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Many people with eating disorders don't seek treatment because they are embarrassed, or because they think their problems are unique, or because they don't think there's a problem. Treatment saves lives. Here are 10 things to know about eating disorders.

Experts tell us that 30 million people in the United States live with some kind of eating disorder. Epidemiologists estimate that the world-wide incidence of eating disorders is closer to 70 million people. An eating disorder can be a profound personal burden, but it's nothing to be ashamed of, and there is help.

Here are 10 facts that may bring the reality of eating disorders and the reasons to hope to overcome them closer to home.

Eating disorders affect all ages, all races, and all sexes all over the world

When American researchers analyzed the records of 35,000 people who had eating disorders, their data challenged some long-held assumptions. Researchers found that:

  • Women and girls are more likely to have eating disorders than men and boys, but only slightly.
  • People of northern European descent are more likely to have eating disorders than people of African, Asian, or Hispanic descent, but only slightly.
  • Eating disorders can occur at any age, not just in adolescence. 
Even people who live in countries that have food distribution challenges may develop anorexia. At any given time 0.3 to 1.0 percent of women and 0.1 to 0.3 percent of men live with the condition. Up to 3.7 percent of women develop the condition at some point in life.

Parents have tremendous influence over the way children experience eating disorders

Children who have eating disorders typically have periods they would rather just forget about their problem and go out and play. Researchers have found that pursuing happy activities is normal even for children who have eating disorders, unless parents are constantly nagging their children to eat more or eat less, exercise more or avoid exercising too much. The researchers found that it was the parents' attitudes that had the most to do without how much the children suffered from their condition, not the children's attitudes. It's important to accept the reality of eating disorders, but it is also important to avoid catastrophizing about them.

The kind of eating disorder you develop has a lot to do with the people around you

Sometimes an eating disorder, especially in a young person, develops in response to emotional pressure from families and friends. Anorexia is a relatively frequent challenge for young women pledging college sororities. It is also more common for dancers, actors, skaters, runners, models, wrestlers, flight attendants, and gymnasts. Binge-eating disorders are about three times as common in teenagers who are bullied by families and peers for their eating habits. The people with whom people living with eating disorders interact have tremendous influence for either good or ill.

There are millions of teenagers who 'don't quite' have an eating disorder

Researchers at Harvard Medical School and University College London have found that up to four and one-half times as many teenagers have "sub-threshold" levels of eating disorders as have full-blown eating disorders. In any given 12-month period:

  • 0.2 percent of teenagers in the US and the UK will be diagnosed with anorexia nervosa, but
  • 0.9 percent of those teenagers will be found to have "sub-threshold" anorexia nervosa.
  • 0.6 percent of teenagers in the US and UK will be diagnosed with bulimia nervosa, but
  • 2.0 percent of those teenagers will be found to have "sub-threshold" bulimia nervosa or a binge-eating disorder.

Porn can be a problem for people who have eating disorders

But not necessarily for the person who views the porn. Women who are partnered with men who regularly watch pornography tend to wonder "Why is he doing this?" and sometimes respond by inappropriate efforts to look like the women they see in social media. (These women typically do not watch the porn to compare themselves directly.) Researchers at Ohio State University found that when women were married to men who watched more than an hour of porn per day:

  • 3.1 percent started vomiting after eating.
  • 3.7 percent began binge eating.
  • 4.7 percent became preoccupied with their body fat.
  • 4.7 percent reported feeling guilty about eating.
  • 5.1 percent reported they were preoccupied with food.

Short-term eating disorders are very common among patients in hospitals

Dr Andrew Dunn of the Mt. Sinai Hospital System in New York City reported a study that found that one-third of hospital patients eat less than one-quarter of the food on their trays even when they were permitted to eat. Patients who did not eat at all were six times more likely to die during their hospital stay.

Food insecurity is a cause of binge-eating

Binge-eating rates are unusually high among people who don't have secure access to food. These would be people whose food money runs out before the end of the month, and people who live in "food deserts" where it is not easy to find healthy food for purchase. Or they may have to "stretch" their food by adding sugar, starches, chips, noodles, rice, or instant potatoes to add bulk and calories.

People who live with food insecurity are up to four times more likely than average to have a binge-eating disorder, a study led by Grace Rasmusson at the Yale School of Public Health found. Doctors usually think of binge-eating as the result of self-imposed dieting, but it can also result from simply not having enough money to buy food regularly.

Obesity surgery is more successful for people who have certain eating disorders rather than others

Bariatric surgery isn't a cure for an eating disorder. It is a way to enforce portion control so that weight loss becomes more nearly automatic. A study published in the journal Obesity reported that weight loss surgery often helps people with eating disorders lose finally lose weight, but that the longer a person has been obese, the less likely weight loss surgery will be successful. The people who lose the most weight after weight loss surgery tend to be diabetics who also have an eating disorder.

Before adolescence, boys are just as likely to have eating disorders as girls

After puberty, girls are three to ten times more likely than boys to develop eating disorders. But there are no sex differences in the rates of eating disorders of pre-pubescent children in the United States.

Don't fail to seek help for behavior in a child that seems to be caused by an eating disorder just because the child is a boy.

Scientists are beginning to believe that eating disorders may be related to taste bud deficiencies

Just about everybody likes sweet foods, but not everybody can taste sweetness. When researchers tested volunteers by giving them drinks to rate for sweetness, they found that those who had the least ability to taste sugar actually consumed more sugar — 12 pounds (about 5.5 kg) of sugar per year. Researchers believe that future treatments for eating disorders may include taste bud rehabilitation, enabling people to get more enjoyment from less food.

  • Preti A, Girolamo Gd, Vilagut G, Alonso J, Graaf Rd, Bruffaerts R, et al. The epidemiology of eating disorders in six European countries: results of the ESEMeD-WMH project. J Psychiatr Res. 2009 Sep. 43(14):1125-32.
  • Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents: results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry. 2011 Jul. 68(7):714-23.
  • Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet. 2010 Feb 13. 375(9714):583-93.
  • Photo courtesy of SteadyHealth

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