9 Essential Facts About Eating Disorders

The Nine Truths About Eating Disorders

Eating disorders—including anorexia nervosa, bulimia nervosa, and binge eating disorderhave the highest mortality rate of any mental illness. Despite improved research on the topic, eating disorders are vastly misunderstood by the general population. Sadly, the persistent myths surrounding eating disorders make it harder for people with eating disorders to get the help needed to fully recover.   

As a result, in May 2015, 13 US-based eating disorder organizations, in collaboration with Cynthia Bulik, Ph.D., FAED, who serves as Distinguished Professor of Eating Disorders in the School of Medicine at the University of North Carolina at Chapel Hill and Professor of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Stockholm, Sweden, published the “Nine Truths About Eating Disorders.” This document was inspired by Dr. Bulik’s 2014 “9 Eating Disorders Myths Busted” talk at the National Institute of Mental Health Alliance for Research Progress meeting.  

The Nine Truths document was a historic collaboration and reflects the culmination of some of the most recent research on eating disorders. Because eating disorders are so often misunderstood and carry a great deal of stigma, it is hoped that the common messaging will challenge myths and stigma, increase understanding about and compassion for those with eating disorders, and help pave the way for greater access to adequate treatment.  

Dr. Bulik said, “The single best way to fight stigma is with truths. These consensus ‘Nine Truths’ are the new scaffold on which we will build our advocacy efforts for eating disorders. United around these principles, we can enlighten public understanding about eating disorders and advocate effectively for treatment access and resources.”

The Nine Truths (shown with their corresponding myths) follow:

Eating Disorder Truth 1

Myth # 1: You can tell by looking at someone that they have an eating disorder.

Truth #1: Many people with eating disorders look healthy yet may be extremely ill. 

People commonly believe that you can tell whether someone has an eating disorder just by looking at him or her. This is because most people picture a person with an eating disorder as someone who is very emaciated. The reality is that eating disorders can present in diverse ways and among people of varying sizes. It may not be obvious that an individual is ill.

Eating Disorder Truth 2

Myth # 2: Families are to blame.

Truth #2: Families are not to blame; they can be the patients’ and providers’ best allies in treatment. 

For many years, parents—especially mothers—were blamed for causing eating disorders. This is still widely believed, even today. Thanks to recent research and advocacy efforts, we know this to be false. Eating disorders are caused by a complex interplay of genetic and environmental factors. We also know families can powerfully contribute to the solution.

Eating Disorder Truth 3

Myth # 3: Mothers are to blame.

Truth #3: An eating disorder diagnosis is a health crisis that disrupts personal and family functioning. 

Dr. Bulik felt the blame on mothers was so great, she reiterated it as a myth in her talk. Eating disorders can be lethal. They have profound effects on the body, interfering with an individual’s ability to function. They increase stress on the entire family. Meals can become tense, relationships strained, and family patterns disrupted as families struggle to cope with an internal crisis.

Eating Disorder Truth 4

Myth # 4: Eating disorders are a choice.

Truth #4: Eating disorders are not choices, but serious biologically influenced illnesses. 

Eating disorders are often dismissed as illnesses of choice and vanity, or the consequence of a deliberate adoption of an extreme diet. However, these disorders have far more complex origins. They are not merely a rigid diet that someone can easily choose to abandon. Low weight and restrictive eating patterns biologically alter an individual’s psychological functioning and become firmly rooted.

Eating Disorder Truth 5

Myth # 5: Eating disorders are the province of white upper-middle-class teenage girls.

Truth #5: Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses. 

Eating disorders are commonly believed to be an affliction of affluent white females. This is far from the truth. Eating disorders affect males and females, families from different ethnic backgrounds, and people from varied economic circumstances. This dangerous myth keeps many who do not meet the stereotype from recognizing that they have an eating disorder and accessing help.

Eating Disorder Truth 6

Myth # 6: Eating disorders are benign.

Truth #6: Eating disorders carry an increased risk for both suicide and medical complications. 

All eating disorders—bulimia nervosa and binge-eating disorder included—carry with them an increased risk of death. Medical complications may include problems with all bodily systems. Suicide is a common cause of death for a person suffering from an eating disorder.

Eating Disorder Truth 7

Myth # 7: Society alone is to blame.

Truth #7: Genes and environment play important roles in the development of eating disorders. 

The factors that cause eating disorders are complex and not well understood. Current research suggests that approximately 40 to 60 percent of the risk for anorexia nervosa, bulimia nervosa, and binge eating disorder is genetically influenced. Chance and bad luck play a role, and individuals vary in their genetic risk. Even despite every common preventative measure, those with extremely high genetic risks may go on to develop an eating disorder after just one or two otherwise innocuous triggering events. Others with low genetic risk may escape an eating disorder despite exposure to numerous environmental risk factors.

Eating Disorder Truth 8

Myth # 8: Genes are destiny.

Truth #8: Genes alone do not predict who will develop eating disorders. 

It is doubtful there is a single eating disorder gene. More likely, variations in several genes contribute in differing degrees to traits that interact with environmental factors to increase or decrease certain individuals’ risk for these disorders.

Eating Disorder Truth 9

Myth # 9: Eating disorders are for life.

Truth #9. Full recovery from an eating disorder is possible. Early detection and intervention are important.

In the past, we lacked effective treatments and many remained chronically ill. With the earlier introduction of treatments that prioritize regulation of eating and address symptoms directly, more patients are achieving full recovery.

Nine Truths translations and collaborating organizations

The Nine Truths have been translated into over thirty different languages including Spanish, Norwegian, Estonian, German, Swedish, and Finnish.  All are available on the AED website. 

The organizations that collaborated on the Nine Truths are:  Academy for Eating Disorders; Binge Eating Disorder Association; Eating Disorders Coalition for Research, Policy & Action; Eating Disorder Parent Support Group; Families Empowered and Supporting Treatment of Eating Disorders; International Association of Eating Disorders Professionals Foundation; International Eating Disorder Action; Multi-Service Eating Disorders Association; National Association of Anorexia Nervosa and Associated Disorders; National Eating Disorders Association, Residential Eating Disorders Consortium; Project HEAL; and Trans Folx Fighting Eating Disorders.

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Article Sources
  • Becker, Carolyn Black, Keesha Middlemass, Brigitte Taylor, Clara Johnson, and Francesca Gomez. 2017. “Food Insecurity and Eating Disorder Pathology.” The International Journal of Eating Disorders 50 (9): 1031–40. DOI: 10.1002/eat.22735.

  • Schaumberg, Katherine, Elisabeth Welch, Lauren Breithaupt, Christopher Hübel, Jessica H. Baker, Melissa A. Munn-Chernoff, Zeynep Yilmaz, et al. 2017. “The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders.” European Eating Disorders Review: The Journal of the Eating Disorders Association 25 (6): 432–50. DOI: 10.1002/erv.2553.