Written by: Natalie Faella, MS, RDN, LDN | February 22, 2022
There are many misconceptions about eating disorders. Movies and TV shows over the years have poked fun at them (remember George’s bulimic date on Seinfeld?), making them seem purely superficial and mild. And comments like “Ugh, I wish I had anorexia” or “I would take an ounce of her self-control” when learning someone has an eating disorder are common not only on TV but in real life.
When in reality, if we saw the extreme physical and psychological pain of person with any eating disorder, we wouldn’t wish it on our worst enemy.
Eating disorders affect people of all ages, genders, races, sexual orientations, body weights/shapes, etc. and are estimated to affect at least 9% of the US population. And that is at the very least because the nature of the disorder itself is secretive, so many individuals do not seek help and suffer with their disorder in silence (it’s estimated less than 1/4 of those affected by an eating disorder will seek treatment). Plus, statistics don’t include those who fall outside of the very specific diagnostic criteria. For example, those that are of “normal” weight in terms of their BMI but meet other criteria for anorexia.
Up to 20% of eating disorder cases will result in death, making it the second most deadly mental illness (opioid overdose is #1). This is especially of concern for teenagers and young adults whose odds for suicide increases up to 32 times with an eating disorder. And while recovery from an eating disorder is possible, it is really really hard. Support options are often limited or inaccessible (for example, health insurance coverage can be difficult) and for most individuals, their eating disorder will become a chronic disease — something they will have to continually deal with on varying levels of severity for their entire life.
This is why prevention is so important. Eating disorders are caused by genetic and environmental factors. So in order to prevent eating disorders, we must focus on trying to reduce those risk factors that are in our control, like body dissatisfaction, association of self-esteem with body shape/size, association of self-worth with eating and exercise habits, fatphobia, and weight stigmatization.
Here are some ways we can help to prevent eating disorders:
1. Educate yourself.
Learn more about anorexia, bulimia, binge eating disorder, and orthorexia* to increase your awareness. This will help to avoid making judgments or assumptions about people’s weight, or eating and exercise habits, and recognize when someone you know needs help.
Websites like NEDA, ANAD, and Eating Disorder Hope are a few helpful resources where you can learn more. NEDA has a great "How Do I Help?" page with resources for parents, healthcare providers, coaches, and more.
2. Walk the walk & talk the talk.
Be a positive influence on your children, friends, coworkers, clients, followers, etc. Unlearn diet culture's harmful messages and avoid promoting them to others. For example, the message that we have been “good” or “bad” based on our eating habits, or that "thinner is better," or that weight loss should always be praised and weight gain should always be corrected. It's been reported that 42% of girls in the 1st to 3rd grade want to be thinner and 81% of 10-year-olds are afraid of being fat. We start picking up on these messages from a young age! We can do our part by not promoting them.
Additionally, we can work on our own relationships with food, exercise, and our bodies so that we can set a positive example for our kids, students, family members, etc. Sending the message that it's important to nourish and care for our bodies, and treat them with respect and love is more helpful than we know.
3. Learn more about Health at Every Size.
Health at Every Size is an inclusive movement that supports people of all sizes in adopting healthy behaviors, with the focus being on health and not weight or size alterations. It also recognizes that social, economic, genetic, and environmental influences are the main determinants of our health status and that body weight/shape and fat mass can be influenced by these factors, but are not the sole determinants of our health.
This can be tough to accept when we've been led to believe weight /BMI is what largely determines our health status. But the research is there—when we take weight out of the picture, it helps promote size acceptance, self-esteem, and long-term health behaviors, while decreasing the likelihood of weight-cycling and preoccupation with food, weight, and exercise (this preoccupation is a huge risk factor for eating disorders).
Some of my favorite resources include Body Respect (quick read), Health at Every Size (longer read), and not to toot my own horn but, these two blogs of mine: Health at Every Size: Taking Weight Out of Wellness, Health at Every Size: Common Questions Answered. : )
4. Promote body positivity & acceptance.
Notice the thoughts or judgments you might have about other people’s body weight and/or shape. Notice what you follow on Instagram and how it makes you feel about yourself. Speak of and treat your body with respect, remembering that you are so much more than the number on the scale or the tag of your pants. The way you talk about yourself not only impacts you but those around you, too.
The Body Positive and NEDA are helpful online resources and here is a list of some body positive Instagram accounts. The Body Project has also been shown to be helpful in preventing eating disorders in at risk populations.
5. Challenge diet culture.
While eating disorders have been around for a long time, there has been a steady increase since the 1950s in Western cultures—around the same time dieting for weight loss and attention to body weight and shape increased, too. There is certainly a correlation between the rise of diet culture and those impacted by eating disorders. By definition, a diet is a form of disordered eating, so it makes sense even a diet that is intended to be short-term can snowball into a lifelong eating disorder.
When you see a promotion for a new fad diet with its "before and after" pictures and too-good-to-be-true claims, remember the facts about diets and their nearly nonexistent success rates. Remember that many of the pictures you see on social media are edited and the lifestyles are embellished. And remember that happiness, self-esteem, and self-worth are not long-term results of dieting and weight loss.
I really love the book Just Eat It, an intuitive eating resource that does a good job of challenging diet culture. Christy Harrison has some great anti-diet resources like her own book, podcast, and newsletter.
6. Don’t judge a book by its cover.
We’re prone to think of that textbook image of an extremely thin person when we think about eating disorders, but not even 6% of people with eating disorders are classified as “underweight.” So instead of thinking “their eating disorder can’t be that bad” or “they must be doing better because their weight is [normal, higher, etc.]” keep in mind that we never know a person’s whole story, and certainly don’t know any more about a person because of their weight or shape.
If an eating disorder cannot be prevented, early intervention is the next best thing to help increase the likelihood that an individual will recover. The sooner a person with an eating disorder gets help, the better the outcome. If you suspect someone needs help, reach out privately in a nonjudgmental, supportive, and empathetic way. Here are a couple of helpful tools from NEDA: an eating disorder screening tool and a resource for how to approach someone with an eating disorder.
I realize these are all easier said than done. It’s going to take time to learn to reject diet culture and appreciate and accept our own bodies before we can promote these things to our kids, students, clients, etc. But that doesn’t mean we can’t start working on them in the meantime. By being mindful of our own judgments and beliefs, and by practicing being a positive influence in this diet-cultured world, we can get to that place of diet culture freedom while helping others get there along the way.
I still have times when I have to challenge that diet culture voice in my head and what it says about my body, diet, and exercise habits, too. It takes time, but writing about it and promoting it has helped me tremendously.
Help spread the message: if you found this blog helpful, like it (click the heart below), share it on social media, or email it to a friend!
*Orthorexia is not recognized by the DSM-V as an eating disorder, but is on the rise and a major stepping stone to a full-blown eating disorder.
3. UC Berkeley
4. Eating Disorder Hope
Additional Eating Disorder Resources:
For Practitioners (books):