When friends and family find out that someone they love has an eating disorder, we hope they react with love, compassion, and support. However, some may respond with “victim-blaming, cattiness or awkward silence,” as Bustle writes — in no small part due to harmful stereotypes about people with eating disorders.

Eating disorder stereotypes are, unfortunately, a prominent reality for many eating disorder patients. While some are based on twisted versions of the truth, most are simply myths that have been perpetrated by society over time. The problem is that many stereotypes further stigma, or shame, in eating disorder patients, making it more difficult to talk about eating disorders — and more difficult for many people to recover from them.

So, what are some of these eating disorder stereotypes, and are they true? In this blog post, we explore some of the myths surrounding eating disorders, ranging from anorexia nervosa to binge eating disorder, and how they came to be.

Myths About Eating Disorders

Some eating disorder stereotypes are specific to different disorders — but many are applicable to eating disorders of all kinds. Below, we discuss some of the myths perpetuated about eating disorders and why you shouldn’t put stock in stereotypes about eating disorders.

Eating disorders aren’t a “real disease.”

Unfortunately, it seems that everyone knows someone who “doesn’t believe in mental illness.” But new studies have busted the myth that eating disorders aren’t “real diseases.”

One study published in the journal Psychosomatic Medicine found structural changes in the brain before and after eating disorder recovery. The study found reduced levels of gray matter in patients with acute anorexia nervosa, and that these patients’ gray matter returned to normal levels after re-feeding and weight restoration.

Eating disorders also impact normal brain function. Personality traits like anxiety and perfectionism create changes in the brain that predispose a person to develop an eating disorder. Once an eating disorder has developed, patients’ self-perception of their bodies becomes distorted, leading scientists to believe that the brain may actually process information differently when suffering from an eating disorder.

Eating disorders only affect women.

One of the most harmful myths surrounding the diagnosis of eating disorders is the myth that eating disorders are a “woman’s disease.” This negative stereotype frequently prevents men who are suffering from receiving the help they need to recover from serious eating disorders.

Despite stereotypes, the National Eating Disorders Association (NEDA) states that one in three people suffering from an eating disorder is male. In fact, from 1999 to 2009, the hospitalization of men for eating disorders increased by 53%. Men represent almost 40% of those with binge eating disorder, and a quarter of those with anorexia nervosa and bulimia nervosa respectively.

Eating disorders also affect people who are transgender or non-binary at high rates. For example, a survey of college students found that transgender students had over four times greater risk of being diagnosed with anorexia nervosa or bulimia nervosa. This may occur because transgender people feel out-of-place in their bodies and want to change their physical appearance to align with their gender identity.

You must be skinny to have an eating disorder.

When you picture someone with an eating disorder, do you picture an emaciated teenage girl? Though this is the typical stereotype of someone with an eating disorder, not all people with eating disorders lose significant amounts of weight. Here are some statistics that prove the opposite is true:

• The DSM-V recognizes atypical
  anorexia as a subtype of anorexia nervosa, in which patients exhibit symptoms
  of anorexia nervosa but do not lose significant amounts of weight. These
  patients may have a normal BMI or even be classified as overweight. According
  to NEDA, research has not found a difference in the psychological impact of anorexia nervosa and
  atypical anorexia on patients.
• Most patients with bulimia nervosa
  are not underweight; in fact, bulimia nervosa behaviors may actually lead to weight gain. In one study, 64% of patients with bulimia nervosa were
  classified as overweight and 36% of patients with bulimia nervosa were
  classified as normal weight.
• Binge eating disorder (BED) is a
  serious and life-threatening eating disorder, just like anorexia nervosa or
  bulimia nervosa. However, these patients often first seek help for overweight
  rather than eating disorder thoughts or behaviors, according to studies. In the
  general population, the prevalence of BED is 2-5%; in those seeking weight loss
  treatment, the prevalence is 30%.
• Disordered eating habits, often
  classified as Other Specified Feeding or Eating Disorders (OSFED), can affect
  anyone of any weight. They apply to anyone who exhibits signs of an eating
  disorder, but does not meet the strict criteria for diagnosing anorexia nervosa,
  bulimia nervosa or another feeding or eating disorder. Patients with OSFED scored just as high on
  measures of eating disorder thoughts and behaviors as patients with anorexia
  nervosa or bulimia nervosa.

As you can see, the profile of a person with an eating disorder varies greatly between disorders. While “typical” anorexia nervosa has a BMI requirement, it is by no means necessary to be underweight to be diagnosed with atypical anorexia or any other type of eating disorder.

People with eating disorders should “just eat.”

One of the most harmful things you can possibly say to someone with an eating disorder is some variant of the phrase “Why don’t you just eat?”

The phrase “just eat” trivializes the eating disorder experience by suggesting that eating disorders are a matter of willpower. However, as we saw previously, eating disorders are real diseases caused by physiological changes in the brain. “Just eat” may work for someone whose hunger cues haven’t been interrupted — but in someone with an eating disorder, it takes time to relearn the feelings of hunger and fullness after they haven’t been honored for so long.

There is also a strong psychological component to eating disorders that make eating disorder recovery far more complicated than “just eating.” As Sam Dylan Finch writes for Healthline, “eating disorders aren’t choices. If they were, we wouldn’t have chosen them to begin with.”

It’s important to remember that eating disorders are coping strategies developed over a period of years. These behaviors, while harmful to our health, provide a sense of comfort and safety — and even by replacing eating disorder behaviors with better coping strategies, it takes time to unlearn the behaviors we’ve relied on for years to see us through the difficult times in our lives.

Eating disorders are caused by vanity or the need for attention.

Eating disorders are diseases caused by complex genetic, psychological and societal factors, not matters of vanity.

Patients rarely embark on restrictive diets because they like the way they look. As Sheila MacLeod writes in The Art of Starvation, “dieting is a matter of vanity, but anorexia nervosa is a matter of pride.” While patients may start a diet hoping to change their bodies, patients who go on to develop eating disorders are more likely to hide their bodies under baggy clothing.

Nor are eating disorders caused by a “cry for attention.” Patients with anorexia nervosa may receive positive compliments on their initial weight loss, but as they continue to lose weight, the attention becomes negative and unwanted. Patients with eating disorders are also more likely to endure teasing or bullying on their physical appearance than those who do not develop these diseases. According to NEDA, as many as 65% of patients said that bullying contributed to the development of their eating disorder.

Eating disorders are “cured” after inpatient treatment.

Many people seem to believe that inpatient treatment is a magical cure for eating disorders. You walk into a facility and, after four to six weeks, walk out at a healthy weight with no signs of an eating disorder whatsoever! But this could not be further from the truth.

Hospitalization or residential treatment for an eating disorder focuses on short-term intensive care. Often, this treatment emphasizes weight restoration, but it may not address the negative thought patterns or interpersonal relationship difficulties that led to the patient developing harmful eating disorder behaviors. This means there’s often a long way left to go in recovery when a patient leaves intensive inpatient care.

So, instead of viewing inpatient treatment as a cure for eating disorders, patients and their families should think of inpatient treatment as the beginning of their journey toward getting well. After discharge from an inpatient treatment facility or hospital, patients should establish care with an outpatient therapist or therapy group that can help support them in their recovery from their eating disorder.

Here at The Meadowglade, we have many trained professionals who specialize in the outpatient treatment of eating disorders. Our therapists and counselors can help support you in your journey toward changing your eating disorder thoughts and behaviors and continuing to get well after your discharge from an inpatient treatment program (or if you’ve never received treatment for your eating disorder at all).