The Crossroads Between Weight Stigma and Eating Disorders

Welcome to day 4 of Weight Stigma Awareness Week! Part of the purpose of the National Eating Disorder Association (NEDA) hosting a Weight Stigma Awareness week is to highlight the issues of weight bias in the treatment of Eating Disorders.

While messages in our media, how we define health and wellness, the fitness industry, the clothing industry, public transportation, general public settings, and the healthcare industry also contribute to weight stigma in the eating disorder community, causing additional challenges within this population. Like everything else we’ve talked about this week, it’s very complex.

Let’s start by identifying some common misconceptions/stereotypes are eating disorders:

-Eating disorders are a “wealthy, skinny, white girl problem”.

-Eating disorders are a choice/phase.

– People have to look emaciated in order really get help for an eating disorder.

– Only people that are thin get eating disorders.

– Medical consequences only occur in thin people with eating disorders.

-Eating disorders are rare.

– Eating disorders would be cured if the person would just eat!

Eating disorders do not discriminate across socioeconomic status, size, race, or gender. They are not a choice or a phase but are a medical AND mental health condition that require some level of treatment. They do not just “go away” on their own and are not cured by making a person eat.  Eating disorders are not rare and often undiagnosed due to stigma and barriers to treatment. These can often contribute to the concept that the individual is not “sick enough”, which is a challenge many face when fighting eating disorders.

If a person in a small body sees a provider and describes weight loss, calorie counting, rigidity in food/eating, compulsive exercise and obsessive thoughts regarding body image, they are often diagnosed as having an eating disorder. Yet when a person in a larger body sees a provider, regardless of what the primary concern may be, they are PRESCRIBED weight loss and the same things we identified as being disorder in the smaller body. This is one example of how weight stigma can be prevalent in our society in regards to the treatment of eating disorders.

It’s important to know that all eating disorders occur all across the size spectrum. This means that individuals in larger bodies can still suffer from eating disorders including anorexia, often referred to as atypical anorexia. (It also means that individuals in smaller bodies may be struggling from Binge Eating Disorder).

Below are some of the reasons why weight bias might be keeping an individual for seeking help for an Eating Disorder:

-The weight loss is praised instead of being diagnosed as a disorder

-The weight loss can be encouraged and provides the illusion of striving towards health while instead individual is suffering from an illness

-Others (family, friends, employers, medical providers) may not support individual getting treatment

-Individual may not believe they need treatment or that they are not “sick enough” for help

-Struggles with insurance company regarding healthcare coverage for Atypical Anorexia or Binge Eating Disorder due to person’s weight.

-The person may have been told that Binge Eating Disorder can be “cured” via diet and weight loss methods.

It is important to note that there are many different types of barriers to individuals across the size and eating disorder spectrum. This list is not meant to be a comprehensive list but to highlight the ways that weight stigma can be impacting the treatment of those with eating disorders. Please note that you do not have to be diagnosed with an eating disorder to need help and support with your relationship with food. Reach out if you feel like you are struggling with healing your relationship with your body, food or feel like you might have a form of disorder eating.

Stay tuned for our last day of Weight Stigma Awareness Week 2019 tomorrow. I’m looking forward to continuing to sharing more information with you

Katie Hill Stewart MA, LPC, LCPCWelcome! My name is Katie Hill Stewart; I am a Licensed Professional Counselor (LPC) practicing north of Kansas City in Liberty, Missouri. My mission is providing support to adults struggling with disordered eating, body image issues, trauma, anxiety and depression.