The truth about anorexia nervosa: 5 myths and 5 facts

Knowing the truth about anorexia can save lives. When people with anorexia and related eating disorders dont grasp the severity of their illness, they may not seek help, says Philip Mehler, MD, the founder and executive medical director of the ACUTE Center for Eating Disorders and Severe Malnutrition in Denver.

It is critical to pursue early intervention strategies, such as education and screening, to prevent chronic malnutrition, long-term health complications, and death, Dr. Mehler says.

So, whats the real story? Here are 10 things you should know about anorexia.

1. Fact: Anorexia Can Be Caused by Many Things

Anorexia is a complex mental health condition caused by many factors working together that all play a role of some kind, says Chelsea Kronengold, a former associate director of communications at the National Eating Disorders Association.

• Family history
• Dieting history
• Past weight bullying
• Life transitions, such as the end of a relationship, loss or illness of a loved one, or a new home, school, or job

Keep in mind that two people with the same eating disorder can have very different causes, symptoms, perspectives, and experiences, says Kronengold.

While it can be helpful to identify the root of ones eating disorder, or as much as they can uncover, recovery is still possible without being able to pinpoint the entire cause, especially in terms of physical and behavioral recovery, she says.

2. Myth: Anorexia Is an Obsession With Thinness That Can Be Stopped

Although people with anorexia do desire to be thin, having anorexia is not something they simply choose. People do not just catch an eating disorder for a period of time, says Kronengold, adding that its unlikely that an eating disorder like anorexia can be stopped as desired.

Anorexia is a bio-psycho-social disease, which means that genetic, biological, environmental, and social elements all play a role, says Mehler. He also notes that eating disorders may run in families.

Events like physical illnesses, childhood bullying, and other life stressors, or conditions like major depression, anxiety, social phobia, or obsessive-compulsive disorder, may raise the risk of developing anorexia as well, says Mehler.

3. Fact: Dieting Can Lead to Eating Disorders

4. Myth: Anorexia Only Affects Straight, Young, White Women

• Athletes
• People in the LGBTQ+ community
• People with disabilities, including those with chronic illnesses or mental health conditions
• People of color
• People withlarger bodies
• Veterans
• Children and older adults
• The neurodiverse community, including autistic people, those with attention-deficit/hyperactivity disorder, and people with intellectual disabilities

5. Fact: Anorexia Causes Serious Medical Complications

Anorexia can affect every organ system in the body, says Mehler, adding that not eating enough calories or healthy nutrients can cause heart failure, long-term digestive issues, hormonal issues, and other health consequences like severe dehydration and kidney failure.

Additionally, eating disorders are known to have the second highest mortality rate of all mental health disorders, surpassed only by opioid use disorder, Kronengold says.

6. Myth: People With Anorexia Are Purposely Starving Themselves

And although not taking in enough calories to meet the bodys needs is a well-known symptom of anorexia, its not the only one. People with anorexia may also binge eat, exercise excessively, and purge either by vomiting or by taking laxatives, says Kronengold.

7. Myth: You Need to Be Considered Underweight to Have an Eating Disorder or Symptoms of Anorexia

Unfortunately, due to the misconception that people must be thin to have the disorder, those who meet several of the criteria for anorexia but do not experience significant weight loss or have a low body mass index often go undiagnosed, Kronengold says.

Given the rampant weight stigma surrounding this illness, many people suffering from atypical anorexia fail to recognize they have a severe eating disorder or may be less likely to be diagnosed due to cultural prejudice against fatness, she says.

8. Fact: Recovery Is Possible

The road to healing isnt always easy, but recovery is possible. Healing from an eating disorder is a journey. Dont give up, says Jacquelyn Ekern, founder of Eating Disorder Hope.

Some people might be hesitant to seek help because they fear stigmatization, believe that their problem isnt that bad, or think they can recover on their own, says Kronengold.

It is important to decide that you are worth it and deserve to heal from your eating disorder and live a fulfilling and healthy life, says Ekern. And its important to remember that no ones recovery journey is perfect. Many have recovered, but they likely had a few slips and challenges along the way, Ekern says.

9. Myth: You Can Get Over Anorexia if You Eat Normally

In a proper recovery plan, Kronengold says, its essential to address the eating disorder symptoms and medical consequences, as well as all the external forces that contribute to or maintain the eating disorder.

10. Fact: Early Treatment Equals Better Recovery Outcomes

Without professional treatment, eating disorder behaviors are likely to get worse and cause greater health consequences, says Ekern, adding that earlier treatment can lead to longer-term recovery. And the later someone begins treatment, the less responsive they may be to treatment, says Mehler.

If youre worried that someone you care about may have an eating disorder, its important to share your concerns early on, rather than wait until they meet specific physical or emotional criteria, says Kronengold.

The Takeaway