Knowing the truth about anorexia can save lives. When people with anorexia and related eating disorders don’t grasp the severity of their illness, they may not seek help, says Philip Mehler, MD, who is the founder of the ACUTE Center for Eating Disorders and Severe Malnutrition in Denver. “It is critical to pursue early intervention strategies, such as education and screening, to prevent chronic malnutrition, long-term health complications, and death,” Dr. Mehler says. So, what’s the real story? Here are 10 things you should know about anorexia.
1. Fact: Anorexia Can Be Caused by Many Things
Anorexia is a complex mental illness caused by many factors working together that all play a role of some kind, says Chelsea Kronengold, who has a master of arts in clinical psychology and serves as the associate director of communications at the National Eating Disorders Association (NEDA). According to Mayo Clinic, common risk factors for anorexia nervosa include:
GeneticsDietingLife transitions, such as the end of a relationship, or a new home, school, or job
Keep in mind that two people with the same eating disorder can have very diverse causes, symptoms, perspectives, and experiences, says Kronengold. “While it can be helpful to identify the root of one’s eating disorder, or as much as they can uncover, recovery is still possible without being able to ‘pinpoint’ the entire cause, especially in terms of physical and behavioral recovery,” she says.
2. Myth: Anorexia Is an Obsession With Thinness That Can Be Stopped
Although people with anorexia do desire to be thin, having anorexia is not something they simply choose. “People do not just ‘catch’ an eating disorder for a period of time,” says Kronengold, adding that it’s unlikely that an eating disorder like anorexia can be “stopped as desired.” Anorexia nervosa is not merely a desire for thinness — there is an obsessional component to it, as well as an inability to see one’s body as is it truly is that makes this eating disorder more much more complicated. Mehler adds, “Anorexia is a bio-psycho-social disease, which means that genetic, biological, environmental, and social elements all play a role.” He also notes that eating disorders may run in families. Events like physical illnesses, childhood bullying, and other life stressors, or conditions like major depression, anxiety, social phobia, or obsessive-compulsive disorder, may raise the risk of developing anorexia as well, explains Mehler.
3. Fact: Dieting Can Lead to Eating Disorders
Giving weight loss a go is very common among Americans. According to a 2018 survey from the Centers for Disease Control and Prevention (PDF), nearly half of adults had tried to lose weight within the previous 12 months. And nearly 63 percent of those weight loss attempts involved eating less food. Though not all weight loss is inherently harmful, dieting can be dangerous even under so-called “normal” circumstances. According to NEDA, 35 percent of “normal” dieters progress to compulsive dieting behaviors, and 20 to 25 percent of those people progress to a partial or a “full-syndrome” eating disorder that meets the all of the essential criteria for diagnosing the disease.
4. Myth: Anorexia Only Affects Straight, Young, White Women
Stereotypes and misconceptions about who “gets” eating disorders can often lead to delays in diagnosis or seeking treatment, NEDA says. In truth, people of any age, racial or ethnic background, body weight, and gender identity can develop an eating disorder like anorexia, the National Institute of Mental Health (NIMH) states. “Although anorexia is more common in females, researchers and clinicians are becoming aware of a growing number of males and nonbinary individuals who are seeking help for anorexia nervosa,” notes Mehler. According to NEDA, populations that have a higher risk of eating disorders also include:
AthletesThe LGBTQ+ communityPeople with disabilitiesPeople of colorThe Jewish community
5. Fact: Anorexia Causes Serious Medical Complications
“Anorexia can affect every organ system in the body,” says Mehler, adding that not eating enough calories or healthy nutrients can cause heart failure, long-term digestive issues, hormonal issues, and other health consequences like severe dehydration and kidney failure. Other anorexia-associated health issues that can happen over time include growing lanugo, or fine, downy hair all over the body, as well as low blood pressure, infertility, and brain damage, the NIMH states. Additionally, eating disorders are known to have the second highest mortality rate of all mental health disorders, surpassed only by opioid addiction, Kronengold notes. This is not only due to the physical health risks of self-starvation, but also because anorexia is a risk factor for suicide. A study published in June 2019 in the journal BMC Medicine showed that American adults who have been diagnosed with an eating disorder like anorexia nervosa at any point in life have a significantly increased risk of attempting suicide.
6. Myth: People With Anorexia Are Purposely Starving Themselves
It’s true that folks who are struggling with anorexia may deny their hunger, not eat or drink enough, and experience an intense fear of gaining weight, says Kronengold. But the eating disorder is less about the food and more about the person’s physical and mental health, including their unique risk factors that contributed to developing anorexia, symptoms, and whether they have any other health conditions that could play a role, such as depression or anxiety. And although starvation is a well-known symptom of anorexia, it’s not the only one. People with anorexia may also binge eat, exercise excessively, and purge either by vomiting or by taking laxatives, says Kronengold.
7. Myth: You Need To Be Considered ‘Underweight’ to Have an Eating Disorder or Symptoms of Anorexia
A doctor may diagnose someone with “atypical anorexia” or “subclinical anorexia” when there are significant symptoms of anorexia present, but the individual is not (or at least not yet) underweight, according to NEDA. Unfortunately, due to the misconception that people must be thin to have the disorder, those who meet several of the criteria for anorexia but do not experience significant weight loss or have low BMI often go undiagnosed, Kronengold says. “Given the rampant weight stigma surrounding this illness, many people suffering from ‘atypical anorexia’ fail to recognize they have a severe eating disorder or may be less likely to be diagnosed due to cultural prejudice against fatness,” she says.
8. Fact: Recovery Is Possible
The road to healing isn’t always easy but recovery is possible. “Healing from an eating disorder is a journey. Don’t give up,” says Jacquelyn Ekern, licensed professional counselor and founder and president of Eating Disorder Hope. A study published in November 2019 in the International Journal of Eating Disorders showed that 72 percent of caregivers of children with eating disorders like anorexia nervosa reported that their child had, at some point, partially or fully recovered. Some people might be hesitant to seek help because they fear stigmatization, believe their problem isn’t “that” bad, or think they can recover on their own, says Kronengold. “It is important to decide that you are worth it and deserve to heal from your eating disorder and live a fulfilling and healthy life,” says Ekern. And it’s important to remember that no one’s recovery journey is perfect. “Many have recovered, but they likely had a few slips and challenges along the way,” Ekern adds.
9. Myth: You Can Get Over Anorexia if You ‘Eat Normally’
Even though anorexia nervosa is associated with starvation, having the disorder isn’t about food or whether you’re “eating normally.” In a proper recovery plan, Kronengold says, it’s essential to address the eating disorder symptoms and medical consequences, as well as all the external forces that contribute to or maintain the eating disorder.
10. Fact: Early Treatment Equals Better Recovery Outcomes
The earlier the treatment, the greater the chances of full recovery — and it’s never too early to start. Without professional treatment, eating disorder behaviors are likely to get worse and cause greater health consequences, explains Ekern, adding that earlier treatment can lead to longer-term recovery. And the later someone begins treatment, the less responsive they may be to treatment, adds Mehler. If you’re worried that someone you care about may have an eating disorder, it’s important to share your concerns early on rather than wait until they show physical and emotional signs of a full-blown eating disorder, says Kronengold.
