What is the Connection Between Eating Disorder Stereotypes and Not Feeling “Sick Enough”?
Written by: Eleanor Eng, APCC | Eating Disorder Therapist San Diego
Imagine someone with an eating disorder. The odds that you imagined a white, affluent, young, thin, teenage woman with anorexia? Quite high. The actual percentage of people with an eating disorder who fit that image? Not as high as you’d think. Stereotypes contribute to misconceptions and perpetuate harmful, misleading narratives of eating disorders. In reality, eating disorders do not have a look- eating disorders impact people from all walks of life and all bodies.
You can’t ‘see’ an eating disorder
One of the most common and possibly most damaging myths about eating disorders is that you can tell whether someone has one or not by how they look. You cannot.
Eating disorders (ED) are serious mental health conditions with many behaviors and thoughts that go unnoticed by other people. Someone may be struggling with not eating enough, being unable to stop eating, overexercising, self induced vomiting, or even intense anxiety when it comes to food; all while appearing completely “healthy” from the outside (though health doesn’t have a look either). Appearance based assumptions can be harmful in this regard. Bringing up someone’s changing body in conversation without completely knowing what contributed to the change can reinforce harmful eating disorder thoughts and behaviors. Weight loss alone doesn’t indicate health status, and neither does weight gain.
Can you be malnourished at any body size?
Eating disorders impact people of all races, ages, ethnicities, genders, sexualities, socioeconomic background and body size. While anorexia nervosa may be the eating disorder most commonly associated with eating disorders (thanks to Hollywood), it is only one of several. Bulimia nervosa, binge-eating disorder, avoidant/restrictive food intake disorder (ARFID), and other specific feeding or eating disorders (OSFED) can look quite different from the other. Yet, many people still associate eating disorders with one specific body type: someone who is visibly malnourished. It’s important to know that you can be malnourished at any size, those in larger bodies with eating disorders tend to be taken less seriously and malnourishment can even be encouraged- leading to further medical issues and more chronic disordered eating.
Eating Disorder Stereotypes: where do they come from and why do we have them?
Stereotypes are our brains' way of saving energy. Our brain naturally connects and groups similarities to help process information quicker, a function that has helped our survival instincts for generations. They are formed through these processes, cultural influences and our own lived experiences. Media representation reinforces this learning of grouping people. While it’s helpful for our brain’s energy reserves, it can be quite harmful and limiting to those who don’t fit into the box that stereotypes create. Stereotypes are often not accurate- typically further marginalize BIPOC, queer, trans, disabled, poor and people in larger bodies.
The damage of eating Disorder stereotypes
Stereotypes don’t just affect who have eating disorders. Their affects ripple into:
Who gets properly diagnosed
Who receives treatment
Whose experiences are taken seriously
Who is granted compassion vs. judgement
People from marginalized communities experience additional barriers to recognition and treatment. LGBTQ+ people, people of color, older individuals, and people in larger bodies face misconceptions that make it harder for others to recognize their symptoms. Additionally, men and boys displaying markers of disordered eating or body dysmorphia are often missed or dismissed due to the stereotype primarily affecting women and girls. Transgender, non-binary, and/or gender expansive people (TNG) experience disproportionately high rates of eating disorders and have unique barriers to accessing care because of eating disorder stereotypes and gender discrimination (Goetz & Wolk 2023).
Beyond a Skinny, White, Affluent Girl Issue
Remember when I asked you to imagine someone with an eating disorder? The harmful stereotype you possibly imagined actually as a name, “SWAG”, and stands for Skinny, White, Affluent Girls. They are often portrayed in mainstream media, overrepresented in clinical research and residential treatment centers. However, that doesn’t mean that this group has the highest prevalence of having an eating disorder. They are just getting diagnosed and treated more than people of other races or socioeconomic statuses because they are more likely to be screened for an eating disorder from healthcare providers and more likely to access treatment due to financial privilege. Breaking this stereotype within the general public and healthcare communities can help save lives. Especially as anorexia nervosa has the highest death rate of any eating disorder and any mental health condition. Someone dies from an eating disorder every 52 minutes, and I can’t help but wonder how much of this is due to stereotypes and lack of inclusive treatment.
Anorexia also isn’t the most common eating disorder in the US. Of the 9% of people in the US who reported experiencing an eating disorder, 2.8% of them experience Binge Eating Disorder, 1% experience Bulimia Nervosa, and only .6% experience Anorexia Nervosa (according to NEDA). ARFID is left out of this study entirely (we can assume what that means). The assumption that eating disorders come with a “look” or need to be visibly ill before their eating disorder is considered serious needs to be dispelled. Eating disorders are medically and psychologically dangerous regardless of someone’s weight or appearance.
Challenging stereotypes is Eating Disorder Prevention: A Call TO Action
To begin the process of deconstructing stereotypes and stigma, we need to change the way we talk about eating disorders. Instead of asking what someone with an eating disorder “looks like”, we can learn:
How eating disorders can look different across different people, different neurotypes and different cultures.
We can stop treating certain body types as inherently healthier or more concerning than others.
We can listen when someone says they’re struggling rather than deciding whether their experience is “bad enough”.
We can also be more thoughtful about the way we talk about food, weight and bodies in everyday life. Casual comments about someone’s body or eating habits may seem insignificant, but they reinforce the idea that someone’s worth or health can be measured by their appearance.
Most importantly, we can remember that there is no one single eating disorder experience nor is there a “right” way to heal from them. Some people may recognize their symptoms immediately. Others may spend years wondering whether what they’re experiencing is serious enough to deserve help. Some may get a diagnosis, others may not. Some may recover quickly, while others may experience a longer or more complicated journey.
Are you “sick enough” to have an eating disorder?
None of these experiences make someone’s struggle more or less valid- there is no “sick enough” when it comes to struggling with an eating disorder. You wouldn’t say someone with cancer isn’t sick enough because it’s stage 1 and not stage 4, right?! So why do we do that with eating disorders? If we care about eating disorder prevention, we need to make it valid and acceptable to seek help the first sign there is even a curiosity someone might be struggling with food or their body.
Everybody, every body, deserves recognition and support in eating disorder recovery
Breaking stereotypes surrounding eating disorders isn’t about replacing one image with another. It’s about understanding that there isn’t a single image in the first place. Eating disorders don’t discriminate and neither should our compassion or treatment.
If we want people to feel comfortable asking for help, we need to create an environment where they don’t first have to prove that they look/are “sick enough”. We need to recognize the signs beyond appearance, challenge the assumptions we have been taught and make room for experiences that don’t fit the stereotype.
There is no one way to have an eating disorder, and there is no one way to deserve help.
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References
Capuano, E. I., Ruocco, A., Scazzocchio, B., Zanchi, G., Lombardo, C., Silenzi, A., Ortona, E., & Varì, R. (2025). Gender differences in eating disorders. Frontiers in nutrition, 12, 1583672. https://doi.org/10.3389/fnut.2025.1583672
Frostad, S., & Bentz, M. (2022). Anorexia nervosa: Outpatient treatment and medical management. World journal of psychiatry, 12(4), 558–579. https://doi.org/10.5498/wjp.v12.i4.558
Goetz, T. G., & Wolk, C. B. (2023). Moving toward targeted eating disorder care for transgender, non-binary, and gender expansive patients in the United States. The International journal of eating disorders, 56(12), 2210–2222. https://doi.org/10.1002/eat.24055
Halbeisen, G., Brandt, G., & Paslakis, G. (2022). A Plea for Diversity in Eating Disorders Research. Frontiers in psychiatry, 13, 820043. https://doi.org/10.3389/fpsyt.2022.820043
National Eating Disorders Association. (n.d.). Statistics. https://www.nationaleatingdisorders.org/statistics/
Striegel-Moore, R. H., Rosselli, F., Perrin, N., DeBar, L., Wilson, G. T., May, A., & Kraemer, H. C. (2009). Gender difference in the prevalence of eating disorder symptoms. The International journal of eating disorders, 42(5), 471–474. https://doi.org/10.1002/eat.20625
