Open Letter to Medical Professionals

Dear medical professionals,

The way that eating disorders are treated, by society and by the medical world, is unfair. People with eating disorders are badly affected by stigma and stereotypes about their illnesses. People who don’t fit the white, underweight, anorexic girl mold are often taken less seriously than those who do.

In the United States, around 30 million people suffer from an eating disorder. Binge eating disorder is the most common, along with OSFED (other specified feeding or eating disorder), and anorexia the least common. Eating disorders have the highest mortality rate of any mental illness, with anorexia having a 10% to 20% mortality rate. A fifth of deaths by anorexia are suicides (“Statistics and Research”).

There are many groups of people who are affected by these stereotypes. One group is men and boys. Although men and boys make up one third of those suffering from an eating disorder, they are much less likely to seek treatment than women are (“Eating Disorders in Men”). This is due to the stereotype that eating disorders only affect women, and that men are weak or feminine if they suffer from an eating disorder. The mortality rate is actually higher for men with eating disorders than it is for women, because men often do not receive treatment for their eating disorders.

Also affected by this stigma are people of color. Many people think that eating disorders only affect rich or middle class white teenage girls, but in reality, eating disorders can affect anyone of any race, gender, or socioeconomic status. In fact, according to the National Eating Disorders Association, black teenagers are 50% more likely than white teenagers to exhibit bulimic behaviors, and Hispanic teenagers are significantly more likely to suffer from bulimia nervosa than teenagers who are not Hispanic. However, since eating disorders are thought to be diseases for white teenage girls, many people, including medical professionals, do not see that teenagers (and adults) of color can also struggle with eating disorders. Doctors are more likely to ask white people about eating disorder symptoms than they are people of color (“People of Color”).

There is also a very common stereotype that everyone who suffers from an eating disorder is severely underweight. In reality, the majority of those with an eating disorder are at a “normal” weight or overweight. Most people suffering from binge eating disorder, OSFED, or bulimia are not underweight. It is commonly believed that it isn’t possible to have anorexia if your BMI is not technically underweight. Even in the DSM-5, there is a weight criteria for anorexia — your BMI has to be under 17 to fit the criteria. However, it is quite possible to be suffering from anorexia but not be technically underweight. One woman with anorexia nervosa describes her experience: “I felt I needed to become more unwell to meet the criteria expected of someone with anorexia” (“You do not need to be underweight”).

This stereotype also affects me personally. Despite being diagnosed with anorexia nervosa, I often feel like my eating disorder is not taken seriously because, even at my lowest weight, I never “looked” anorexic. Despite not being underweight, my eating disorder had serious effects on my health. My hair was falling out, I was always cold, I was malnourished, and at one point I was orthostatic. I thought that I didn’t have a problem because I had gained back the weight I had lost, but the truth is, I was just as sick at my “normal” weight as I was with an underweight BMI.

I think that it’s possible to reduce stigma around eating disorders. For this to happen, the most important thing is to provide education about eating disorders. Health classes in schools should give more accurate information about eating disorders — showing that eating disorders are never the person’s fault, that you do not have to be underweight to have an eating disorder, and that anyone can struggle with one. Doctors should also have proper education about eating disorders, and should be trained to spot symptoms of eating disorders other than extreme weight loss. I think that, if medical professionals look out for different symptoms and ask questions about eating behaviors regardless of gender and race, it will help more people get the treatment they need.

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