Eating Disorders: The Conversation Isn't Over

By Jocelyn Gardner '17
Mental Health Columnist & Webmaster

TW: eating disorders, including descriptions

By the time this is published and you are reading it, NEDAwareness week 2016 will be a thing of the past, but I still have a lot I could say on the topic. Each year, the National Eating Disorders Association (NEDA) has an Eating Disorder awareness week—I wrote an article for last year’s NEDAwareness week, too. That article has been one of my most engaged-with and read articles since I started writing this column in the beginning of last year. (Thanks, everyone!) This year, I’d like to devote my NEDA article to the topics that people tend not to know about when it comes to eating disorders, disordered eating and the like.

A brief distinction before we get started—eating disorders are specific diagnostic categories (I’ll discuss diagnostic categories in-depth further on) while disordered eating is more of a description. Disordered eating isn’t necessarily an eating disorder—often, disordered eating describes behaviors that don’t strictly fit into diagnostic categories of eating disorders. There will be a section unpacking these ideas of diagnoses and categories—don’t worry.

I think it is fair to say that most people at Scripps know about eating disorders to some extent. Of course, there is much more information out there, and having a basic understanding is sometimes not enough. Basic understandings can lead to generalizations, and I’ve found that nuance is vital when it comes to people’s minds and mental health. An example of a basic understanding is how people recognize that media and the critical way society views bodies, health, exercise and food contribute extensively to body shaming and sizeism. However, it is nowhere near accurate to say that this is the source of eating disorders. Can it be a source? Certainly. And that’s disgusting and alarming. There are a lot of other reasons that eating disorders develop, such as trauma and other mental illnesses. I have on many occasions heard someone talking about another person suffering from an eating disorder and using language like, “Why would she do that? She’s already so thin!” The generalization here is that eating disorders start when a person wants to look thinner. This is not always true! By the way, we all need to stop saying that people “choose” to have eating disorders. Even if a person starts down that path seemingly voluntarily, there is still something “off” about the thought processes that go into eating disorders and disordered eating. Disordered eating is NOT a choice. If someone “chooses” an eating disorder, this person is already under the influence of the thoughts that can snowball into one. More on this in my example:

Recently, I saw that “All About That Bass” (a supposedly body-positive song that actually shames other people instead) singer Meghan Trainor said that she “wasn’t strong enough” to have an eating disorder. Just…no. “Having an eating disorder doesn’t show ‘strength,’” responds singer Demi Lovato, who is open about her own experiences with mental illness including eating disorders. “Strength is when [you] are able to overcome your demons after being sick and tired for so long. There’s a wide misconception that anorexia and/or bulimia is a choice and you often hear people say things like ‘why doesn’t she just start eating?’ Or even ‘just stop throwing up.’ It’s the ignorance and lack of education on mental illnesses that continues to put mental health care on the back burner to congress even though this is an epidemic that is sweeping our nation, and causing more and more tragedy every day. Starving is not a ‘diet’ and throwing up isn’t something that only extremely thin men or women do. Eating disorders do not discriminate. Neither does any other mental illness. These are deadly diseases that are taking lives daily. So please, let’s be cautious of the words we use when discussing ED’s and other mental illnesses.”

Now that we’re all on the same page, agreeing that mental illnesses have many causes and are not choices or fads, I want to talk about some of the lesser-known aspects of eating disorders. Basically, I want to add some nuance to the eating disorder conversation.

In her response above, Demi Lovato mentioned, “Eating disorders do not discriminate.” Usually, people stereotype eating disorders as a “young, rich, white girl mental illness.”  Again, this is a harmful generalization. According to NEDA, “Eating disorders were once thought to affect only a narrow portion of the population in the teens and early twenties, but we now know that they affect people of every age, race, gender and socio-economic status.” Maybe the existence of this stereotype means that we as a society need to think about visibility. Acknowledgement or even just awareness is the first (and possibly biggest) step to getting people help; once people know something, they can take action. We need to close the information gap, and this goes two ways: we need to get information to people, and we have to understand that problems exist whether they are visible to us or not. If we can accomplish these two things, we can raise awareness and promote prevention.

In summary, we need to be aware that eating disorders can and do affect all types of people. But, even keeping this in mind, there is still a lot of information hidden beneath generalizations. When people think of eating disorders, they think about two categories: anorexia and bulimia. This is a problem because eating disorders and disordered eating range greatly, and many of them don’t fall under those categories (which are actually in themselves more complex). NEDA, following DSM-V, lists three major and many lesser-known eating disorders. Again, you’ve probably already heard of anorexia nervosa and bulimia nervosa. Before I talk about the aforementioned lesser-known disorders, I want to make a note of our following of DSM-V, a diagnostic tool that uses a lot of statistics and helps mental health practitioners determine treatments. A diagnosis is just a tool, basically, so we have to be careful not to pigeonhole people into outlined/common symptoms and dismiss or otherize people who don’t fit those descriptions. In other words, DSM-V generalizes, so we should proceed with caution.

Other than the two well-known eating disorders, NEDA lists binge-eating disorder, purge-eating disorder, night eating syndrome, avoidant/restrictive food intake disorder, pica, rumination disorder, and other unspecified disorders. Just because these “other” disorders are not as common does not mean that they are insignificant. Specified or unspecified, eating disorders are mental illnesses, and they should be taken seriously. I want to include brief descriptions of these lesser-known disorders for the sake of awareness.

Binge-Eating disorder: “Frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain… A feeling of being out of control during the binge eating episodes…Feelings of strong shame or guilt regarding the binge eating…Indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior.”

Purge-Eating disorder: purging behaviors without binges.

Night eating syndrome: “excessive nighttime food consumption.”

Avoidant Restrictive Food Intake Disorder: “Failure to consume adequate amounts of food, with serious nutritional consequences, but without the psychological features of Anorexia Nervosa. Reasons for the avoidance of food include fear of vomiting or dislike of the textures of the food.”

Pica: “The persistent eating of non-food items when it is not a part of cultural or social norms.”
Rumination Disorder: “Regurgitation of food that has already been swallowed. The regurgitated food is often re-swallowed or spit out.”

These are very, very short descriptions, which goes against my idea of minimizing generalizations, but I think that it is still important to have information about these disorders. In that spirit, I hope that you take them as such.

In conclusion, as glad as I am that there are events for NEDAwareness Week, I know that there is still a lot of work to be done to combat lack of awareness and generalization alike. When we witness something that doesn’t feel right, like Meghan Trainor’s comment, we know what stereotypes feed into her words. (Also, I personally love how Demi Lovato responded without simply bashing Trainor.) Information is the antidote to this kind of damage, as Lovato observed. An awareness week is great, but being open all the time to the fact that stereotypes play into our concepts of mental illness is even better. So, even though NEDAwareness Week is over and far in the back of the public’s attention, the awareness itself should not need an occasion.

Visit National Eating Disorder Association’s website for information, resources and more: