I’m an Eating Disorders Physician. Here’s What I Wish Everyone Knew About Eating Disorders
Katherine Hill, MD
Two hands typing on a laptop with a stethoscope in the foreground

Eating disorders run rampant in our society, yet nearly every day I encounter well-intentioned people, even medical professionals, with potentially harmful misconceptions about eating disorders and the people who get them.

Eating disorders are deadly and pervasive: they are the second deadliest mental illness with a mortality rate of 4-5 percent, and about 5 million Americans will get an eating disorder every year - that’s more than the population of Los Angeles! The rate of eating disorders during the pandemic has surged, with inpatient hospitalizations more than doubling since the pandemic began. Our society is long overdue to dispel some common myths about eating disorders.

Eating disorders don’t just affect thin, young, affluent white girls

The number one misconception I encounter about eating disorders is they exclusively affect thin, white, upper-middle class girls and women . Eating disorders affect people of all ages, genders, ethnicities, body sizes, and socioeconomic statuses. Unfortunately, due to this pervasive myth, the diagnosis and opportunity for treatment is often missed in any people who don’t fit the stereotype, including men and those in larger bodies. This often means that by the time they do receive a proper diagnosis, these patients are sicker and harder to treat.

People with eating disorders don’t “look” a certain way

Repeat after me: You can’t tell by looking at someone if they have an eating disorder. Many believe that all people with eating disorders must be underweight But the vast majority of those struggling with eating disorders do not appear excessively thin. So it’s important to avoid commenting on anyone’s body or weight as you might inadvertently trigger someone who is struggling with eating or body image. Even commenting positively on someone’s weight loss or body might fuel the fire for someone predisposed to disordered eating.

Anorexia nervosa and bulimia nervosa are not the most common eating disorders.

While the most well-known eating disorders are anorexia nervosa and bulimia nervosa, the most common eating disorder in the US is binge eating disorder, affecting about 3 percent of Americans . Binge eating disorder is characterized by loss of control and consuming large amounts of food, which can have harmful medical and psychological consequences. Another common but lesser-known eating disorder is Avoidant and Restrictive Food Intake Disorder, or ARFID, which involves an apparent lack of interest in food and eating due to factors like the sensory characteristic of the food itself or fear of vomiting People with ARFID generally don’t have body image concerns, unlike in anorexia or bulimia, but can suffer from the same psychological or physical harm nonetheless.

Eating disorders are rooted in many factors

Stop blaming the parents, the soccer coach, or that reality TV show. Eating disorders are complex brain disorders that are largely genetic and rooted in biological, psychological, social, and environmental factors. No one person or event is responsible for an eating disorder.However, if someone is genetically predisposed, they might be more sensitive to certain conversations, such as “Fitspiration” on social media and diet talk.

With prompt and proper treatment, eating disorders are very treatable

Eating disorder treatment has traditionally been incredibly expensive, not evidence based, and inaccessible to most people. Only about 20 percent of folks with eating disorders will receive any treatment at all, and an even smaller number will have access to gold-standard treatment like Family-Based Treatment. But greater accessibility to affordable evidence-based treatment can help change that narrative and ensure that everyone is able to achieve lasting recovery.

Katherine Hill, MD
Vice President, Medical Affairs
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