Ending Stigma and Stereotype: National Eating Disorder Awareness Week

Photo courtesy of PsyCom.

We at The Oracle want to begin this week’s editorial with a trigger warning. If reading about disordered eating or any topics associated with it might trigger you, please do not continue reading. 

If you are reading this editorial the day it is published (or anytime from Feb. 21-27) you are reading this editorial in the midst of National Eating Disorder Awareness (NEDAwareness) Week. If you aren’t, no worries. Eating Disorder awareness, as you will soon find out, has a place any time of the year; it is a pervasive and misunderstood issue in university and everyday life.

According to the National Eating Disorder Association (NEDA) website, “National Eating Disorders Awareness Week (NEDAwareness Week) is an annual campaign to educate the public about the realities of eating disorders and to provide hope, support, and visibility to individuals and families affected by eating disorders.”

Eating disorder awareness is needed more now than ever. According to NEDA, 28.8 million Americans will experience an eating disorder at some point in their lives. Further, they state that every 52 minutes, someone dies as a direct result of an eating disorder. Recent studies highlight that eating disorders have only increased since the COVID-19 pandemic, potentially making these numbers even more grim.

But eating disorder awareness must extend beyond these broad statistics. Eating disorders are highly stigmatized illnesses and highly stereotyped to boot. Most people’s image of someone with an eating disorder is female presenting, young, underweight, white and of high socioeconomic status. How could it not be? Our society has been inundated with this “anorexic stereotype” since the 70s, focusing on A-List celebrities such as Karen Carpenter, Portia De Rossi and Mary-Kate Olsen.

These celebrities certainly had very real, very valid and very severe eating disorders, but focusing on these stories exclusively only paints one image of how an eating disorder may present.

Eating disorders affect people of all genders, all ages, all body types, all races and ethnicities at all income levels. While the media have effectively portrayed a single cause for eating disorders (wanting to be thin at all costs), eating disorders have no one cause and arise as the product of many genetic, environmental and psychological factors, according to Mayo Clinic. This is not to discount the very real social factor that is our society’s unrealistic beauty standards.

“Black teenagers are 50% more likely than white teenagers to exhibit bulimic behavior such as binging and purging,” the NEDA website read. Although recent studies highlight that rates of eating disorders are similar among whites and people of color, the same studies show that people of color are significantly less likely to receive treatment or help of any kind. 

Further, “In one study of ultra-Orthodox and Syrian Jewish communities in Brooklyn, 1 out of 19 girls was diagnosed with an eating disorder, which is a rate about 50 percent higher than the general U.S. population (Sacker, 1996),” NEDA states in their collection of statistics.

Transgender people are also at a signifigantly higher risk of eating disorders than cisgender people and eating disorders are of statistically significant higher prevalence in Queer communities than non-Queer communities.

For people in larger bodies, eating disorder treatment is especially hard to come by. Many people do not realize that oftentimes, someone with a diagnosable, restrictive eating disorder is not underweight (directly contradicting a common stereotype). In fact, many people with restrictive eating disorders are a normal weight or even overweight or obese. Unfortunately, even for people in larger bodies that find the courage to seek treatment despite this stereotype, many are referred to weight-loss programs which only serve to exacerbate the eating disorder. This is also invalidating and dangerous because that referral turns the eating disorder from a mental health issue into a weight issue, which it is not.

Eating disorders (and subclinical levels of disordered eating) run rampant on college campuses. Based on Mayo Clinic’s causes for eating disorders paraphrased above, this sad truth is not hard to comprehend. Not only is college a time of rapid change and adjustment, it is also a time of unique and intense academic, social, financial and romantic stress for many students.

While campuses like SUNY New Paltz do a relatively good job of making mental health resources available to students, without proper education and awareness of eating disorders directed towards the entire student body, stereotypes and stigmas are at serious risk of blocking students from recognizing an eating disorder in themselves or in their peers. One cannot obtain help for themselves or for a friend if they don’t know that they or their friend have a problem.

A prime example of under-recognition for eating disorders is in student athletes and male presenting student athletes in particular.

“In a study of 204 female college athletes from 17 sports at 3 universities, 2% were classified as having an eating disorder and another 25.5% exhibited symptoms . . . ,” read one collegiate survey. A glaring oversight here is that male identifying athletes weren’t even surveyed.

“Males represent 25% of individuals with anorexia nervosa, and they are at a higher risk of dying, in part because they are often diagnosed later since many people assume males don’t have eating disorders,” according to NEDA statistics.

Regarding athletes, many sports such as men’s wrestling, volleyball, track, cross-country and bodybuilding endorse practices of weight loss for performance and “cutting and bulking” – periodic timeframes of weight loss and gain (not unlike yo-yo dieting) – that many experts agree is disordered and akin to illnesses such as anorexia and bulimia. However, under the guise of “sport” or “fitness” many of these disordered and unhealthy behaviors often go under the radar.

That being said, catching eating disorders early (for men and women alike) can not only save years of illness and hardship, it can save lives. 

“Based on diagnostic interview data from the National Comorbidity Survey Replication (NCS-R), median age of onset was 21 years-old for binge eating disorder and 18 years-old for both bulimia nervosa and anorexia nervosa,” according to the National Institute of Mental Health. Clearly, the above information is absolutely crucial to college aged individuals.

In addition to spreading proper awareness about eating disorders for students (so that students may spot eating disorder symptoms despite stereotypes and stigma and seek resources), universities like SUNY New Paltz must also provide easy access to food.

The Oracle has covered on several occasions the difficulty that can be dining on campus. From limited hours to limited options, an editorial from September highlights that breakfast before an 8 a.m. class (which many freshmen have) is nearly impossible: the dining hall doesn’t open until 9 a.m. (at the time of reporting, 10 a.m.) and because of this, every other option has nearly an hour wait. In that editorial we reported that one student said, “It’s like the college wants us to go to class hungry.”

In addition, this semester, food prices have increased everywhere, including campus largely in part to supply chain issues from COVID-19. However, dining dollars have not increased to match this inflation. Therefore, the dining hall is a necessary resource to many students on campus who cannot afford daily spending in on campus eateries. Multiple anonymous sources have reported that they feel the dining hall should return to prioritizing early morning hours when food on campus is scarce; many places are closed and the few open places are pricey and have unreasonably long waits.

For people with eating disorders, this is simply dangerous. On the surface, it seems obvious that for students predisposed to eating disorders, the ability and ease of skipping meals (like breakfast) is a temptation too great to resist. After all, if students without eating disorders aren’t able to eat breakfast either, this is a disordered behavior that is extremely easy to hide in plain sight.

A deeper dive into this issue is a biopsychological one, coming from eating disorder experts’ analysis of animal studies.

Some eating disorder specialists hypothesize that energy deficit (taking in less calories than one burns) may actually trigger an eating disorder in those that are genetically predisposed to an eating disorder. Thus, a few seemingly innocent meal-skips due to limited hours and options may put some students at risk of going down a disordered slippery slope.

This downward slope can and will have irreversible health impacts. Eating disorders are often glamorized, while the physical and psychological consequences are left out. There are short term impacts, like losing hair, bad breath or exhaustion. Permanent organ damage, loss of teeth and enamel, bone loss (like osteoporosis) and indigestion issues such as gastroparesis can develop from disordered eating and permanently lower quality of life. Some of these eating disorder implications can persist even after recovery.

Every year, NEDA provides their week of awareness with a theme and slogan geared towards sufferers and survivors, as well as families and allies. Past slogans have included “Come as you are,” and “Every body has a seat at the table.”

This year’s theme is “See the change, Be the change.”

“Celebrating twenty years as the National Eating Disorders Association (NEDA), #NEDAwareness Week 2022 is an opportunity to #SeeTheChange by recognizing change within the ever-evolving eating disorders field, and to #BeTheChange through advocacy, awareness, and community building,” writes NEDA.

We at The Oracle encourage our readers to advocate for change through shifting our perceptions of eating disorders away from a stigmatized and stereotyped paradigm. The more knowledge of eating disorders the general public has, the more people with eating disorders may find relief and recovery. By understanding that eating disorders are not solely to do with weight and affect people of all identities, we can start to look out for the true signs in ourselves, our peers and our loved ones.

Signs to look out for are preoccupation with food, calories and/or macronutrients; preoccupation with body size; preoccupation with exercise and engaging in compulsive, excessive exercise; obsession with “health” or “clean eating” to the point of severe and interfering food restriction; scars and bleeding of the knuckles (a signal of purging); sudden and dramatic weight changes or fluctuations (up or down); avoidance of eating meals; social withdrawal; fear of eating in public spaces and around friends; repetitive measuring of body parts (waist size, wrist size) with hands; rapidly consuming more food in a set period of time than is usual for others with similar lifestyles in similar periods of time; withdrawing to the bathroom shortly after or during meals; feeling guilty for eating or for eating without exercising; repetitive, compulsive looking in the mirror, repeatedly lifting up one’s shirt in mirror, or any other kind of “body checking” behavior. 

If you think you or a loved one may be struggling with the topics covered here, we urge you to reach out for help. If you are in a crisis and need help immediately, text “NEDA” to 741741 to be connected with a trained volunteer at Crisis Text Line. NEDA has a hotline to call (800) 931-2237, Monday — Thursday 11 a.m. — 9 p.m. ET, and Friday 11a.m. — 5 p.m. ET. Translation services are available on the phone for those who need it. This number can also be reached by text, Monday—Thursday 3 p.m. — 6 p.m. ET, and Friday 1 p.m. — 5 p.m. ET.

Recovery is not only possible, it is necessary and it is urgent.