#Don’tMiss an Eating Disorder Based on Body Size

Chevese Turner

Over 15 years ago I met a reporter writing an article on eating disorders for Time Magazine. We were both attending an event on Capitol Hill and she was looking for people to interview. We struck up a conversation and she asked me if I was there to support someone with an eating disorder. I shared that I struggled with Binge Eating Disorder (BED) and was attending the event to get involved in advocacy.

I could tell by the look on her fact that the reporter was confused. I knew she was thinking to herself, “How can this woman have an eating disorder – she is fat, not thin?” She asked me to tell her about Binge Eating Disorder and began writing a story about my journey.

I struggled with the same question about eating disorders and body size for years. I did not know anyone with the diagnosis of BED and my own impression was that people with eating disorders were either thin or very thin. Throughout my long history of eating disorders, I was sure that my relationship with food had to do with my lack of will-power. I thought my weight cycling and extreme obsession with dieting and losing weight was the expected outcome of someone who was morally defective when it came to food. Unfortunately, most of the places in which I sought help agreed with me. They could not give a fat person an eating disorder diagnosis despite meeting criteria for several through the years.

Since that time, I have met people in higher weight bodies with eating disorders – lots of them. I now understand that an eating disorder can manifest in any size body and that the stereotype of a thin, white, emaciated teen-ager is the minority in terms of who is affected by these dangerous disorders.

Why is it important to know that eating disorders do not discriminate based on body size? According to the National Eating Disorders Association (NEDA), 32 million people have an eating disorder at some time in their life. This, combined with the mortality rates that put eating disorders close to the top of the list of lives lost from mental health issues, it is critical that we recognize and treat ALL people who are in the throes of these illnesses.

Across the spectrum of eating disorders, every body type and size can be found. A person presenting with Anorexia may be in a body that is higher weight. Like-wise a person with BED may be in an underweight body and assummed to have Anorexia or Bulimia.

Most people interact with someone with an eating disorder on a regular basis and are not aware. Perhaps the person who checked you out at the grocery store has Bulimia or your doctor has BED. Maybe your friend’s son has Anorexia. In most cases, you will not be able to discern whether or not someone has an eating disorder by the size of their body.

Fortunately, I found a therapist many years ago who did not make assumptions about me or my relationship with food based on the size of my body. She listened carefully to my journey and recognized that many of my behaviors sounded like an eating disorder. She did not tell me that I needed to change anything about my shape and size. She recognized I was in pain and needed relief. She worked on the underlying issues that manifested the need for an eating disorder and helped me find acceptance around my higher weight body in a thin obsessed world. She helped me find the resilience to heal and become the advocate I am today.

It’s time for healthcare providers who are the first line to mental health disorders to be more aware of who is at risk and who may be struggling. This begins with the recognition of what someone with an eating disorder looks like: you and me.

I hope that the Time Magazine reporter that I met all those years ago would not have the same reaction if she were to meet someone in a higher weight body at an eating disorders function today. She would recognize that anyone in the room could be struggling or recovered. She would know, as she walks down the street, that she cannot discern who has an eating disorder and she would realize that she cannot make any assumptions based on body size.

By the way, that story that the reporter wrote was a very comprehensive report on eating disorders and talked at length about the many misconceptions including size. It never saw the light of day because Time Magazine’s editorial director, back in early 2000, thought it was more important to do a story on obesity since “eating disorders are a small problem in comparison.”