but I don’t “look” like I have an eating disorder
One of the most common, if not MOST common misconception surrounding eating disorders is that they have a “look”…
When I say “look”, I’m almost certain that you, the reader, know what I mean by that. Living in a body that is below what is considered to be a “healthy weight” is the tremendously outdated idea surrounding this mental illness.
Research shows that eating disorders can happen across a wide range of body types, and they’re not exclusive to any specific weight category. And to take that even further, you should know that less than 6% of folks who meet criteria for an eating disorder are “underweight”
One big issue? People with higher body weights often go undiagnosed or misdiagnosed because they don’t fit the typical stereotype of someone with an eating disorder, even when their behaviors are the same as someone in a smaller body.
The issue gets bigger…
People in larger bodies also experience weight stigma which is the judgment or discrimination based on someone’s size. Both the experience and internalization of weight stigma have been established as critical risk factors in the development of eating disorders. In fact, data suggests that higher weight folks are less likely to be diagnosed with an ED and the severity of their illness is often understated by providers even when their behaviors are identical to those in lower weight bodies.
The Power of Words: Changing How We Talk About Weight
An essential part of addressing weight stigma is being mindful of the language we use. Words matter! While there isn’t one perfect term that everyone agrees on, many people prefer phrases like "people with higher weight" or "living in a larger body" instead of using terms like "overweight" or "obesity." These alternatives were recommended based on consultations with individuals who have both lived experience and research to back it up.
Eating Disorders in People with Higher Weight: The Reality
Despite the fact that eating disorders are increasingly common in people with higher weights, they’re still often overlooked and not treated properly. Many times, people with larger bodies face delays in getting diagnosed or receive inappropriate treatment. They may also be subject to widespread stigma within the healthcare system, making their path to recovery even harder.
The National Eating Disorders Collaboration (NEDC) recently created a clinical practice guideline to help healthcare providers better support people with higher weights who are dealing with eating disorders. This guideline is a crucial resource for making sure that treatment is equitable and based on solid evidence.
Eating disorders affect all body types: They aren’t limited to people with low body weight. Anyone, regardless of size, can experience an eating disorder.
Under-recognition is a problem: People with higher weight often don’t get the help they need because their eating disorder may go unnoticed or misdiagnosed.
It’s not just binge eating disorder: While binge eating disorder is more common among people with higher weight, they can also experience conditions like bulimia nervosa, atypical anorexia nervosa, and other specified feeding or eating disorders (OSFED).
Eating disorders are on the rise: And this is especially true for those with higher weight. In Australia, over half of the people struggling with an eating disorder are in larger bodies.
Early intervention is key: The sooner an eating disorder is recognized and treated, the better the chances for recovery.
Every person deserves access to quality care: No matter their body size, everyone with an eating disorder should have access to safe, equitable, and evidence-based treatment.
Eating disorders are serious, no matter the weight: People in larger bodies can face the same life-threatening complications and psychological distress as those in smaller bodies.
Many don’t realize they have an eating disorder: Often, people seek treatment for weight loss without realizing they have an underlying eating disorder. And here’s a major takeaway—weight loss shouldn’t be automatically celebrated or encouraged without considering the bigger picture.
The bottom line? Eating disorders don’t discriminate by body size. It’s time to move away from outdated stereotypes and make sure that everyone gets the care they deserve. Whether you’re in a smaller or larger body, an eating disorder is a serious condition that deserves attention and proper treatment.
resources:
McEntee ML, Philip SR, Phelan SM. Dismantling weight stigma in eating disorder treatment: Next steps for the field. Front Psychiatry. 2023 Apr 11;14:1157594. doi: 10.3389/fpsyt.2023.1157594. PMID: 37113547; PMCID: PMC10126256.
Mauldin K, May M, Clifford D. The consequences of a weight-centric approach to healthcare: A case for a paradigm shift in how clinicians address body weight. Nutr Clin Pract. (2022) 37:1291–306. doi: 10.1002/ncp.10885, PMID
Hunger JM, Smith JP, Tomiyama AJ. An evidence-based rationale for adopting weight-inclusive health policy. Soc Issues Policy Rev. (2020) 14:73–107. doi: 10.1111/sipr.12062