Expert debunks common misconceptions about a potentially deadly condition: 'It's just gross'

Editor’s Note: This article contains mentions of eating disorders and disordered eating. Please take care while reading, and note the helpful resources at the end of this story.

Societal depictions of people with eating disorders often show thin or emaciated bodies. For many, that is an accurate representation of the effects of those wretched conditions, but that strong association has created a stigma that can leave people with larger bodies without the treatment they need.

The misconception that fat people don’t face the damaging impacts of eating disorders, like malnutrition and negative body image, can make diagnosis, treatment and recovery difficult. In fact, people who are overweight are far more likely to engage in dieting and disordered eating than those who are not.

Erin Harrop, a licensed social worker and assistant professor at the University of Denver, has researched and co-authored multiple studies about the intersection between weight stigma and eating disorder treatment.

They told In The Know that even the best clinician might look at someone and assume, based on their size, what sort of behaviors — restrictive like anorexia, excessive consumption like binge eating disorder or purging like bulimia — they are partaking in. In reality, that’s not at all an effective way to diagnose someone.

“Bodies can be starving and malnourished at any size,” they explained. “You can be a fat person, not eat for a period of time, and your body doesn’t magically transform into a thin person just because you haven’t been eating.”

The way people’s bodies respond to disordered eating habits can be different. Whether your body “supports” starvation is based on genetics, epigenetic history, trauma and personal history. There’s no way to look at someone and know all of that, Harrop said.

There’s no textbook way to have an eating disorder, either. Though the three categories mentioned above are what most people understand to be the three diagnoses, many have “mixed presentation,” which is their body’s way of using all sorts of tactics to both lose weight and sustain itself.

Because of the stigma of weight, fat people with eating disorders might not think that they need help, or other people (including doctors) might enforce them.

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“When you have an eating disorder, there’s already a voice saying you’re not sick enough. You don’t deserve treatment,” Harrop said. “Society reinforces that … They might even be the voice of your eating disorder for you, which seems right.” When people say you look great or you’re glowing because you’re getting thinner because of your eating disorder, that’s not the kind of voice that makes someone want to seek treatment.

“The reality is that none of these disordered behaviors makes our bodies function better,” they continued. “They all detract from our quality of life and what we’re able to do with our bodies.”

Because recovery often means weight gain, it’s especially hard for people of all sizes to resist that disordered thinking. Having to fight the stigma associated with gaining weight on top of that can be brutal.

“I think it’s harder to sustain recovery as a fat person,” Harrop said, adding that they were speaking from personal experience. “With fat folks, people are like, ‘god, what happened to you?’ They might not even know what an eating disorder is a part of it … there’s more policing of fat bodies, and there’s this assumption that you did recovery wrong.”

What seems like a harmless suggestion, like offering advice about portion control or eating more greens, from loved ones or even the media can lead people in recovery to second guess the way they treat their own bodies. It’s like people want them “to get better from our eating disorder, but not too much better.”

“It’s just so gross that people have all these assumptions about what other people’s bodies are allowed to do and be,” Harrop concluded.

The solution isn’t easy, but it is simple: confront your fatphobia and urge those around you — doctors, friends, family, others in recovery — to do the same. Note how the world is systematically designed to penalize larger bodies, and question how that has affected your own perceptions of others, including yourself.

As with anything involving your health, the goal of recovery should never be thinness alone.

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If you enjoyed this story, read more about why fat-shaming and skinny-shaming are not the same.

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