Eating Disorders Don’t Have a “Look”
When you imagine an individual being diagnosed with an eating disorder, what does that individual typically look like? How old are they? What is their sexual orientation? How does the media portray eating disorders? If you thought of a very thin, young, cisgender, white woman, you aren’t alone! News and media coverage disproportionately present eating disorders as simplified, yet dramatized, conditions that only impact young, white, thin women, leaving out realistic information regarding the stereotypes and stigma associated with eating disorders, the barriers to treatment and the realities of recovery (O’Hara & Clegg Smith, 2007). While this may not seem like a big concern, this misrepresentation has a significant impact on the diagnosis and treatment of eating disorders, who decides to seek treatment, who has access to treatment, as well as consequences related to weight bias and stigma. Curious to know more about the media’s impact on eating disorders and weight bias? Let’s break this down some more.
The reality is, eating disorders affect all individuals regardless of body size, ethnicity, sexual orientation, or age (Palmer, 2008). While news and media coverage paint a picture of eating disorders based upon appearance and body weight, the reality is that anorexia nervosa is the only eating disorder that utilizes weight and body mass index as a criterion for diagnosis. The vast majority of individuals that are diagnosed with an eating disorder are not underweight, nor do they fit within the stereotypical image in the media. While the media’s portrayal of eating disorders might lead you to believe we are able to make conclusions based upon someone’s appearance, this is far from the truth. Anorexia nervosa (which involves a low body weight) only makes up 3% of total eating disorder diagnoses, whereas binge eating disorder makes up 47%, other specified feeding and eating disorders make up 38%, and bulimia nervosa makes up 12%.
Eating disorders don’t have a typical “look” and we aren’t able to determine if someone has an eating disorder based upon how someone looks, or their body size. This idea that weight is the sole and best indicator of eating disorder risk perpetuates the problem and leads to many questioning if they are “sick enough” to seek treatment. This idea of not being “sick enough” stems from not only the media’s portrayal of eating disorders, but the cultural normalization of disordered eating patterns, thoughts, and behaviors, as well as weight stigma and stereotypes. These stereotypes can show up in everyday life in harmful ways. Women from minority groups who have eating disorders are statistically underdiagnosed, as well as disproportionately report not being treated for an eating disorder (Cachelin, et al, 2001). Minority groups report a lack of recognition from peers acknowledging that they have an eating disorder, not to mention the lack of health care referrals made by clinicians for these minority groups (Cachelin, et al, 2001).
While it has been frequently reported that minority groups are more likely to receive inadequate (if any) treatment related to eating disorders, the weight discrimination and stigma reported impacts all ethnicities and age groups. Weight stigma is the discriminatory acts and ideologies that are targeted towards individuals because of body size, typically individuals in larger bodies. While we know that eating disorders impact individuals of all sizes, shapes and body weights, this discrimination besieges those in larger bodies which can prevent individuals with eating disorders from getting the needed treatment. Not only does weight bias and stigma decrease someone’s ability to seek or gain access to treatment, but actually perpetuates eating disturbances and behaviors, body image dissatisfaction, stress levels, depression and anxiety, low self-esteem and chronic disease risk (Wu & Berry, 2017; Tomiyama et al, 2018).
So, how do you know if you are someone you know has an eating disorder? The answer involves complex interactions between biological, psychological, and sociocultural issues (National Eating Disorder Association, 2021). The media’s portrayal of eating disorders is not only inaccurate, but harmful to all ethnicities, age groups and genders and perpetuates harmful ideas like weight bias and discrimination. Next time you see or read something in the news or in the media related to body weight or eating disorder risk, I challenge you to think about any stereotypical messages and biases that might be present. If you are interested in learning more about risk factors associated with eating disorders, stay tuned for more…
- Palmer, L.C. (2008). Crossing the color line: Emerging realities about eating disorders and treatment with women of color. Journal of Feminist Family Therapy, 19(4), 21-41. https://doi.org/10.1300/J086v19n04_02
- O’Hara, S.K., & Clegg Smith, K. (2007). Presentation of eating disorders in the news media: What are the implications for patient diagnosis and treatment. Patient Education and Counseling, 68(1), 43-51. https://doi.org/10.1016/j.pec.2007.04.006
- Cachelin FM, Rebeck R, Veisel C, Striegel-Moore RH. Barriers to treatment for eating disorders among ethnically diverse women. Int J Eat Disord. 2001 Nov; 30(3):269-78. https://doi.org/10.1002/eat.1084
- Wu, Y. K., & Berry, D.C. (2018). Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review. Journal of Advanced Nursing, 74(5), 1030-1042. https://doi.org/10.1111/jan.13511
- Tomiyama, A., Carr, D., Granberg, E. et al. (2018). How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Med 16(123), 123 https://doi.org/10.1186/s12916-018-1116-5
- National Eating Disorder Association. (2021). Risk Factors. Retrieved from https://www.nationaleatingdisorders.org/risk-factors