by Sophie Padalecki

Sophie is a rising sophomore at Elon University and a CEED Summer Intern

When someone utters the  phrase “eating disorder,” for most people an immediate stereotype comes to mind : a young, white, affluent, and underweight female (Sonneville & Lipson, 2018). Indeed, since the 1980s, nearly every eating disorder movie has featured a protagonist who fits into this tight box. From The Best Little Girl in the World (1981) to Netflix’s To the Bone (2017), the same picture is painted of a young, white, affluent, cisgender female experiencing anorexia nervosa, dropping to a shockingly low weight, and then recovering, or dying. However, in reality these stereotypes portrayed in pop-culture are far from the truth and cause considerable harm.

This inaccurate stereotype of who experiences eating disorders has created an exclusionary environment that discourages individuals who do not fit this profile from seeking help. These individuals are left wondering, questioning: are their experiences and their suffering valid? Do they merit help? Individuals from these are deprived of appropriate diagnosis, treatment, and healing from eating disorders, in part because they do not see themselves reflected in common, shared understandings and media representations of eating disorders.

This exclusion is especially troublesome for those who are not perceived as thin or underweight. For example, higher weight individuals are completely left out of the conversation regarding disordered eating even though less than 6% of people with eating disorders are medically diagnosed as underweight. We need to change our viewpoint; eating disorders do not care what someone weighs!

BIPOC individuals are also left out of the conversation and are less likely to receive help for their disordered eating. Not only does the eating disorder stereotype discourage BIPOC individuals from seeking help, but it also biases the judgement of clinicians. The white, affluent, and cisgender stereotype associated with eating disorders is so pervasive, that when clinicians were presented with identical case studies of disordered eating in white and Black women, 44% identified the behavior as problematic for the white women, and only 17% identified it as problematic for the Black women (Gordon, Brattole, Wingate, & Joiner, 2006). We need to change our viewpoint: eating disorders do not care what one’s race, ethnicity, or culture is!

The LGBTQIA+ community is also left out of this conversation. Those in the LGBTQIA+ community have unique stressors, like fear of rejection, internalized negative messages, discrimination, and higher-than-average instances of PTSD, which may contribute to and exacerbate eating disorders (NEDA, 2021). Despite this, queer and trans people are rarely represented in cultural conversations and representations regarding disordered eating. We need to change our viewpoint: eating disorders do not care what sexual preference or gender identity someone has!

Individuals living in lower socioeconomic conditions are also left out of the conversation. Eating disorders are seen as an “affluent disease,” when in reality symptoms of eating disorders are distributed equally across socioeconomic strata (Mulders-Jones et al., 2017). We need to change our viewpoint: eating disorders do not care who has the most money!

Males are also left out of the conversation. Many men have problematic thoughts about their weight and physique, as one in three people struggling with an eating disorder is male (NEDA, 2021). Despite this, many assume that only women can experience eating disorders. We need to change our viewpoint: eating disorders do not care about your gender!

Individuals with disabilities are also left out of the conversation—both physical disabilities and individuals who are neuro-atypical. We know strikingly little about eating disorders in individuals with a whole range of physical disabilities. Nor do we know how best to tailor treatments to meet their needs. In fact, women with physical disabilities are more likely to develop eating disorders (Eating Disorder Hope, 2020) and 20-30% of adults with eating disorders also have autism (Solmi et al., 2020). Many of our treatment approaches may be particularly challenging for individuals who are neuro-atypical. We need to change our viewpoint: eating disorders do not care about ability!

Older adults are more frequently entering the conversation, but there is more work to do. Although eating disorders are largely depicted in young women, eating disorders occur across the life course, including during adulthood and during middle age. Individuals may have struggled since youth and never recovered, be in relapse, or have a new onset disorder in midlife. Older bodies can be less resilient to the physical consequences of an eating disorder and older people may feel ashamed due to the stereotype that it is a “teenagers” problem (NEDA, 2021). We need to change our viewpoint: eating disorders do not care about age!

As you can see, the restrictive eating disorder stereotype in the media and pop culture is not just erroneous, but is actively dangerous. Not only does this stereotype keep marginalized communities from seeking help, but it also prevents clinician’s from recognizing a problem and providing adequate referrals and treatment. If these groups are continuously left out of the eating disorder conversation, there will forever be a disparity in diagnosis, treatment, and recovery. We as a scientific community must work each and every day to design culturally competent and inclusive studies, diagnostic tools, and intervention methods, in order to debunk harmful myths about disordered eating. We need to change our viewpoint on eating disorders!

References:

1. Disabilities and Eating Disorders and Their Connection. (2020, September 04). Retrieved July 16, 2021, from https://www.eatingdisorderhope.com/blog/connection-disabilities-eating-disorders#:~:text=While%20there%20is%20little%20research,likely%20to%20develop%20eating%20disorders.

2. Gordon, K. H., Brattole, M. M., Wingate, L. R., & Joiner, T. E., Jr. (2006). The Impact of Client Race on Clinician Detection of Eating Disorders. Behavior Therapy, 37(4), 319–325. https://doi.org/10.1016/j.beth.2005.12.002

3. Identity & Eating Disorders. National Eating Disorders Association. (2018, February 21). https://www.nationaleatingdisorders.org/identity-eating-disorders.
4. Mulders-Jones, B., Mitchison, D., Girosi, F., & Hay, P. (2017). Socioeconomic Correlates of Eating Disorder Symptoms in an Australian Population-Based Sample. PloS one, 12(1), e0170603. https://doi.org/10.1371/journal.pone.0170603

5. Solmi, F., Bentivegna, F., Bould, H., Mandy, W., Kothari, R., Rai, D., . . . Lewis, G. (2020). Trajectories of autistic social traits in childhood and adolescence and Disordered eating behaviours at age 14 years: A UK general population cohort study. The Journal of Child Psychology and Psychiatry, 62(1), 75-85. https://doi.org/10.1111/jcpp.13255