It’s not all about food: 5 myths about eating disorders that every parent should read

Body image is a struggle for any average teenager, but when concerns about appearance, dieting, exercise and weight loss become all-consuming, they can lead to the development of eating disorders.

Most of us have heard of anorexia and bulimia, and have a basic understanding of what they are. But eating disorders aren’t as clear-cut as many of us imagine them to be. In fact, there are many misconceptions that surround disordered eating conditions. Dr. Holly Agostino [1], a specialist in Adolescent Medicine at the Montreal Children’s Hospital, helps us separate fact from fiction.

Myth # 1: Eating disorders are all about food.

False. “While it’s true that the focus of an eating disorder is food, the real root of the illness often stems from something completely different such as stress at school or bullying. At times, we can never identify the true cause - it is a very individualistic disease,” says Dr. Agostino. “What is consistent between various eating disorders is the person’s perception that there is something wrong with their body. This persistent and intrusive preoccupation with an imagined defect in one's appearance leads children and teens to focus disproportionately on their eating patterns. The food is the obsession, but it’s fueled by a serious, negative perception of their body.”

Myth # 2: You must be underweight to be diagnosed with an eating disorder.

False. According to Dr. Agostino, this is perhaps the most widespread misconception about eating disorders, and may be one of the reasons many disordered eating conditions go undiagnosed.

“Children or teens who are overweight or who register at a normal weight are not immune from eating disorders,” she says. “Children who are overweight can have a very poor body image and can start dieting, restricting their food allowance and exercising excessively in an effort to drastically lose weight. This rapid weight loss causes the same severe medical complications we see in underweight patients.”

Myth # 3: If you vomit you must have bulimia.

False. “Bulimia is characterized by episodes of eating without control, and then feeling a tremendous sense of guilt and shame afterwards,” says Dr. Agostino. “In order to rid themselves of these feelings of guilt and shame, children and teens who exhibit bulimic behaviour will try to compensate for their overeating. Vomiting is one form of “purging” but it can also take the form of excessive exercise, or limiting food for the hours or days that follow, sometimes even using laxatives to try and prevent weight gain.”

According to Dr. Agostino it’s also important to note that vomiting can be a symptom in children and teens who struggle with anorexia, or who have some symptoms of an eating disorder but may not necessarily exhibit all of the criteria of anorexia or bulimia.

Myth # 4: Eating disorders only affect girls.

False. While statistics show that 10 times more girls are affected by eating disorders than boys (data from Statistics Canada), it’s not true that disturbed eating behaviours only affect females. Boys can be as equally preoccupied with their bodies and weight as girls.

“The same way that many teenage girls strive to emulate thin models they see in magazines, on TV and online, teenage boys often strive to emulate their own versions of the ideal male appearance: muscular, toned bodies that they perceive as looking most ‘fit’,” says Dr. Agostino.

“Whereas a teenage girl might be focused on limiting her food intake to lose weight and appear thinner, a teenage boy might restrict his diet to only include protein and vegetables, while exercising excessively to gain muscle,” she explains. “Any diet or weight loss strategy that is drastic, very restrictive and excessive is dangerous, whether it’s initiated by a boy or a girl.

“Being overweight is unhealthy for children and teens, but trying to lose weight in a drastic manner, with little or no supervision by a health professional or nutritionist is equally unhealthy and very dangerous,” cautions Dr. Agostino.

Myth # 5: Eating disorders only affect teenagers.

False. “Children as young as eight or nine years old can begin exhibiting signs and behaviours consistent with eating disorders,” says Dr. Agostino, who says that the earlier patients receive treatment for an eating disorder, the better their chances of recovery.

Many of the patients she treats for eating disorders are in their teens, but Dr. Agostino emphasizes that eating disorders are long-term chronic illnesses and can affect individuals throughout the course of their childhood, adolescence and into their adult years.