This week is National Eating Disorder Awareness Week. The theme is “It’s time for change.”  For too long, the stereotype of someone with an eating disorder is a young, white privileged female who wants to be thin. Stigma about eating disorders leads to a disproportionate amount of people who suffer to go undiagnosed and untreated. It’s time to put an end to the common misconceptions about the second deadliest mental illness in the US. 

Men and Persons Who Identify As Male

10 million boys and men in the USA will experience an ED some time in their life (Hudson et. Al, 2007).  Some of the most common reasons for onset in men are avoidance of teasing for having a bigger body, increase sports performance, avoid weight-related medical illnesses seen in other males in their families. There is also a particularly higher risk of eating disorders among gay men. 

Black, Indigenous, and People of Color 

BIPOC struggle with eating disorders, at higher rates and with less recognition. Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior, such as binge-eating and purging.  Hispanic people are more likely to suffer from bulimia than non-Hispanic peers. (Goeree, Ham, Iorio, 2011).Some stressors leading to the need to control are influenced by racism, stress, trauma, and poverty. Additionally, current assessments and treatment interventions for eating disorders often miss major areas of impact such as differences in skin color, hair, and acculturation. These tools and treatments must change to be competent and inclusive for people of all races and ethnicities. 

Transgender and Non-Binary People

32% of transgender people report using their eating disorder to modify their body without hormones (Duffy, Henkel, Earnshaw, 2016). Efforts to lose weight or prevent weight gain are thought to help avoid typical female body traits and systems such as breasts, hips, and a menstrual cycle. Transgender people also tend to have a higher rate of body dissatisfaction than their nontransgender peers. 

People With Neurodivergent Minds

20-30% of adults with eating disorders also have autism (Solmi et al., 2020). There is overlap in characteristics of autism that those with eating disorders often struggle with such as emotion regulation, need for routines and rigidity, and restriction of stimuli with sensory complexity, such as food consistency. This can be particularly difficult to treat, as many of the standard treatment approaches are not designed with these people in mind. 

People in Larger Bodies

Less than 6% of people with eating disorders are medically diagnosed as “underweight.” (Flament et.al, 2016). Living in a larger body is often seen as a risk factor for eating disorders, and a common outcome. People living in larger bodies are less likely to be diagnosed, and instead encouraged to lose weight. This is particularly problematic because eating disorder behaviors – whether they lead to weight loss or not – can still lead to severe medical and psychological consequences. 

Let us keep in mind that no two eating disorders look the same. People of all genders, backgrounds, races, and abilities are at risk of developing anorexia nervosa, bulimia nervosa, binge eating disorder, and any combination of disordered eating behaviors. Though the treatment field has a long way to go in making help accessible and inclusive, there are many of us willing and able to help.