It’s estimated that at least 1.25 million people in the UK are living with an eating disorder. Eating disorders are also responsible for more loss of life than any other mental health condition. But despite becoming more prevalent over the last few decades, they are still widely considered to be misunderstood. As the theme of this year’s Eating Disorders Awareness Week (24 February – 2 March 2025) is “anyone can be affected”, our therapists expose the truth about some the most common misconceptions we have about eating disorders.

  1. Eating disorders are rarely about food

Accredited psychotherapist and eating disorders specialist, Allie Outram, says that a common misconception of eating disorders is that they are all about food. “This actually couldn't be further from the truth,” asserts Allie who says that disordered eating habits and weight control behaviours are often only the symptoms of a much bigger issue. Instead, Allie describes eating disorders as an unconscious attempt by the body, mind, or psyche to cope with something unbearable. “We may see the symptoms of overeating or restrictive eating as opposites, but underneath is the inability to nourish or to receive. Underneath is often doubt, shame, and the inner critic, which fuel the overeating or restrictive eating, and also the body hate that drives the behaviour. When we are able to live in our bodies instead of hiding from them, we are able to have a relationship with ourselves and then with others,” explains Allie.

Registered counsellor and therapist, Lindsay George, agrees and says that although managing weight may start as a way of trying to feel better about ourselves and feel more in control, it can escalate to the point of controlling us. “Perhaps you’re trying to gain more personal autonomy or feel more confident as a teenager or maybe you feel trapped in a controlling relationship and not able to advocate for yourself. You might be lacking in self-esteem and not feel good enough. What often starts as a good idea to make yourself feel better about yourself can quickly take hold and becomes an obsession if you are vulnerable and lacking confidence and self-worth,” shares Lindsay.

“Eating disorders can develop due to many factors,” adds Edinburgh based eating disorder specialist and accredited therapist, Ruth Micallef. “As well as unprocessed trauma - where we see eating disorders as coping mechanisms – they can also be a sign of undiagnosed autism or wider neurodivergence.”

  1. You don’t need to be underweight to have an eating disorder

Often when we think of someone with an eating disorder, we think of someone who is significantly underweight. However, Lindsay says that “although weight loss is typical in anorexia nervosa, most people with an eating disorder stay at what is considered to be a healthy weight or may even be considered overweight.” In fact, studies have shown that as much as 85 per cent of people with eating disorders aren’t underweight. “People with eating disorders often look healthy so their friends and family may not realise they have an eating disorder,” adds accredited counsellor and eating disorder specialist, Harriet Frew.

Ruth agrees and says that the most misunderstood eating disorder, bulimia nervosa, can result in both weight loss and weight gain but claims it’s only ever represented on screen with the purging symptom being vomiting. “In reality, purging can also include restrictions, the use of laxatives or diet products, and over-exercising,” explains Ruth. “At least 41% of people with an eating disorder has binge eating as a symptom.”

  1. Eating disorders don’t just affect young, white females

“The media representation of an eating disorder is often a privileged white teenage girl with anorexia nervosa – but the reality couldn’t be further from the truth,” shares Ruth. “Not only does anorexia account for less than 8% of all eating disorder cases, eating disorders impact people from every intersection of life. For example, a quarter of eating disorder cases are male, roughly 23% of eating disorder cases are autistic, and there’s a disproportionate number of cases from the LGBTQ+ community.”

Harriet adds that fitness industry is also rife with people with eating disorders - “especially guys who are into wellness and outwardly look so healthy,” shares Harriet. “There’s still so much stigma around men with eating disorders that may don’t find the support they need. Society needs to expand its idea of the stereotype as eating disorders don’t discriminate. Anyone can be affected.”

  1. Eating disorders aren’t about being vain or attention seeking

Lindsay says that although there is often an association between body dissatisfaction and eating disorders, they’re not about someone being vain or just wanting to look a certain way. “Eating disorders are serious diagnosable illnesses, they are not a lifestyle choice, a phase, or someone being attention seeking,” explains Lindsay. “Often people diagnosed with an eating disorder will go to great lengths to hide it. Many people with eating disorders actually report wanting to ‘disappear’ and hide themselves away, feeling inferior to others or like they don’t want to be seen. Confidence is usually very low at this time and it’s common for sufferers to become introverted and struggle to socialise.”

Harriet agrees and adds that “eating disorders are about deeper issues, about something traumatic they’ve experienced. Monitoring the food they put in their bodies brings a sense of control, a distraction from deeper pain, and even a sense of achievement for some.”

  1. Eating disorders are not a choice

Lindsay says that eating disorders are complex illnesses – there is no single cause. Instead, they are thought to be caused by a combination of biological, psychological, and sociocultural factors. “Eating disorders are both distressing for the individual and their loved ones. They require specialist treatment, but people can and do get better from them. Eating disorders are mental health disorders and are never a personal choice,” shares Lindsay.

“It is important to recognise that eating disorders are simply coping mechanisms,” adds Ruth. “Whilst many intersections indeed collide to create an eating disorder, including genetics, personality, culture, and, of course, trauma, no two people will have the same lived experience or eating disorder journey, so try not to compare your experience to others and minimise your own. If you are struggling with any eating disorder, you are worthy of support.”

Harriet says that research has shown that you are more likely to recover from an eating disorder if you seek help within the first three years of it developing – but it’s never too late to recover.

  1. There is no 'one size fits all' when it comes to therapy

“While the NICE Guidelines recommend talking therapies such as Schema Therapy (my own modality) and enhanced CBT as pathways for recovery, remember that only you will know if a therapy style or practitioner feels right for you,” suggests Ruth. “Schema Therapy can support you in understanding and processing the experiences and negative core beliefs which led you to develop your eating disorder whilst also helping you create healthier pathways for the future.”

Harriet says that, whichever therapy path you choose, there’s no doubt it can help people recover from eating disorders in multiple ways. “Therapy is about understanding your past and the things that have led to your eating disorder – whether that’s traumas, bullying, your environment…etc,” explains Harriet. “It’s also about working on symptom interruption. People are often ambivalent about change and may feel safe using food to cope with their deeper-seated issues. So therapy can help work on their motivation and help find other ways to cope. It also encourages self-compassion and a healthy relationship with your body image – when self-worth has been become so overly linked to body image, making it hard to feel good about yourself.” 

Lindsay agrees and says that although eating disorders are different for everyone, the common denominator is often the same - trying to take control of your feelings. “The sad thing is the individual often doesn’t see this and can become deluded into believing they have a grip on the situation, when in fact they haven’t. Specialist help and support is often required to help the individual work through their feelings and gently challenge their negative thought processes and behaviours into more healthy ones.”

To find a trained and registered eating disorder therapist or counsellor, please visit BACP’s therapists directory.