We’re told that women get eating disorders more than men do. I have never thought this to be true. What I think is true, is that more women get diagnosed than men do.
Outdated information, misrepresentation, stigma, assumptions, ignorance. These things all contribute to people with eating disorders who don’t “fit the mold” not being diagnosed. Early diagnosis — nipping behaviours in the bud — leads to shorter duration of illness. Missed diagnosis can mean that a person spends 5, 10, 15 … 55 years trapped in a prison of their own head. Not to mention the malnutrition, which can cause long-term damage to a body, and result in death.
I often hear “you can’t be what you can’t see.” This saying is used to illustrate why the media only depicting white men in certain types of career, and especially in positions of power and importance, is a problem.
If a little girl only sees men fighting fires, she can’t imagine herself being a fire fighter when she grows up, can she?
The same is true for eating disorders. If we only show pictures of white, middle class, alarmingly thin, cis gender, teenage girls as anorexia patients, then we overlook diagnosis in everyone else. Mostly: adults, men, people of colour and different ethnicities, LBGTQ+ populations, and pretty much everyone who doesn’t have a very thin body.
Under-representation catches medical professionals out
If a doctor can’t see something, she can’t diagnose it.
My family GP never diagnosed me with anorexia. Later on, after I had already lost a significant amount of weight, another GP started to question the dynamics of my family life. I pretty much stopped bothering with doctors after that. Or, went so infrequently that I stayed under the radar. Even now, knowing what my weight must have read on the doctors scale and knowing that someone somewhere must have been noting that down, it blows my mind that I was able to escape too many questions. You see, I was self-confident, not a teenager, had a loving family, didn’t see myself as “fat,” and knew I was underweight. I wasn’t the “type” of person to get anorexia.
Only, I was. And, I did have anorexia.
If someone like me — a straight. young, white female who is very underweight — can escape diagnosis, what hope is there for anyone less “stereotypically” an anorexia candidate than was?
What happens to the not-statistically-underweight black male whose rigidity around what he eats and fixation with his body torments him to the point he can only have 2 very calculated and controlled meals a day and only if he has worked out?
What happens to him is that his doctor and his friends will congratulate him for being so healthy.
What happens to the 56-year-old woman who spends all day cooking the delicious foods that she desires for her family and friends but her fear of eating them herself drives her to be forever on the go, always “too busy” to eat what she makes herself?
What happens to her is that her doctor and her friends will congratulate her for being a wonderful wife and mother.
What happens to that young trans guy a couple of blocks down the street who obsessively runs marathons and secretly hates every step but has to keep entering races so that he always has an excuse to run because the thought of a single week not running makes him turn cold with dread?
What happens to that waitress in her fifties at the restaurant down the road who could have got a job in her twenties as a marketing professional but she turned it down because the prospect of sitting down all day seemed unfathomable?
What happens to the man who led his whole family into a vegan lifestyle claiming it was because not eating animal products would give them all more energy when the real reason was because he needed something to not only shield and excuse his restrictive eating but to evangelize it also, so to hold him accountable to his own restrictive rules?
What happens to the grey-haired woman you see almost every time you go to the local grocery store who hovers over the reduced goods section at the end of the day waiting for the store staff to lower the price of the food that is past it’s best so that she can justify buying something to take home and hoard in her fridge or cut into tiny “portion” sizes to wrap in cling film and put in the freezer?
What happens to the bloke who lies to his husband, telling him that he’s staying at work late because his boss gave him another last-minute project rather than telling the truth and admitting he is going to the gym because he knows that his partner has began to notice that he never takes a day off from working out and it is beginning to be a “thing.”
Nothing. Nothing is what happens to those people. Nobody tries to help them because nobody can “see” their eating disorder. They get sicker and sicker to the point where they have themselves given up all hope of changing. Their bodies slowly deteriorate. Over the years, sometimes, the expression of their restriction has to change to accommodate their failing bodies, and the fatigue of loved ones … but, other than that, nothing really changes.
Under representation catches people with eating disorders out too
Me. I too thought that only silly, vain, unconfident, little girls got eating disorders. That is why I didn’t think it was possible I could have anorexia. Sure, I was underweight. Sure, I was scared to eat anything unless I had worked out that day. Sure, I was terrified of not exercising. Sure, I was obsessed with losing weight. But I didn’t want to be thin. Not really. I was scared of weight gain, yes. But I didn’t want to be thin. Those two things are not the same. And I had always been self-confident. In fact I had liked my body a lot … before it got so thin. Plus I had no family trauma or abuse. And anyway, I was almost 18 when all this started and everyone knows people only get anorexia when they early teens …
I wasn’t in denial as much as I was in a state of ignorance. Ignorance that had been taught to me by the A-level psychology course I had studied at college. I genuinely thought that because I had not suffered trauma as a child, and because I was 18, and because I never hated my body, that I couldn’t possibly have anorexia.
Had I known at 18 that I had anorexia, especially if I had known that before my illness got too deep, I am convinced I would have done something about it. There was this tiny slither of time that I still remember where I was concerned about myself. I knew I was losing too much weight. I knew something odd was happening to me. I was worried about myself and I wasn’t too entrenched yet. I think then had I known what was going on I would have been able to get myself to stop playing around with not eating enough. I had only just started with the exercise and at that point I think, had I understood, I would have been able to drop it. I have gone back to that time and space mentally a thousand times or more, wondering how different my life could have been had I known then that what was happening to me was the start of an eating disorder. Then, when none of my behaviours were so deep I couldn’t contemplate stopping them. Then, when I could have taken action that would have diverted my path and stopped the next ten years of my life being so hopeless and … dead.
I’ll admit that the thought of anorexia had crossed my mind, but I pushed it out with all those above excuses. And also … I didn’t want to have anorexia. I felt that even entertaining such a thought was insulting to myself and my family — because everyone knew that anorexia was a product of bad parenting.
Eating disorders do not discriminate. When we discriminate, we allow eating disorders to ruin lives.