What does an eating disorder look like? For most people, that question conjures a very specific image of someone who is deep within their illness and dangerously underweight. This stereotypical concept of what it is to have an eating disorder is harmful on two fronts: it perpetuates stereotypes of those who are living with an eating disorder and creates roadblocks in recovery for those who do not fit into that extreme.
While about nine percent of the US population will experience an eating disorder in their lifetime, less than six percent of those diagnosed are ‘medically underweight.’ This means more than 94 percent of people with eating disorders are misrepresented and more likely to go undiagnosed and untreated due to misinformation and misconceptions of a deadly disease. In fact, many don’t even realize their struggles with food or exercise are symptoms of an eating disorder. Education about conditions such as Anorexia Nervosa and Bulimia Nervosa is woefully lacking, and there is even less awareness of conditions beyond these two including orthorexia, ARFID, OSFED, and binge eating. Lack of awareness combined with internalized shame and fear may leave many in need of care questioning: Am I sick enough for treatment?
What is ‘Sick Enough?’
This is a common question among those with eating disorders and other mental health conditions. ‘Am I sick enough for treatment?’ ultimately translates to ‘do I deserve to get better?’ or ‘it’s not that bad, I’m in control.’ It suggests there is some specific point at which the problem is actually serious enough to warrant attention: the fabled ‘rock bottom.’ In truth, rock bottom doesn’t exist– or, at the very least, not in the way we often think. You don’t have to meet some imagined quota of suffering before it’s okay to seek treatment. More precisely, you shouldn’t; early intervention is paramount to protecting your health and long-term success.
Because society perpetuates one particular image of what it means to have an eating disorder, the question of ‘sick enough’ may also be ‘am I sick at all?’ Symptoms of disordered eating may be subtle and difficult to identify, especially in the beginning. Often, they seem like mindfulness and responsibility. We tell ourselves ‘I won’t eat this burger because it is bad for me’ or ‘I am exercising to keep my body healthy.’ While those two things may be true, they can also be step one of a slippery slope into dangerous territory.
A few more examples of potential signs of an eating disorder include:
- Marking specific foods as ‘off limits’
- Obsessive calorie counting and negative feelings when exceeding a certain number
- Rapid cycling through fad diets and ‘quick weight loss’ tactics
- Body checking, especially right after a meal
- Anxiety regarding eating in front of others; avoiding social situations which include eating
- Negative self-talk after eating
- An uncontrollable urge to eat when emotionally distressed
- Exclusively eating one particular food or type of food
Debunking Harmful Stereotypes
Just as the United States is a melting pot of cultures, identities, and experiences, so too is the spectrum of those living with eating disorders. Unfortunately, representation in the media has failed to encompass this, perpetuating one stereotypical image. Often this is a teenage or young adult white, female-presenting person who is extremely underweight.
While this portrayal may be accurate for some, it fails to show the entire picture. This oversight fails to recognize that the majority of people living with an eating disorder are not excessively underweight and may in fact be average or even overweight. Exclusive representation creates barriers to care including misdiagnosis or failure to diagnose by medical professionals, lack of access to treatment, and lack of education and awareness in underrepresented populations.
Though 10 million men in the United States experience some form of disordered eating in their lifetime and black teens are 50 percent more likely to exhibit bulimic behaviors, they are greatly underrepresented and underserved when it comes to eating disorder treatment. Studies have even shown that when polled, people were less likely to identify problematic eating habits in minority populations.
Despite this, it is important to recognize that we all have the right to seek better for ourselves. We all deserve health, wellness, and a chance for a brighter future.
Beyond Anorexia and Bulimia
Underrepresentation and miseducation goes beyond those affected by eating disorders. Most of the information available regarding eating disorders is limited to Anorexia and Bulimia. While these conditions certainly deserve awareness, neither is the most common form of disordered eating in the United States. Binge eating disorder affects more Americans than both Anorexia and Bulimia combined yet public knowledge is lacking. Often the media depicts it for comedic effect, showing characters in shows and movies eating excessively in response to break ups and stress. In reality, binge eating disorder can be deeply mentally distressing, interfering with one’s life, health, and happiness.
Part of the reason people wonder ‘am I sick enough for treatment?’ is because of this lack of public education about the full spectrum of eating disorders. When symptoms don’t align perfectly with the available information, people are left in limbo or convince themselves the problem doesn’t exist. Less acknowledged eating disorders include:
- Binge eating disorder: severe, recurrent episodes of consuming large quantities of food in a short period of time or to the point of discomfort, often coupled with a feeling of loss of control, guilt, or same.
- Orthorexia: obsessive restriction of one’s diet, with a nearly phobic attitude toward ‘unhealthy’ foods.
- ARFID: the need to avoid or restrict certain foods, or all foods
- OSFED: eating behavior that causes significant distress and impairment in areas of functioning, but does not meet the full criteria for other eating disorders
- Pica: the consumption of non-food items with little to no nutritional value, such as paint, chalk, dirt, or paper.
- Anorexia Athletica: obsessive, excessive exercise to the point of injury or bodily breakdown, with sufferers often failing to allow adequate recovery time between workouts.
- Purging Disorder: distinct from Bulimia, this disorder hyper focuses on the act of purging with little change to one’s eating habits otherwise.
Please don’t worry if you’re “sick enough” for treatment. If you have an unhealthy relationship with food, your weight, or your body, you are sick enough to get help. Anyone and everyone who is experiencing the pain of an eating disorder deserves treatment.
Eating disorders are insidious and grow stronger every day they are left untreated. The faster we can begin treatment, the better the outcome will be for long-term recovery. If you or someone you love is struggling with food, we’re here to help. Contact us today to talk about your options.