Misconceptions About Eating Disorders

About 2% of the population has been diagnosed with an eating disorder (ED). However, there are many unrecorded cases. As the efforts to educate the public about EDs have been insufficient, some do not forcibly recognise that they are ill. Others do not think they are 'ill enough' to seek help, since they have no physical complications. The rates are probably higher at KTH, since EDs are more prevalent among young adults.

A research team at the Karolinska Institute also found a correlation between genes associated with anorexia nervosa and genes associated with high education. Although the statistics are inconclusive, it would not be a stretch to claim that more than five people in a lecture theatre are suffering from an ED. In fact, this approximation may be too modest. Given that EDs are this common, I would like to sort out some widespread misconceptions.

Firstly, you cannot tell whether someone has an ED. Sure, most anorectics are underweight. An anorectic will starve themself and probably exercise compulsively. As a result, their weight will drop. Orthorectics, who are excessively concerned about eating ‘healthy’ food and exercising, may also be underweight. Yet, it seems as if bulimia and other binge eating disorders are more common. Bulimia involves consuming unreasonable quantities of food in a short time and vomiting or taking laxatives. This ED does not imply that the person is underweight; in fact, he or she may well be overweight. Moreover, as I touched on briefly, people with EDs try to conceal it. In some sense, it is part of the illness. For instance, they may avoid events where food is served, try to eat alone or lie about having eaten. This is essentially a means to avoid anxiety. As odd as it may seem, eating properly can be associated with extreme anxiety. In addition, there is a taboo around psychiatric disorders in general. Many people with EDs do not bring up the topic, since they do not know how the other person will react. Overall, it is hard to tell who is ill.

Secondly, it is worth stressing that all EDs are serious. Occasionally, you may hear that anorexia nervosa is the mental illness with the highest mortality. Nevertheless, bulimia, binge EDs and other unspecified eating disorders may be equally harmful. The clear-cut distinction between different diagnoses is also quite problematic, as the issues of people with EDs may vary over time. For example, a good number of anorectics develop issues with binge eating, and vice versa. In general, all kinds of EDs can have devastating effects. For example, being underweight means freezing all the time, regardless of how many long johns one wears. Moreover, it leads to impaired focus, as one cannot stop thinking about food. People who vomit regularly will also wear down their teeth. Yet, EDs also have effects that go well beyond the mere physical complications. The illness can make people irritable or dishonest, and it often gives rise to conflicts with friends and family. In the long run, it can mess up relationships or one’s career. I have met people who have been unable to work for a decade, due to their issues with food. Admittedly, EDs may be more or less severe. Being restrictive with food is not the same thing as having a full-blown anorexia. Yet, EDs quickly spiral out of control. By cutting out ‘unhealthy’ products or not sating one’s appetite, the ED will grow more powerful. In short, all sorts of EDs need to be addressed as early as possible.

Thirdly, no one chooses to have an ED. It seems as if some people want to remain sick, but that is merely a consequence of the illness. As a matter of fact, EDs are the result of external circumstances and genetics. According to a twin study at the Karolinska Institute, genetics account for 40-60% of the risk of developing anorexia nervosa. Genetics also plays a significant role in the development of other EDs, but there have not been enough studies. A traumatic event, such as the parents’ divorce or being fired, may trigger the illness. Restricting one’s food intake starts out as a coping strategy, but it quickly becomes an addiction. Dieting is another common trigger. Whereas most people struggle to eat less, a few take pleasure in going hungry. Again, this may seem incomprehensible, but studies have shown that the sensation of hunger can release dopamine for those with EDs. Once they have started, they cannot cannot stop. I often come across people singling out unattainable beauty ideals as a major cause of EDs. Whereas these ideals are harmful in many ways, they do not offer a satisfactory explanation. Not all people with EDs are obsessed with getting a thigh gap or a flat stomach. It is not that they are gullible and believe that they will be happy once they are slimmer. That viewpoint is too simplistic and does neither heed environmental factors nor genetics.

For those of you who have an unsound relationship with food, I want to leave you with a final word. The only way to recover is to expose yourself to anxiety. It will be very taxing, more taxing than imaginable. Getting rid of an ED means counteracting the illness at all times. If you have had more than strictly required, perhaps during a lunch with friends, you still need to eat a full meal in the evening. If not, the illness has gotten the upper hand. It will always try to find loopholes to make you eat less. Regardless of how much willpower you have, there will be moments in which you need support. This does not mean that you are weak or lack motivation. As pointed out, EDs are serious. By getting professional help, you stand much better chances of recovering. Just hang in there, and let the anxiety pass away.