‘Vain.’ ‘Selfish.’ Exclusive Survey Highlights Misconceptions About Eating Disorders

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Vain. Selfish. Attention-seeking. There are plenty of misconceptions floating around about eating disorders — and those who suffer from them most feel their weight, according to a new survey conducted by Yahoo and Silver Hill Hospital, a mental-health treatment center in Connecticut.

Of the 2,300 respondents who self-identified as having an eating disorder or disordered eating habits, nearly half said outsiders were negative about their condition and behaviors — either “not very understanding” (39 percent) or “critical” (6 percent).

Related: What Life Is Like After an Eating Disorder

The group also detailed how they felt about themselves and how they thought others felt about them. According to the survey, those with eating disorders thought that others viewed them as attention-seeking (85 percent), selfish (74 percent), vain (72 percent), and unhealthy (66 percent), whereas they saw themselves as unhealthy (79 percent), insecure (75 percent), compulsive (71 percent), and sick (70 percent).

It’s clear that those with eating disorders feel misunderstood, says psychologist Erin Kleifield, director of the eating disorder program at Silver Hill Hospital. “The disconnect between how people with eating disorders see themselves and how they feel they’re seen by others jumps out,” she tells Yahoo Beauty. “These beliefs just perpetuate the disorder, as they feel extremely invalidated. They feel a lack of hope.”

Related: I Had the ‘Perfect’ Body — and I Hated it

If an eating disorder continues long-term, it often gets worse — and it becomes very difficult to treat, according to Claire Mysko, interim CEO of the National Eating Disorders Association (NEDA). “The sooner you get help, the more effective the treatment is,” she tells Yahoo Beauty. “We want people to get help before the behaviors become psychologically entrenched.”

On that note, this week, Feb. 21 to 27, is National Eating Disorders Awareness Week, and the theme is early intervention — specifically how “three minutes can save a life,” says Mysko. To that end, NEDA is encouraging men and women who feel they might have an unhealthy relationship with food and eating to take a three-minute online screening test.

This quick quiz will also direct you to resources for help. “We really want to reach those who are experimenting with disordered eating behaviors,” Mysko says. “There is a lot of damaging, destructive behavior happening under the label of ‘health,’ and we want people to understand when it could be an eating disorder.”

There are lots of misunderstandings with eating disorders — including what constitutes healthy versus disordered eating practices. Below, experts explain the most common myths and misconceptions about the 20 million women and 10 million men in the United States who will experience an eating disorder in their lifetimes.

Myth: Eating habits are a choice — and everyone has some food issues.

The irony of an eating disorder, says Kleifield, is that the behaviors are initially rooted in control. “Of course, that controlled behavior quickly spirals out of control,” she says. “When it comes to the point of an eating disorder, it is not a choice. You cannot eat the slice of cake. You’re afraid to eat the grilled cheese sandwich. There is a lot of underlying brain chemistry that won’t allow you to eat normally.”

Kleifield says that eating disorders are rooted in extreme behaviors that go beyond cautious eating and self-care. While some hide weight strategically beneath clothes, others hide a disorder with a flood of social media images that can project a health-centric lifestyle — a new hallmark of orthorexia, an ED characterized by an obsession with very specific healthy foods.

“It’s almost like your car breaking down, but instead of fixing the transmission, you go get it washed and waxed instead,” Kleifield says. Although it may be falling apart on the inside, the body appears perfect on the outside — an unrealistic standard cultivated and circulated by online venues like “pro-ana” websites, which 64 percent of respondents in our Yahoo survey admitted to visiting, mostly for “thinspiration.”

Myth: Eating disorders are obvious and fit a predictable profile.

You probably know the stereotypical profile of someone suffering from an eating disorder to be a privileged white teenage girl obsessing over her appearance. But in actuality, eating disorders are not discriminatory, says Jennifer Carter, MD, sports psychologist and eating disorder specialist at the Ohio State Wexner Medical Center. “They affect people of all ages and affect both genders,” she tells Yahoo Beauty.

According to Kleifield, they also affect people of all sizes and weights. She tells the story of one woman who confessed about an ED to her doc. “He said, ‘Well, you don’t look like you have an eating disorder,’” Kleifield says. “And this was an expert in the field. Some people can maintain their weight while bingeing and purging or overexercising.” So don’t be fooled — anyone can be suffering.

Myth: Anorexia is the only serious eating disorder.

While Carter says that anorexia is the least common and most deadly eating disorder, it’s typically the one that gets the most attention for its dangers. But, she says, “Binge eating disorders are most common, followed by bulimia nervosa. Eating disorders have the highest death rates of all mental health disorders.”

According to Kleifield, there are many avenues to a tragic ending. “Cause of death can be from comorbid conditions, suicide, and the actual behaviors,” she says. “Anorexia is not the only serious condition. People can die of purging, for instance, which is very hard on the heart.”

Myth: Eating disorders are easy to treat — you just have to eat.

Carter can’t even begin to count the number of times she has heard “Just give her a cheeseburger,” and says, “There aren’t simple solutions to eating disorders. When most people eat, they feel a sense of pleasure. However, for people with eating disorders, eating can cause anxiety and distress — it’s almost like an allergic reaction to food.”

Because of their complexity, eating disorders can also take a long time to treat — and for many, it’s a lifelong battle. In our Yahoo/Silver Hill survey, 27 percent admitted to struggling with an eating disorder or disordered eating for five to 10 years; 40 percent said they’d been fighting a condition for 10 or more years. “Sometimes individuals need a higher dose of treatment — like an intensive outpatient program, day treatment, residential treatment, or inpatient treatment,” says Carter. “Eating disorder treatment also often requires psychological, nutritional, and medical approaches. The length, level, and breadth of treatment can be time-consuming and expensive, even with health insurance.”

“This survey underscores that the thoughts and attitudes associated with eating disorders can be amplified in online and social media environments, making it clear that these platforms are truly one of the most critical front lines in eating disorder intervention,” says NEDA’s Mysko. “When we better understand how those at risk or struggling with eating disorders are using social media, we will be better positioned to break through stigma to offer effective support and resources in the moments when they are needed most.”

How to help

If you know someone who’s struggling with an eating disorder, Carter says to approach the subject carefully and thoughtfully. “It’s often helpful to start with ‘I’m concerned about you. I’ve noticed …,’ and describe specific observations or behaviors that have concerned you,” she says. “Encourage the individuals to meet with a therapist, dietitian, or physician to assess the situation and recommend the next step.”

Offer to tag along for the appointment, and check in to encourage follow-through. “Assure them that tackling a problem is a sign of strength, not weakness,” Carter says. “Say that you want to see the return of their personality — that you want them to enjoy life again without feeling strangled by constant fear and obsessive thinking.”

After all, “Three minutes can save a life.” If you think you might be suffering from an eating disorder or disordered eating, take the NEDA three-minute test to check your behaviors and get help.