When Disordered Eating Isn't About Weight
By Alexa Noel Dyrness, AdiosBarbie.com
June 24, 2018

It's Easy to be Biased…

Stereotyping and the stigmatization of disordered eating is ever present in today's society. Recently, I asked a couple of my friends: "What comes to mind when they think about eating disorders?" What I found was a common theme-a picture of the underweight anorexic woman. A woman who looks extremely thin. A woman who restricts her food intake with the purpose of losing weight. A woman who places her body image over her health.

As humans, we naturally seek to make sense of things through social categories. And although there are benefits to this process, social categorization can lead to stereotypes that limit our perspective. Recently, I caught myself jumping to this same anorexic stereotype.

I was out to dinner with a lifelong friend and noticed that my friend was looking quite thin-to the point where she looked underweight. When we were eating, I noticed that she was not eating much. My mind immediately went to the anorexic stereotype of someone who must care deeply about their body image. But the thought that she may be struggling with anorexia also surprised me. She was not someone who ever commented on her appearance and seemed confident in herself.

I was making biased deductions from my observations, past experiences, schooling, and through media exposure. Personally, I have had my own struggles with disordered eating and engaged in binging and purging that stemmed from body image issues. As someone who has struggled with an eating disorder, I thought that I had a pretty solid understanding that disordered eating stemmed solely from body image issues. But, I turned out to be wrong.

One Person's Experience
I asked my friend about her weight loss and she began to tell me about her relationship with food. It concerned me. It was not a struggle that stemmed from body image. It was not a struggle to be thin and desirable. But, rather, she described to me that her weight loss and lack of eating was rooted in a deep anxiety around consuming food that is poisonous or unhealthy.

My friend was diagnosed with Hashimoto's disease, a thyroid condition, in her teenage years, and since then she has engaged in a long struggle of trying to maintain healthy hormone levels through varying methods. My friend noted that certain diets have been found to be helpful for the condition and those diets are what kick started her fears around food. She shared her experience of being consumed with eating the right way for her health and it snowballing into intense anxiety that now influences her daily functioning.

After having this conversation with my friend (and providing her many referrals to get help), I reflected on my own reactions and understanding of where disordered eating stemmed from. I began doing research to better understand what my friend was going through and what I could do to help.

Exploring New Possibilities
What I found was that there are people who suffer from extreme forms of food phobia, cibophobia, and those who have Avoidant/Restrictive Food Intake Disorder (ARFID). It appears that cibophobia can lead to ARFID. ARFID is a relatively new mental health diagnosis that appeared in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). ARFID is an eating disorder that manifests in avoidance of certain foods and insufficient nutritional/energy needs. It can lead to significant weight loss, nutritional deficiency, and interfere with daily functioning. There are many ways that ARFID presents – from fear of harm to animals to fear of choking. These fears lead to restricting or avoiding foods that are relevant to the fear itself.

ARFID is an eating disorder that has nothing to do with body image. And yet I had thought that body image was a core aspect of eating disorders. My mind was blown. This made me reflect on my own ways of categorizing things, making assumptions, and how I can continue to strive to increase my perspective and acknowledge my bias around the world around me.

In my research, I came across other forms of disordered eating that do not stem from body image. For example, some find deprivation of food to be a way of feeling alive. Disordered eating can also be a symptom of severe depression. The point is that there are many reasons that may lead to disordered eating – not just a problem with body image.

Having an Open Mind
Ultimately, my friend is going through a similar struggle to mine with my own disordered eating. We both had fear. She is fearful of poison, while I was fearful of fat. Our relationships with food have caused us great distress and negative health consequences. But I was too quick to assume that her issue must have been a body image issue, as that was my experience. It's important to note that eating disorders serve a purpose: they are used as an unhealthy coping mechanism for dealing with underlying issues.

It was an excellent reminder that my experience is not everyone's experience. My hope is that I can continue to open my mind, to make fewer automatic assumptions about people, and to encourage others to do the same by reflecting on their bias. Just because someone has struggles with food, it does not mean that they have a problem with their body image or size.

If you or someone you love is struggling with disordered eating, feel free to call the National Association of Anorexia Nervosa and Associated Disorders (ANAD) helpline at 1 (630) 577-1330 (Illinois) or text the word HOME to 741741 (Crisis Text Line available 24/7).

The point is that there are many reasons that may lead to disordered eating - not just a problem with body image.