What Anorexia Actually Is, Since It's Certainly Not Just Wanting To Be Thin


There is no doubt society has come a long way in the understanding of emotional, psychological and behavioral disorders. Through research, education and personal experiences, we have collectively made progress with our knowledge.

Pop culture has played a role in conveying certain disorders to the masses. NBC’s “Parenthood” crafts a delicate picture of a child with Asperger’s, while Showtime’s “Homeland” portrays a woman struggling with bipolar disorder.

Regardless of whether or not these shows perfectly nailed their depictions, a dialogue has been started, which is important in and of itself. With that said, there is still much stigma attached to mental illness in general, and there’s a lot we have yet to grasp as a society.

Eating disorders, particularly anorexia, are among the psychological diseases continually riddled with stereotypes and myths.

The statistics on eating disorders are staggering. The National Association of Anorexia and Associated Disorders reports that eating disorders have the highest mortality rate of any mental illness.

Up to 24 million people of all ages and genders suffer from eating disorders in the US. (Yes, men suffer from eating disorders, too.) Furthermore, anorexia is the third most common chronic illness in adolescents.

Why, then, are we still perpetuating myths and falsities about this disease?

The most upsetting perception of anorexia is that it is an illness marked by vanity, but people who struggle with it do not suffer from a shallow desire to be skinny. Like any mental illness, anorexia is multilayered and no two cases are alike.

For one person, it might be about the desire to be entirely self-sufficient. There is a fear of being excessive that comes along with this illness, combined with an urge to need nothing.

For another individual, the driving force behind anorexia could be entirely different. It is a monster of a disease that has the ability to shape-shift; it fits the mold of the person it inhabits.

It is less about the idealistic dream of being skinny and more about the emotions involved in the process of disappearing. It is not about how one looks, but how one feels.

Wrapped up in this myth is the notion that images of fashion models cause eating disorders in women.

Not only is this untrue, it is also a very dangerous lie, one that undermines the deadliness of the disease. While it can be said that overexposure to size-zero models is a breeding ground for poor body image, it's important to remember poor body image is not a mental illness -- anorexia is.

Pointing the finger at fashion photography (or Photoshop retouching) is an expenditure of energy that isn't getting us closer to understanding the actual disease.

Part of the overall difficulty in understanding eating disorders is the way they are diagnosed. The DSM-5 diagnostic criteria for anorexia nervosa includes restriction of food, fear of gaining weight and, most problematically, a BMI that indicates being underweight.

Quite simply, in order to qualify as anorexic, one must be visibly thin.

Because eating disorders are mental illnesses, it would logically follow that it's possible to struggle with the psychological symptoms without necessarily exhibiting physical symptoms.

This is where the term "OSFED" comes in, which stands for Feeding or Eating Disorders Not Elsewhere Classified. This term used to be referred to as ED-NOS (Eating Disorders Not Otherwise Specified).

Basically, this term gets applied to anyone who displays the psychological signs of anorexia (and other eating disorders) without being drastically physically affected.

For many, this feels like a throwaway label — a way to categorize "almost anorexics" without actually paying attention to them. Because we are still so conditioned to think anorexia is about thinness, even doctors struggle with this grey area.

One of the overarching factors responsible for these false perspectives is our desperate need to understand why eating disorders happen. We want to know what causes them and how to prevent them.

In her iconic memoir, "Wasted," Marya Hornbacher hit the nail on the head with this topic:

There is never a sudden revelation, a complete and tidy explanation for why it happened.... You want one and I want one, but there isn't one. It comes in bits and pieces, and you stitch them together wherever they fit....

Because anorexia is so personal and so specific to the individual, there is no textbook response to any of this, which is what makes the disease so difficult to grasp and why we latch on to "simple" answers.

We decide anorexia is about being thin because it is easier than attempting to look deeper. We put the blame on the fashion industry, and we decide it is a culture-based illness.

The first step in understanding this complex disorder is the acknowledgement that we may never understand it, not in the way we want to.

We need to embrace the uniqueness of the illness itself and stop perpetuating these stereotypes that are doing more harm than good. Only then do we stand a chance of helping the millions of individuals who are struggling with this disease.