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10 Truths About Eating Disorders from Someone Who Had One

At some point in their lives, 20 million women and 10 million men will develop an eating disorder. Yet considering how common they are, plus all the media attention they get (props to celebs like Demi Lovato and Kesha, who’ve gone public with their own personal struggles), there’s a scary amount of misinformation out there about anorexia, bulimia, andbinge eating disorders—the three types clinically recognized by psychologists.

Ilene Fishman, licensed clinical social worker and therapist based in New York City, has spent her career helping people understand the facts and following new research and science on them. Fishman herself successfully beat anorexia and bulimia as a young adult, and she knows firsthand the physical and emotional tolls they take. Here, she lays it all out.

1. Eating Disorders Aren’t Just a Teenage Girl Thing

“Up until recently, eating disorders were thought to affect mainly female adolescents. But now we know that people of all ages get them. Adult women can develop them and men as well. There’s so much pressure these days not just for women to have a thin, idealized body but for men to have one, too. For men, there is pressure to be muscular and have low body fat, but treatment for men is harder to find.”

2. They Consume a Person’s Life
“That’s the basic definition of an eating disorder—your life is reduced to what you can and can’t eat. Day-to-day life revolves around food and meals, eating and/or purging or taking laxatives, or excessive exercise in some cases. Eating takes over your mood, thoughts, and behavior.”
3. They Have One Underlying Trigger
“People with eating disorders tend to be attractive, bright, and high-achieving. But there’s one underlying trait that needs to be there for the disorder to stick: low self-esteem. If you don’t feel good about yourself, you are susceptible to the pressure to be thin or muscular. Seeing images of idealized bodies plays a part. But a person needs to have a bad self-image in the first place for a disorder to take hold.”
4. Clean Eating Can Be a Warning Sign
“Having an eating disorder goes beyond a preoccupation with dieting or eating compulsively in one sitting. The whole trend of eating clean can mask one. Eating disorders are a preoccupation with food and eating, so if you follow a clean or organic diet and that leaves you restricting your intake, that can also signal an eating disorder.”
5. Excessive Exercise Can Also Be a Clue
“For some sufferers, their eating disorder is less about what they do or don’t consume but an obsession with burning it off. It could be about going to the gym all the time or doing marathons. The key to crossing the line into a disorder is when it becomes extreme.”
6. Excessive Thinness Is Not Always a Symptom
“Thinness doesn’t mean someone has an eating disorder. While people who suffer from anorexia tend to be extremely thin, that’s not true for all disorders. People with bulimia, who purge food after eating, can be of normal or average weight. And those with binge eating disorder, which is characterized by consuming a lot of food in one sitting and then making up for it by restricting eating at other times, are also average weight.”
7. They Can Kill
“Of all mental health illnesses, eating disorders have the highest fatality rate. Part of that has to do with the fact that they tend to go hand and hand with depression and mood disorders, and these may lead to suicidal thoughts. But also, they take a physical toll on the body. The heart issues, dehydration, digestive problems, and other health consequences can all be lethal.”
8. Treatment Works—but Can Take a Long Time

“When I was struggling with anorexia and bulimia as a teenager and young adult, not much was known about treatment. It took 10 years and several hospitalizations to finally get the psychotherapy that helped me beat both disorders. Today, people struggling with an eating disorder can start getting psychotherapy during in-patient treatment at a hospital or on an outpatient basis. The point is to address the underlying self-esteem issues. Psychotherapy can take a long time, even many years, but it can result in a full recovery.”

9. Don’t Second-Guess Yourself if You Suspect a Friend Has One

“Considering that her life might be at stake, don’t be afraid to voice your concerns, even if you think it will upset her. When you’re alone with her, be direct and say, ‘I’m worried about you’ or ‘I don’t want to jeopardize our friendship, but I want to help you get help.’ Eating disorders can bring on intense feelings of shame, and she also might be relieved to share her secret.”

10. But Don’t Be Surprised if He or She Denies It

“If she blows you off or reassures you that she’s fine, bring it up again at another time. Text her the URL of a website like the National Eating Disorders Association (NEDA) or offer to go with her to a support group.”

Women’s Health