by Nicole Wilkes
Photo courtesy of Photofromflicks.com
When visualizing someone with an “eating disorder,” we all conjure the same image: an emaciated young white woman with tortured eyes and dulled features (a.k.a. Lily Collins in Netflix’s “To the Bone”). Society has come to accept this as the universal “eating disorder look” as this girl is easy to identify—she’s wasting away, she clearly needs help. This acceptance of this image as the sole object of the public eating disorder narrative has led to the exclusion of the majority of sufferers from said narrative, and its effect on these individuals is oftentimes crushing.
“There are a multitude of people who are suffering who may not look like what the media and society believe eating disorders look like,” said Mia Findlay, body image and eating disorder advocate and creator of “recovery chat” YouTube channel What Mia Did Next. “That emaciated look only represents 3% of people with eating disorders.”
Anorexia nervosa is the only eating disorder that lists low body weight in its diagnostic criteria. While this disorder deserves awareness—it has the highest mortality rate of any mental illness—we have let it eclipse the actual experiences most people with eating disorders go through.
Bulimia, binge-eating disorder and Other Specified Feeding and Eating Disorders (OSFED) are the most common eating disorders and do not list low body weight as identifying criteria. In fact, those with bulimia typically experience very little fluctuation of weight. Binge-eating disorder, arguably the most common eating disorder in the United States, often causes weight gain—the opposite of the underweight anorexic narrative Americans are accustomed to.
OSFED, which is responsible for 40-60% of cases in eating disorder treatment centers, includes atypical anorexia (meets all criteria for anorexia nervosa except low body weight), atypical bulimia and binge-eating disorder (do not meet the frequency and/or duration criteria of their typical counterparts), purging disorder and night eating syndrome. It is dangerously easy for individuals with these disorders to consider themselves unqualified for help as they don’t meet the full requirements of the more well-known, serious-sounding disorders. This, combined with the idea that many battling OSFED don’t “look the part,” leads countless diagnosable individuals to let their eating disorder thrive where it does best: in secret.
“I never hit the stereotypical look of an eating disorder… but I still had to get help,” said Findlay, reiterating that you don’t have be skin and bone to qualify for treatment. “I may have never qualified for that—I may have been dead and buried before I looked anorexic.”
Society’s exclusion of the vast majority of eating disorder sufferers from the public narrative has even affected the medical field entrusted with treating them.
In a piece for Narrative.ly, recovering bulimic Alexa Giardino describes her disappointment when her lifelong physician failed to realize her rapid, sudden weight loss was a result of regular post-meal purging—and praised her instead.
“We praise these people who are losing weight so fast and intensely, that if they were a smaller size we would be trying to get them treatment, not praising them,” said Giardino. “Where is that line, and why does it exist?”
A number of facilities and organizations, such as Brookhaven Hospital, are making great efforts to spread awareness of the variety of ways eating disorders affect our bodies in hopes of inspiring more non-underweight afflicted individuals to seek help.
“Until the public and medical community are educated about the complex, subtle, and dangerous ways eating disorder manifest in individuals,” said Griffen Sparks in a post on Brookhaven Hospital’s website. “There will continue to be countless people who can’t get proper treatment for the disorder destroying their bodies.”