Challenging myths about . . . eating disorders

Expert shares insight into the complex misunderstandings and misconceptions surrounding such disorders

'Eating disorders are serious and complex mental health conditions with one of the highest mortality rates of all mental health conditions.' Photograph: Marta Miranda
A series about debunking myths. Photograph: Aquir/iStock

Some still question or believe that you cannot recover from an eating disorder or that they are not particularly serious anyway. Others believe that parents or families are to blame for an eating disorder. There remains a widespread belief that to recover from an eating disorder, a person must be treated in hospital. And there is a damaging misunderstanding that eating disorders are about personal responsibility that centres on a lack of control or self-discipline. There are many myths upheld in the public conversations about eating disorders that amplify the taboo and stigma experienced by those suffering with a disorder.

Ellen Jennings, from Bodywhys, the eating disorders association of Ireland, shares insight into the complex misunderstandings and misconceptions surrounding eating disorders.

1) Myth - Eating disorders are rare

“Due to the secretive nature of the condition and stigmas that exist which may prevent people from reaching out for help, it is not always possible to find reliable statistics around the prevalence of eating disorders,” says Jennings.

While the conversations surrounding mental health and eating disorders are more open now, there remain societal stigmas that keep the individual conversations silenced. Eating disorders remain taboo and those experiencing a disorder may struggle to seek help.


“It is likely that eating disorders are under-reported and under-recognised in our society. According to the Health Service Executive’s National Clinical Programme for Eating Disorders, launched January 2018, based on epidemiological projections, an estimated 188,895 people in Ireland will experience an eating disorder at some point in their lives. It is estimated that approximately 1,757 new cases occur in Ireland each year in the 10-49 age group.”

2) Myth - Eating disorders are a lifestyle choice

As a culture we are fascinated with many things. Food, weight, and image being just a few. However, eating disorders are complex and caused by genetic, environmental and societal factors. They are not a lifestyle choice. Because of the association between eating disorders and how a person perceives themselves, with the possibility of poor self-image or body dissatisfaction, there is a damaging misunderstanding that a person chooses to chase a particular body ideal or lifestyle that includes an eating disorder. However, eating disorders are not motivated by vanity.

“A person does not ‘choose’ to have an eating disorder,” says Jennings, “and certainly living with an eating disorder it is not about emanating a certain type of lifestyle. An eating disorder affects every aspect of a person’s life. The person can feel trapped and compelled to continue engaging in the disordered eating behaviour in order to feel safe and secure. This compulsion replaces the conscious choice a person has, and they need help and support to be able to move towards a different way of coping and living.”

3) Myth - Only girls have eating disorders

“Eating disorders can occur in men and women, boys and girls,” confirms Jennings. “They are not specific to women and girls.”

Eating disorders can affect anyone regardless of their age or gender. Unfortunately, there remains a bias that boys and men rarely suffer with eating disorders and as a result the disorders can be become more severe and established before diagnosis.

“Most literature asserts that one in 10 people with an eating disorder are male,” says Jennings, “however, more recent studies suggest that the figure may be substantially higher. It is often more difficult for men to seek out help because eating disorders are still perceived by many to be something that only affects women and girls. It may take some men months or years to acknowledge their experiences as being that of an eating disorder. This can delay help-seeking and lead to the illness becoming more entrenched.”

The myth also perpetuates the belief that men are more likely to focus on building muscle compared with weight loss, however, as Jennings says, “In recent years, extreme dieting and purging has increased amongst men. As well as anorexia nervosa, bulimia nervosa and binge-eating disorder, men and women can be affected by muscle dysmorphia and other muscle-related eating issues.”

4) Myth - Eating disorders are not serious

“Eating disorders are serious and complex mental health conditions with one of the highest mortality rates of all mental health conditions,” says Jennings.

Eating disorders not only result in a severely impacted quality of life but also have a high mortality rate. Along with serious complications from starvation, purging, binge-eating and over-exercise, suicide is also common.

“In a general sense, eating disorders are experienced as disturbances in eating habits and are accompanied by physical and emotional distress,” says Jennings. “They can lead to a deterioration of physical and psychological wellbeing, and ultimately can cause death. Early intervention in eating disorders greatly improves the outcome. It is important to note that recovery is possible: with the appropriate treatment and support, a person can begin to live in a way that is not governed by the eating disorder.”

5) Myth - Eating disorders are all about food

“An eating disorder is not primarily about food,” says Jennings, “this is one part, and it is how the emotional distress and turmoil manifests itself”.

While eating disorders potentially involve an unhealthy focus on calories, image or weight, the misconception that it is all about food sidelines the biological, sociocultural and psychological aspects of the condition. Eating disorders are about much more than food. The behaviours of eating disorders, such as binging, purging, over-exercising and restriction are often centred around control, which encourages the misconception that it is about food. Those who don’t understand believe they are supporting a loved one by enticing them to simply eat more or less.

“Eating disorders affect every aspect of a person’s functioning,” says Jennings. “The person’s thoughts become distorted, irrational and extreme. These distorted thoughts and ideas in turn encourage, trigger and influence the disordered behaviours. When a person’s behaviour and thinking becomes distorted, this causes emotional distress and chaos. In addition to this, eating disorders develop due to underlying emotional distress or turmoil of some kind, so entangled with the other aspects is the emotional wellbeing, or emotional distress the person is experiencing.”

Myths Series

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Geraldine Walsh

Geraldine Walsh

Geraldine Walsh, a contributor to The Irish Times, writes about health and family