Mythbusters #1: “You Don’t Look Like You Have an Eating Disorder!”

“You don’t look like you have an eating disorder!”

“You look so healthy!”

“At least you’re not scary skinny.  I once knew a girl who was anorexic and weighed [x] pounds…”

Nope.  Nope nope nope nope.

Do not say these things to people who tell you about their eating disorders.

Here’s the reality:

(caption: “All of these people suffer from a serious, life-threatening eating disorder.”)

So let’s bust some looks/weight-related myths here, okay?

• Anorexia and bulimia nervosa are not the only two EDs, nor are they the most common.  The most common award goes to Binge Eating Disorder, followed by Eating Disorder Not Otherwise Specified (EDNOS, recently renamed “Other Specified Feeding or Eating Disorder” by the DSM-V), bulimia nervosa, and then anorexia nervosa.  There are others in the mix too, like orthorexia, pica, night eating syndrome, anorexia athletica, atypical anorexia or bulimia, purging disorder, rumination disorder, diabulimia, and more.
• Although a diagnosis of anorexia nervosa does require a certain amount of weight loss, none of the other ED diagnoses have weight as a criteria.  This leads to my next point…
• … not all bulimics are thin.  In fact, many — if not most — are of normal or even slightly over weight.
• Not all thin people are anorexic, and not all anorexics (despite the weight criteria of the diagnosis) may appear super-thin.
• Not everyone with Binge Eating Disorder (BED) is overweight.
• EDNOS, along with with any other diagnosed ED that may not manifest itself in extreme weight loss, can still be majorly life-threatening — sometimes even more so, since those who do not lose a significant amount of weight may not be as motivated to seek treatment.
• Saying “You look healthy/good/better/normal!” to someone who has admitted to having an ED may be interpreted as “You’re not very good at your ED; time to lose more weight/punish yourself some more.”  The most important thing to remember is that it’s not about looks.  You can’t judge the severity of an ED on someone’s looks, nor can you judge where they are with their mental recovery.  Compliments about their personality, their smile, or their newfound energy are much safer bets in talking to someone in recovery.
• On a similar note, early recovery for those needing weight restoration may involve bloating and general puffiness for a while as their body gets used to being properly fed and hydrated.  This makes it especially important not to remark on their looks at this time.
• If you insist on looking for outward signs of an ED, there are things like the eyes being sunken or having bags, low energy levels, cold hands/feet, dry skin, Russell’s sign, dental problems, and more… but I want to reemphasize that there’s no good way to judge an ED from a purely aesthetic standpoint.  Those of us who have dealt with it for a long time have become experts at hiding these things.

I freely admit that my recovery has involved weight-gain plans at some points.  It has also involved weight-maintenance and even weight-loss goals sanctioned by a dietician.  My ED was no less serious when I needed to lose weight than it was when I needed to gain.

I’m often asked “which” ED I had/have.  That’s not a question I like to answer, partly because my diagnosis has changed and evolved over the years and partly because it shouldn’t matter.  I look how I look, I weigh what I weigh, and I still have had a disordered relationship with food through all the ups and downs.  I also don’t want to be prone to trying to meet your expectation of what someone with my diagnosis “should” look like.

What really matters, then?  Knowing that my signature toothy grin is always genuine.  Being willing to hug me, no matter what my size is that day.  Talking about dogs or dance or God or Russia.  Walking comfortably with me on this journey rather than walking on eggshells.