Updated: Oct 16, 2021
Trigger warning: The following includes mention of eating disorders, food insecurity, and body image issues.
Eating disorders are the second deadliest mental illnesses. The conditions are responsible for 10,200 deaths each year — or one death every 52 minutes. A study published by Harvard University shows that 28.8 million Americans will have an eating disorder in their lifetime, and eating disorders affect at least 9% of the worldwide population. According to the National Eating Disorder Association, up to 70 million people, both male and female, suffer from eating disorders.
Over the years, there has been a rise in eating disorders, especially among young children. Experts believe that media and global westernization are potential causes for the increase in eating disorder cases. The numbers are especially alarming for younger children — the average onset age for eating disorders is steadily decreasing. In the 1970s and 1980s, anorexia was regarded as a disorder of upper- and middle-class women. Now, the peak age for the onset of eating disorders is 14 to 18 years.
Types of eating disorders and symptoms
There are three major types of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder.
First, anorexia is an eating disorder characterized by a usually abnormally low body weight, an intense fear of gaining weight, a distorted perception of weight, an obsession with calorie control and dieting, or both The best-known contributor to anorexia nervosa and other eating disorders is body dissatisfaction. Body dissatisfaction can turn into body dysmorphia, a mental health disorder in which one can’t stop thinking about a perceived defect(s) in their appearance. People with body dysmorphia can become obsessed with ‘perfecting’ their body image by any means necessary.
People with anorexia may control calorie intake by vomiting after eating or misusing laxatives, diet aids, or diuretics. They may also try to lose weight by doing excessive extraneous exercise. No matter how much weight is lost, individuals with anorexia continue to morbidly fear and do not stop their unhealthy methods barring weight gain.
According to a study published by Arch Gen Psychiatry, anorexia patients are more likely to die by suicide than the general population. The disorder has the highest death rate compared to other eating disorders. Only one-third of anorexia patients receive adequate treatment for the illness. Even after patients enter the recovery phase, a slew of physical problems may remain behind. These include insomnia, dizziness, thinning of hair, absence of menstruation, dehydration, abnormal heart rates, and more.
Second, bulimia nervosa attributes extensive eating in a specific period. During a binge period, an individual with bulimia may feel that they cannot control how much or how fast they are eating. Often, people with bulimia continue eating until they’re painfully full. Afterward, bulimic individuals attempt to purge to compensate for the calories and carbohydrates consumed and relieve gut discomfort.
Many of the mental and physical symptoms of bulimia coincide with those of anorexia. The only difference between the two disorders is the binge period that is only present in bulimia. It is estimated that 4% of females in the U.S. will have bulimia; it’s also estimated that 3.9% of those women will die from the disorder.
Lastly, the most common eating disorder in the U.S. is binge eating disorder. Individuals with this disorder have symptoms similar to those with bulimia. People with this disorder eat unhealthy amounts of food in short time frames without any control. The difference between bulimia and binge eating disorder is the purging characteristic. People who binge eat don’t restrict calories or take measures to compensate for their binges.
People with binge eating disorders are often overweight or obese, which may increase their risk of medical complications linked to excess weight, such as heart disease, stroke, and type 2 diabetes.
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder that is not as common as the previous three. It’s characterized by disturbed eating either due to a lack of interest in or distaste for specific smells, tastes, colors, textures, or temperatures.
Orthorexia is a disorder that entails an unhealthy obsession with “clean eating.” While not officially recognized by the current DSM as a psychological disorder, it falls under the label of “Other specified feeding or eating disorders” (OSFEDs).
Individuals with both these disorders may not reach a normal caloric intake due to cutting out certain foods or food groups. Both disorders may eventually lead to symptoms associated with anorexia or bulimia. Any other eating disorders that don’t fall into those described by the current DSM are categorized as OSFEDs.
Who can have an eating disorder?
For the longest time, eating disorders were thought to be a ‘white woman problem.’ This label’s earlier reasoning was that the media portrayed all white women as tall and thin and black women having ‘real’ bodies. Therefore, since the images broadcasted on television and billboards showed thin white women, young white females became conditioned to reflect the society-desired image. Thus, throughout history, eating disorders have been associated with the young white girl archetype.
However, newer research shows that eating disorders and body image issues are also prevalent among Black, Indigenous, and People of Color (BIPOC). Because the standard eating disorder ‘image’ is of white females, people of color – especially African Americans – are significantly less likely to receive help for their eating issues. Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior.
BIPOC with self-acknowledged weight and eating concerns are significantly less likely than white participants to be asked by doctors about eating disorder symptoms, despite similar rates of eating disorder symptoms across ethnic most groups. A study conducted in 2006 by Kathryn Gordon, Marissa Brattole, LaRicka Wingate, and Thomas Joiner Jr. examined doctors’ responses to case studies demonstrating disordered eating symptoms in multiple races.
When presented with identical case studies demonstrating disordered eating symptoms in white, Hispanic, and Black women, clinicians were asked to identify if the individuals’ eating behavior was problematic. The case study revealed that 44% identified the white woman’s behavior as problematic, 41% identified the Hispanic woman’s behavior as problematic, and only 17% identified the Black woman’s behavior as problematic. Additionally, the clinicians were also less likely to recommend that the Black woman should receive professional help.
In addition to medical professionals holding biases that may hinder BIPOC and LGBTQ+ people from receiving a diagnosis or proper treatment for a disorder, people with naturally larger body types and figures are also looked at as being unlikely candidates for eating disorders. People in larger bodies are half as likely as those at a “normal weight” or “underweight” to be diagnosed with an eating disorder.
Currently, less than 6% of people with eating disorders are medically diagnosed as being “underweight. Often, when naturally medium-sized or larger individuals start losing weight, they are more likely to be praised or be shown concern if they look sizeably smaller than usual. This makes it more difficult for these people to be taken seriously when they show signs of disordered eating or improper relationships with food.
Reasons for increased numbers in eating disorders
In the 1970s, researchers noticed that the number of eating disorder cases in Japan was on the rise. Alongside Japan, other Eastern countries were dealing with an influx of individuals with eating disorders. A study published in 2015 by Kathleen Pike and Patricia Dunne to the Journal of Eating Disorders attributed this to the westernization of beauty, television, social media as well as urbanization of Asia. Until now, Japan has the highest rate of eating disorders, followed by Hong Kong, Singapore, Taiwan, and South Korea. This coincides with the high suicide rates that many of these countries house, as well.
As aforementioned, the average age for developing an eating disorder has steadily decreased. Transnational media and social-media-use have become a commonality in today’s world. Children of all ages now have easy access to social media of all kinds. Unfortunately, children are also highly susceptible to outside influences. Seeing a specific type of body or a particular lifestyle on social media can convince a child that it is a norm.
Researchers point to the media’s obsession with the ‘ideal body’ and ultra-thinness. According to the Anorexia Nervosa and Related Eating Disorders (ANRED), children in the U.S. watch on average 21 hours of television in one week, not counting other forms of screen time, which can account for changing perceptions of the ideal body image or body shape.
As growing as the body positivity social movement is, the media’s fixation on the white, tall, and thin white body still remains. Eating disorders are still as prevalent as ever in today’s day, especially during the COVID-19 lockdowns. Calls to the National Eating Disorders Association (NEDA) hotline increased 70-80% in recent months. A survey in the International Journal of Eating Disorders in July found 62% of people in the U.S. with anorexia experienced a worsening of symptoms as the pandemic hit.
“We know that eating disorders have a strong link to trauma,” says Claire Mysko, CEO of NEDA. “Many people with eating disorders have past experiences with trauma, and this [pandemic era] is a collective trauma.”
Throughout the world, the rate of eating disorders is rising. This will not change unless mass media shifts its focus away from the linear example of ‘the perfect body’ and begins outwardly promoting bodies and figures of all shapes and sizes.
Through Teen Lenses: Eating disorders have become a lot more common in recent years. Why do you think that is? What factors do you think contribute to this? And what measures should be implemented to keep peoples’ relationship with food a healthy one and help people recover?
“With the rise and prominence of social media, fitting in and having a certain body image that fits societal standards is pertinent now more than ever. Everyone trying to assimilate into a certain image leads to self-doubt and negative relationships with food. Reaching a level of contentment with your image is key and the pillar in having a healthy relationship with food. It starts from within, fueling your body with whatever it desires, and listening to its needs. Our bodies do so much for us, so it’s okay to indulge healthily. Move your body every day, eat whole foods, get rest, and listen to your body!” Kheira Bekkadja, Senior at Edison High School, Alexandria, Virginia
“We’ve been introduced to impossible beauty standards from a young age. Social media is a breeding ground for insecurity; the bodies of celebrities and fitness influencers hold young people to standards that can be incredibly damaging. Businesses capitalize upon these insecurities; diet culture is not a new concept. Social media has allowed diet culture to become even more prevalent and accessible. If I had a dollar for every time I saw an “eat this, not that!” post on my Instagram explore page; I’d be as rich as the diet companies are. Additionally, the glamorization of mental illnesses has become exceedingly common. People toss around terms like “manic episode” and “panic attack” without fully understanding the gravity of these problems; eating disorders are not excluded from that. Saying things like “Wow, I forgot to eat breakfast today! I only eat like one meal a day” makes eating disorders seem like simply forgetting a meal when in reality, they can be a completely soul-crushing experience. Social media isn’t inherently negative. I’ve found that seeing others overcome the obstacles that I currently face inspires and motivates me to recover. To anyone struggling with their relationship with food and their body, I recommend a full social media cleanse: unfollow anyone who makes you feel less than worthy or guilty about how you eat/look. It is so freeing to remove those influences. When it specifically comes to improving your relationship with food, deleting calorie counting apps is always a good place to start, or just trying to remove the idea of food being a number from your mind. Removing the guilt our society attributes to food is really important. Terms like “cheat day” and “clean eating” make food out to be a negative or positive thing, but food has no moral value! Removing the stigma around eating disorders may encourage people struggling with them to seek help without fear: Disordered eating is something we cannot always control. Eating disorders are not limited to looking or acting a certain way: they affect people in countless ways, and raising awareness about that so that we can remove the stigma around this topic is important.” Isabelle Anderson, Senior at Edison High School, Alexandria, Virginia
“Some significant factors are social media, beauty, fitness, and/or fashion standards. Adolescents are frequently exposed to picture-perfect “healthy” standards, and because we’re at an age where we’re sensitive about our physical appearance, we’re, subconsciously or otherwise, drawn to fit into these ideals. The first step to having a better relationship with food would be to understand that food is for our health and that all the trendy diet plans prevalent on the internet are not suitable for everyone. We need to defy standards set by society and embrace our bodies as they are. It’s a long process which can’t be solved with a few words.” Arpa J. Wahid, Senior at Bangladesh International School, English Section, Riyadh, Saudi Arabia
“Eating disorders have become increasingly common due to the rise of social media and unrealistic beauty standards. Diet control products have been pushed more than ever, which makes people, particularly women, conclude that they have to lose weight. Some solutions to this might be platforms on which awareness is spread. Doctors and pediatricians need to be informed and prepared for the influx of kids and women with eating disorders. Advertisers should also portray a more realistic image of women in the media.” Tamam Hammad, Freshman at Northern Virginia Community College, Loudon, Virginia