NEDA TOOLKIT for Coaches and Trainers
Common myths about eating disorders
This information is intended to help dispel all-too-common misunderstandings about eating disorders and those
affected by them. If your family member has an eating disorder, you may wish to share this information with
others (i.e., other family members, friends, teachers, coaches, family physician)
Eating disorders are not an illness.
Anorexia is the only serious eating disorder.
Eating disorders are actually complex medical and
psychiatric illnesses. The American Psychiatric
Association classifies five different types of eating
disorders in the Diagnostic and Statistical Manual, 5th
Edition (DSM-5): anorexia nervosa, bulimia nervosa,
binge eating disorder, avoidant restrictive food intake
disorder (ARFID) and other specified feeding or eating
disorder (OSFED). Several decades of genetic research
show that biological factors play a significant role in who
develops an eating disorder. EDs can co-occur with other
mental illnesses like major depression, anxiety, social
phobia and obsessive-compulsive disorder.
When researchers looked at the death rates of
individuals with any eating disorder diagnosis who
were being treated as outpatients, they found that
bulimia and EDNOS (now OSFED) had the same
mortality rate as anorexia nervosa. During the study,
roughly 1 in 20 people with eating disorders died
as a result of their illness. Individuals who abuse
laxatives or diuretics or force themselves to vomit
are at significantly higher risk of sudden death
from heart attacks due to electrolyte imbalances.
Excessive exercise also can increase the risk of death
in individuals with eating disorders by increasing the
amount of stress on the body.
Doesn’t everyone have an eating disorder these
days? Although our current culture is highly obsessed with food
and weight, and disordered patterns of eating are very
common, clinical eating disorders are less so. A 2007
study asked 9,282 English-speaking Americans about
a variety of mental health conditions, including eating
disorders. The results, published in Biological Psychiatry,
found that 0.9% of women and 0.3% of men had anorexia
during their life, 1.5% of women and 0.5% of men had
bulimia during their life, and 3.5% of women and 2.0%
of men had binge eating disorder during their life. The
consequences of eating disorders can be life-threatening,
and many individuals find that stigma against mental
illness, and eating disorders in particular, gets in the way
of timely diagnosis and adequate treatment.
It’s just an eating disorder. That can’t be a big
deal. Eating disorders have the highest mortality rate of
any psychiatric illness. Up to 20% of individuals with
chronic anorexia nervosa will die as a result of their
illness. Community studies of anorexia, bulimia, and
eating disorder not otherwise specified (EDNOS, now
called OSFED) show that all eating disorders have similar
mortality rates. Besides medical complications from binge
eating, purging, starvation and over-exercise, suicide is
also common among individuals with EDs because of
the severe psychological distress that accompanies the
disease. People who struggle with eating disorders also
have a severely impacted quality of life.
Strict rules about eating or fad diets aren’t a
problem. What appears to be a strict diet on the surface may
actually be an eating disorder in disguise, or the
beginnings of one. Even if it isn’t a clinical eating
disorder, disordered eating can nonetheless have
serious medical consequences, such as anemia and
bone loss. Individuals dealing with serious disordered
eating may benefit from intervention and treatment
to address their concerns before it becomes a full-
blown eating disorder. Chronic dieting has been
associated with the later development of an eating
disorder, so addressing these issues right away may
prevent a full-blown eating disorder.
As long as someone isn’t emaciated, they are
not that sick.
Most people with an eating disorder are not
underweight. Although most people with eating
disorders are portrayed by the media are emaciated,
you can’t tell whether someone has an eating
disorder just by looking at them. These perceptions
can allow eating disorders to linger for years, and
can cause distress in eating disorder sufferers for
fear of not being “sick enough” or “good enough” at
their disorder to deserve treatment. Just because a
sufferer is no longer emaciated doesn’t mean they are
recovered. Someone can experience a severe eating
disorder at any weight.
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