treatment for anxiety, watch “Worried Sick: Living with Anxiety,” a 22-minute video produced for Nick News.


American Psychological Association

Anxiety and Depression Association of America

National Institute of Mental Health

Addiction: A disease or bad behaviors

When chatting with the kids I work with in treatment about the healthy results recovery affords us, I often joke with them that I have 21 years clean and sober and have not been arrested in, let’s see, 21 years. Must be just an odd coincidence.

All jokes aside I can easily appreciate why folks still have such difficulty understanding Substance Use Disorders as a disease rather than a function of poor choices or even character or morality. Let’s look at a few of the factors that may contribute to this difficulty.

I think one that is glaringly apparent regards our culture’s connection to the idea of personal choice. It makes sense that this American ideal would contradict the loss of control a chemically dependent individual experiences as we do not “drink responsibly” as the ad suggests. So powerful is this notion in fact that many of us with this healthcare condition blame ourselves and struggle with significant guilt over our actions while in active addiction.

Another factor is simply statistical. The majority of folks never develop any difficulty with substance use and cannot imagine how someone would not have the ability to control their own behaviors.

Finally, and let’s be honest, quite early on in the progression of this disease an individual begins violating their own system of values and acts in a manner contradictory to commonly held social and legal standards the majority adhere to. Sadly I am the one ruining a good friend’s wedding, picking the kids up after a few too many, or passing out at the birthday party. I am the one who is “super nice” as long as I am not drinking. The list just goes on and folks whisper “why would he keep doing that?”, yet no one waits for the answer.

Well here it is.

To transcend the common misconceptions related to Substance Use Disorders we have to understand their nature. Some individuals simply have a response to substances that is anomalous or exceptional. Think about a bell curve. No healthcare condition effects everyone. This unique response is usually a function of a genetic predisposition and it subsequently begins the ever increasing compulsion and obsession to use substances in spite of sometimes catastrophic consequences in order to maintain the pleasurable reward response. As time goes on my central nervous system is just unable to keep me in balance neurologically and so continued drug use becomes the only option for general comfort or even survival.

Imagine being hungry, having not eaten for days. What lengths might you go to in order to satisfy this need? Now multiply that by hundreds! This is the “why” if you will. Executive [brain] functions (Prefrontal Cortex) simply do not have the ability to override the primal necessity created in the reward pleasure center (Nucleus Accumbens). Human beings are designed like this. Primitive systems such as pain, or flight/fright are designed to take precedence. As such, I do not “want” to use a substance, I “need” to use. This combined with tissue dependence leaves a biological system that only functions normally in the presence of a drug.

This does not mean I am not accountable for my actions as I am solely responsible for my health in recovery and the amends I need to make. It simply means I am not a bad person needing to get good, but rather an individual with a healthcare condition that needs to be managed into remission.