Anorexia Affects People in All Bodies
Mainstream media’s representation of eating disorders lacks diversity on countless fronts. Generally, eating disorders are seen as illnesses that only thin, white, wealthy women struggle with. This flawed narrative regarding people with anorexia perpetuates the harmful stereotypes about individuals with anorexia.
By: Samreen Khan
However, people of all body types, backgrounds, races, and socio-economic statuses can struggle with anorexia, regardless of weight, size, or shape. The dangerous rhetoric that all anorexic patients are “underweight” prevents many individuals from seeking treatment and recovering.
Clinically speaking, two types of anorexia are outlined in the DSM-5, a diagnostic tool published by the American Psychiatric Association, anorexia nervose and atypical anorexia. The criteria for diagnosing anorexia nervosa and atypical anorexia nervosa are very similar with one striking difference: people with atypical anorexia nervosa are not "underweight" according to the problematic BMI scale.
Unfortunately, both societally and medically, weight is seen as an indicator of how severe a person’s eating disorder is. Yet studies show that a third of patients admitted for ED treatment are diagnosed with atypical anorexia. Despite these high statistics, anorexic patients at higher weights are commonly, wrongly perceived as “less anorexic” than their thinner peers.
Unfortunately, a person’s body size plays a key role in how easy or difficult it may be to seek and receive treatment. Finding care as a person in a bigger body with anorexia can be challenging. Even in inpatient and outpatient programs, many medical professionals trained in eating disorder treatment (such as nutritionists, dieticians, therapists, etc.) harbor biases against patients in larger bodies that result in these patients not receiving the care they need. Without compassionate and holistic care, they can be given restrictive meal plans and exercise routines that are often reminiscent of their anorexic habits.
Reaching out for help when struggling with an eating disorder is terrifying enough. But seeking treatment and then being told that you are undeserving of it because you are not at a low enough weight is not only invalidating but also life-threatening. This kind of rhetoric is exactly what the eating disorder’s voice can preach. Those with anorexia who are denied treatment because they do not “look anorexic” experience the same dangerous negative health outcomes that their smaller counterparts suffer from due to their ED, which impacts their hearts, digestion, menstruation, and bones. Those who do not meet the weight criteria for anorexia nervosa are often denied care that will nourish and heal them.
Ultimately, anorexia is an eating disorder, not a weight disorder. Anyone can develop abnormal, disordered eating habits, regardless of weight or size. It is necessary to understand this to support and advocate for your loved ones who may be silently struggling and feel like they cannot speak up for fear of being invalidated. Likewise, this understanding can help people with eating disorders seek treatment, no matter their size. Eating disorders, including anorexia, have no singular “look” that defines their existence.
At BALANCE eating disorder treatment center™, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. In addition to our full-time Day Treatment Program and Weeknight Intensive Outpatient Program, we offer high-quality programming, nutrition counseling with a licensed dietitian, meal support, and various other groups and resources to help those seeking help for food concerns.
Click here to watch BALANCE’s Anorexia in All Bodies Webinar with BALANCE Founder & CEO Melainie Rogers (she/her), dietitian Quinn Haisley (she/they), and Founder of the Lovely Becoming, Mimi Cole (she/her).
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This post was written by BALANCE Blog Contributor, Samreen Khan (she/her/he/him).
Samreen is a high school graduate with an ardent drive to de-stigmatize mental illness and eating disorders. Born and raised in the Bay Area, she experienced the harmful effects of “fitspo” culture firsthand for most of her childhood. Throughout her own recovery journey, she became passionate about deconstructing diet culture and raising awareness about eating disorders in her everyday life. Samreen began extending her own ideology of intuitive eating and body neutrality to others by publishing her own writing online when she was fourteen, and has since received several awards for her prose and poetry. She has conducted research on the biological and evolutionary implications of familial mental illness, and is currently taking college-level Sociology and Psychology courses with hopes to delve further into the social and cultural constructs that bolster disordered eating, especially within marginalized communities. She’s grateful for the opportunity to combine two of her strongest passions — writing and mental health — by working with BALANCE!
References
Harrop, Erin N. “Typical-Atypical Interactions: One Patient’s Experience of Weight Bias in an Inpatient Eating Disorder Treatment Setting.” Women & Therapy, vol. 42, no. 1-2, 31 Dec. 2018, pp. 45–58., https://doi.org/10.1080/02703149.2018.1524068. Accessed 12 Apr. 2022.
Leigh, Suzanne. “Anorexia Nervosa Comes in All Sizes, Including plus Size.” UC San Francisco, UCSF, 13 Apr. 2022, https://www.ucsf.edu/news/2019/11/415871/anorexia-nervosa-comes-all-sizes-including-plus-size.
Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 19, DSM-IV to DSM-5 Anorexia Nervosa Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t15/