85% of people with eating disorders are not underweight

Eating disorders and disordered eating behaviours are often assumed to belong to groups of teenage, adolescent girls who are extremely thin and avidly restricting calories. Although in part this may be true, we know that 85% of people with an eating disorder are not underweight (1) and symptoms often remain hidden. In a culture that praises weight loss, never mind the route taken to achieve the end goal, the sufferer may not even validate their struggle, seeing it as ‘normal’.


Disordered eating

Disordered eating behaviours could include:

  • binge eating
  • chronic overeating
  • purging
  • over-exercise
  • taking detox or laxative teas
  • compulsive body checking
  • extreme dieting

It’s important to recognise and name the symptoms that may be causing an individual distress, even when someone does not fit neatly into a diagnostic box.  These behaviours are disruptive to a fulfilling life. They create low mood, high anxiety, loneliness and withdrawal, and a crippling, negative body image.

It may seem obvious to say but these disordered eating patterns are not physically or mentally healthy for a human being to experience. They naturally should warrant care, understanding and support. Instead, in Western culture, they are often minimised, glossed over or simply not acknowledged as a problem. Because the person ‘looks well’.

Countless people struggle with eating issues though. Food for many of us offers distraction, numbing, escape and coping in life.

Controlling weight and shape can serve similar functions, offering a purpose and sense of power and autonomy, in an unpredictable and precarious world. It can feel like the ‘right thing to do’, when every man and his dog is intermittent fasting or experimenting with a novelty, wellness plan that promises the path to fulfilment.

It’s vital to remember that eating disorders do not belong to a distinct category of broken individuals. We are all on the eating-disorder-to-healthy-relationship-with-food spectrum, with many of us falling somewhere in the middle ground. It’s important to recognise this and offer yourself compassion and understanding, when your relationship with food has become problematic. Even when others around you do not acknowledge or appreciate this, your own experience is valid.

I invite you to reflect and ponder on your relationship with food and your body. Be curious and considerate in noticing your thoughts, behaviours and feelings. If you are genuinely experiencing distress and using food or dieting or exercise to cope, then you need to take these signs seriously. You could begin to reflect on what might be going on underneath and your deeper feelings. You could consider how and when these symptoms began, and the safety they offered you, in a period of uncertainty or trauma.

Historically, it was incredibly hard to access support for disordered eating or eating disorders, unless you met the anorexia stereotype. Sadly, many medical professionals (inadequately trained in eating disorders) minimised or ignored symptoms, leaving the sufferer confused and bewildered, not knowing where to go or what to do next, when clearly in the depths of misery.

Times are slowly changing. Thankfully, diagnoses of bulimia nervosa, binge eating disorder, OSFED, ARFID, and general disordered eating are being recognised more fully. Early intervention through programmes such as FREED is becoming widespread.

Getting support in the first three years of having eating disorder symptoms does enhance the likelihood of a full recovery. The longer you live with ed symptoms, it can be challenging to break the chronic habits and identity changes that can grow deep roots. However, it is never too late to change, whatever your age, duration of illness or life experience. 

Hold on to hope. Recovery is possible. Be kind, supportive and compassionate towards yourself. Acknowledge your struggle. Be brave and get the help that you deserve.

(1)  Fairburn and Harrison 2003

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Cambridge, CB1
Written by Harriet Frew, MSc; MBACP Accred
Cambridge, CB1

Harriet Frew is a counsellor specialising in eating disorders and body image. She has worked in the NHS and private practice since 2003, and is passionate about supporting and educating others through therapy, writing and social media.
Instagram: @theeatingdisordertherapist_; Podcast - The Eating Disorder Therapist Podcast

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