What We’re Really Talking About When We Talk About Eating Disorders

anti-diet bias eating disorders end weight stigma fatphobia mental health awareness therapy Jun 02, 2025

World Eating Disorders Action Day | June 2, 2025 | Breaking Bias & Supporting Families

Let’s get this out of the way first.

Eating disorders are not about vanity. They’re not a phase. They’re not just about food. And they absolutely do not look one specific way.

On World Eating Disorders Action Day, we’re not just raising awareness. We’re raising expectations.

For what care actually looks like.
For who gets seen, heard, and helped.
For how we respond when someone is struggling.
And for what we demand from systems-not just from survivors.

The Origin of the Nine Truths

In 2014, Dr. Cynthia Bulik, PhD, FAED, the founding director of the UNC Center of Excellence for Eating Disorders, worked in partnership with the Academy for Eating Disorders and other global institutions to define and distribute the Nine Truths About Eating Disorders. These truths were created to correct the widespread myths and misinformation that keep people from getting the care they need.

More than a decade later, many of these myths still dominate how eating disorders are portrayed, misunderstood, and treated. The truths haven’t changed. But our understanding of the systems surrounding them must.

Because the conversation around eating disorders has to include fatphobia, mental health stigma, systemic bias, and the cultural forces that create the perfect storm for disordered eating.

We have a long way to go before people understand the harm diet culture and fatphobia have inflicted on our society - in conjunction with the harm other types of prejudice have had (and are still having) on every single one of us.

So we’re not just repeating the truths here. We’re updating them (just a little, because the 9 truths still hold true in and of themselves). Here’s what we actually need to be talking about when we talk about eating disorders:

You cannot see an eating disorder by looking at someone.

Many people with eating disorders appear "healthy" by society’s standards but are extremely ill.

Our culture continues to use appearance as shorthand for health and thinness as shorthand for discipline. That lie is especially dangerous because it validates restrictive, punishing, and disordered behaviors in smaller bodies while dismissing or shaming those same behaviors in larger ones.

People in larger bodies are routinely praised for weight loss at any cost. Meanwhile, people in thin bodies often suffer in silence because they already "look the part." This is not a visual problem. It’s a visibility problem rooted in fatphobia, internalized bias, and medical neglect.

If you are struggling, your body does not have to shrink before you are taken seriously.

You Don’t Have to Be Thin to Have an Eating Disorder - NEDA

Genetics matter, but they don’t tell the whole story.

There is strong evidence that eating disorders have genetic and biological roots. But biology is not fate.

Genetics create the blueprint. Culture writes the story. Environment loads the gun.

Trauma, racism, fatphobia, rigid gender expectations, toxic family systems, neurodivergence, and chronic stress shape the way biology is expressed. They are not side issues. They are the water we are swimming in.

Recovery isn’t just about nutrition. It’s about safety. And until safety is available in our bodies, our families, and our systems, those survival strategies will continue to emerge.

Trauma and Eating Disorders – Trauma Research Foundation

Eating disorders are medical illnesses. And they are deadly.

Eating disorders are the most fatal of all psychiatric conditions. That’s not a scare tactic-it’s a reality.
Medical complications. Suicide risk. Under-recognition. Marginalized care.

We need to start treating eating disorders like what they are:
Health crises.
Not choices.
Not bad habits.
Not aesthetic preferences.

People die from cardiac arrest, organ failure, and suicide. Others live for years with cognitive decline, bone loss, metabolic disruption, and social isolation.

And still, we celebrate disordered eating every day in the name of health. We praise extreme restriction, compulsive exercise, obsession with "clean" food, and dietary rigidity. We market starvation as wellness.

We call it willpower. We call it discipline. It is neither.

It is an illness. It deserves a clinical, compassionate, evidence-based response - not another motivational quote.

Eating Disorders: An Underestimated Crisis

They affect everyone.

Eating disorders don’t just impact thin, white, affluent teenage girls. They never did.
They affect men and boys. Trans and nonbinary folks. People in larger bodies. Black, Latine, Asian, Indigenous, neurodivergent, and disabled people. Queer communities. People with chronic illness. Survivors of violence and oppression.

But our systems are biased in who they screen, who they believe, and who they treat.

When we center one image of who is "at risk," everyone else becomes invisible. And invisibility can be lethal.

Bias in diagnosis and access to care means many of these folks get overlooked. Or worse-blamed.
We have to start recognizing the full spectrum of who’s impacted.
Because eating disorders are intersectional. And our care has to be, too.

Inclusive ED Care: Trans Folx Fighting EDs

Families are not the enemy.

Let’s say this louder: Families are not to blame.
They’re not perfect-but neither is our healthcare system. What families need is support-not suspicion.

Parents don’t cause eating disorders. But they are often the ones who notice first.

Blaming families for complex biopsychosocial conditions is not only outdated-it’s ineffective. Families can be an essential part of treatment if given the tools, support, and education they need.

The real problem is not overinvolved parents. It’s an under-resourced system that delays care, centers weight loss, and punishes bodies that do not conform.

When families are supported, outcomes improve. When they are shut out or blamed, healing -becomes harder. With the right tools and validation, families can be a powerful part of recovery-not an obstacle to it.

FEAST – Families Empowered and Supporting Treatment of Eating Disorders

Early detection and intervention improve outcomes.

Waiting until it’s “bad enough” is a very dangerous game.

Many people with eating disorders go undiagnosed for years. Especially those who are praised for weight loss, who live in marginalized bodies, or who show no outward signs of illness.

By the time someone collapses, the damage is often advanced. But the earlier the intervention, the better the outcome.

You don’t need to wait until it’s “bad enough.”
You do not have to wait until you're in crisis.
You do not have to be underweight to be unwell.
You do not have to justify your pain to get help.

You don’t have to collapse before someone takes you seriously.

If your relationship with food or your body feels scary, chaotic, or obsessive-you deserve support. Now.

Early intervention means better outcomes.
Better care. Less trauma. More life.

Trust your gut. Then ask for help.

Recognizing Eating Disorders Early – APA

Let’s talk about control, shame, and survival-not just symptoms.

Eating disorders are about control, shame, and survival-not just food.

Most eating disorders do not start with body image. They start with a need. Most eating disorders start as a way to cope.

They’re often rooted in:

A need for control in a chaotic world
Deep shame around identity, appearance, or worth
Trauma that was never named, validated, or healed
Emotional pain that never felt safe to express

A need for control. A need for safety. A way to self-regulate in a world that doesn’t feel safe to express emotions.
They begin quietly. They look like discipline. They feel like success. Until they take over everything.

In high-functioning adults-especially women, caregivers, healthcare professionals, and perfectionists-these behaviors are often invisible. Or worse, they are rewarded.

If you’re the one everyone depends on…
If you never let yourself fall apart…
If your eating disorder is quiet, hidden, or “disciplined”-you’re not exempt.
You’re exhausted. And you’re not weak for wanting relief.

ED behaviors are often a brilliant survival strategy in an unsafe world.
That doesn’t make them safe. But it does mean we treat the pain, not just the behaviors.

You do not need to fall apart publicly for your suffering to be real.
You do not have to explain your pain in order to earn care.

Reclaiming Body Trust – Hilary Kinavey & Dana Sturtevant

Bias isn’t just annoying-it’s dangerous.

Weight stigma. Fatphobia. Racism. Gender bias. They don’t just hurt feelings-they kill.

When providers assume that weight loss is always good, or that larger-bodied people can’t have restrictive disorders, they miss diagnoses.
When we assume eating disorders are “just a white girl thing,” we leave people suffering in silence.

Delayed diagnosis isn’t just a mistake.
It’s malpractice in slow motion.

Bias doesn’t just delay diagnosis. It distorts it.

Fatphobia leads providers to dismiss starvation in larger bodies as success.
Racism leads to misdiagnosis or no diagnosis at all.
Gender bias erases eating disorders in boys, men, trans and nonbinary people.
Mental health stigma turns suffering into moral failure.

When people are ignored, invalidated, or told to try harder, they begin to believe it.
That is not a lack of motivation. That is a trauma response.

If your pain was ignored, your restriction praised, or your distress dismissed-you didn’t fail. The system did.

Bias is a barrier. Let’s break it.

Health at Every Size – ASDAH

Recovery is possible.Recovery is real.

It’s not fast. It’s not linear. And it sure as hell isn’t always Instagram-pretty.

But it is possible.

And recovery doesn’t mean “going back to normal.”
It means building a life where food, body, and shame aren’t in charge.

It means rest. Boundaries. Nourishment. Safety. Support.
It means being able to say “I’m full” and mean it.

Sometimes it looks like finally eating lunch.
Sometimes it’s deleting the tracking app.
Or as big as saying no to another doctor pushing weight loss.
It can be messy. It can be noncompliant. It can be quiet.

And sometimes, it’s telling someone you’re not okay-before you collapse.

Recovery is not a straight line. It is not a makeover. It is not a brand.

Recovery is a process of reclaiming your life from systems that taught you to distrust your hunger, your body, and your emotions.

And it can be real.

What No One’s Saying About the GLP-1 Craze

Let’s talk about the injection in the room.

You’ve probably seen the headlines.
The celebrity endorsements.
The influencers casually mentioning their “metabolism shot.”
The doctors prescribing GLP-1 medications like Ozempic or Wegovy for weight loss-even to people without diabetes.

What’s missing? Caution. Context. Consent.

These drugs were created for diabetes. Now, they're being sold as tools for social acceptance. And the risks are being buried in the fine print.

Muscle and bone loss
Malnutrition, dizziness, food aversion
Disordered eating behaviors-sometimes extreme
Deep psychological distress in people who thought they’d found a “cure”

And let’s be honest: none of this is neutral. Especially in a culture that treats weight as a moral issue.

“If someone came in and told me they were eating under 800 calories a day and vomiting regularly, I’d treat it as an emergency. Unless they’re on Ozempic-then it’s called a ‘success story.’”

This isn’t just a medical issue-it’s an ethical one.

If you’re using GLP-1 medications like Ozempic or Wegovy and struggling with food fear or emotional numbness, you are not broken. You are caught in a system that markets malnutrition as empowerment.

You deserve more than a smaller body and a silent struggle.
You deserve care that recognizes the full human being inside the behavior.

The Wellness Trap – Christy Harrison
Fat Talk – Virginia Sole-Smith
Dances With Fat – Ragen Chastain

Naming the Real Culprits: Diet, Productivity, and Purity Culture

Let’s stop pretending eating disorders exist in a vacuum. They thrive in cultures that glorify deprivation, call it virtue, and then sell it back to us in glossy packaging.

Diet culture says control is moral.
Productivity culture says rest is weakness.
Purity culture says your body and appetite are sins that must be managed.

Together, they normalize disordered eating and shame. They turn food into punishment and self-worth into a conditional performance.

These aren’t personal failures. They are cultural indoctrinations.

Undoing them is not indulgent. It is revolutionary.

This is what support actually looks like:

Believing people who say they’re struggling
Validating the emotional roots of disordered eating
Ditching “health” advice that’s just diet culture in scrubs
Advocating for trauma-informed, weight-inclusive, anti-oppressive care
Naming shame when it shows up-and replacing it with truth

If you love someone with an eating disorder:

Learn about trauma-informed care
Get support for yourself, too-this is hard
Practice compassion over control
Remember: your job isn’t to fix them. It’s to walk with them

A Client Story (Anonymized)

One of my clients once whispered, “I’m so tired of pretending everything's OK.”

She was 43, a mom of two, a manager at a biotech firm. Highly competent. Fiercely intelligent.
No one had ever guessed she was surviving on not enough food to feed her toddler and shame.

She was constantly overperforming, taking too much responsibility, getting invalidated and used by her work and her family-and she lived in a bigger body.
Even she didn’t believe she could be a worthwhile human being and look like that. Even if she was having daily heart palpitations.
Even if she couldn’t think clearly.
Even if she was slowly disappearing.

She did not believe she could have anorexia (which is a behavior) if she wasn’t in a heroin-chic body.

When she finally said it aloud-*“I think I have an eating disorder”-*she waited for me to laugh or dismiss her.

Instead, I said, “Of course you do. You’ve been coping with this for your entire life in silence. That’s not weakness. That’s a survival instinct.”

She dissolved into tears.

Because for the first time, someone didn’t make her symptoms a punchline-or her size a barrier.

If You’re Still Carrying Shame

You are not too far gone. You are not too late.

You’re not broken. You’re carrying things no one ever helped you put down.
That ends here. It’s time to set them down.

You do not owe anyone a thinner body, a prettier story, or a faster recovery.
You are allowed to be tired. To be angry. To want something different.
You are allowed to rest. To eat. To be loved in a body that is still healing. You don’t owe anyone a positive attitude or a redemption arc. And yes-you’re allowed to want more.

You deserve a life where food isn’t fear, your body isn’t a battleground, and your worth isn’t up for debate.

This is what breaking bias really looks like.

Want to Go Deeper?

This work doesn’t end today. If this resonates with you, stay connected.
We’re building something that goes beyond awareness.

Coming soon:

Nourishment Rebellion: A course for those who are done with self-denial
Body Respect Reset: For when love feels too far, but respect is the next right step
ABIDE: A framework for weight-inclusive, trauma-informed embodiment