Stigmas surrounding eating disorders - A devastating reality

Article By Christine Morgan, Chief Executive Officer, The Butterfly Foundation

Those who grapple with the devastating reality of an eating disorder also face the additional stress and challenges of serious stigma.  In 2014 there is still a commonly held view that an eating disorder is a lifestyle choice and that recovery means dropping some negative behaviour.  If only it were that simple!  The reality is that eating disorders are very complex, serious psychological disorders that cause significant physical, mental, emotional, and social impairment.  They also kill – with anorexia nervosa having the highest fatality rate of any psychiatric disorder. The overall mortality rate for an eating disorder is 20% and the risk of premature death for women with Anorexia Nervosa is up to twelve times higher than the general population.

In addition to the misconception that an eating disorder is a lifestyle choice, are the views that they only affect teenage girls and that they are merely a ‘diet that has gone wrong’.

Stigma is a significant barrier to help seeking.  Over and above those challenges, it also robs people who are already vulnerable of their dignity, increases their sense of isolation, and further reduces their self-esteem. One of the most harmful consequences of stigma is that it may act as a barrier for people seeking help.  Research indicates that current access to treatment for eating disorders is alarmingly low, with only 22% sufferers receiving specialist treatment for their eating disorder[1].    Research shows that it takes an average of 8-10 years for someone to seek help and yet early help seeking is crucial to curtailing the impact and duration of the illness.  We need to break down the barriers.

Today more than 913,000 people in Australia have an eating disorder, and more than one million Australians are predicated to have an eating disorder within just a few years. Eating disorders are serious mental illnesses that manifest in preoccupation with control over one’s body weight, shape, eating and exercising.  They include Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and atypical presentations.  The total national socio-economic cost of eating disorders in 2012 was $69.7 billion[2]. 

Eating disorders affect more women than men, and more teenagers than older people.  However the current trends indicate increasing numbers of men and increasingly young people.  For men there is an additional stigma - the perception of this being a womens issue.  

Eating disorders are too often sensationalised by the media as celebrity ‘spectacles’. The truth about eating disorders is more complex and far more serious than most people realise. Case studies and people with a lived experience provide us with the most compelling way of understanding these illnesses. The starting point to unravelling the many layers of stigma is to build community awareness of these illnesses, their prevalence, and their impact. There must be a shift in attitude before we can begin the process of eliminating stigma and its consequences.  

What we need to do about eating disorders

Someone with an eating disorder is unlikely to be seeking help.  As such, it is imperative that we build community and individual awareness of the warning signs and an understanding of just how important it is for the person to receive support and treatment.  Acting on the warning signs can have a marked influence on the severity and duration of the illness.

The role of negative body image is important.  The social pressures to achieve an ideal body shape and size as an indicator of personal success are incredibly high.  This can result in serious disordered eating and exercise for many people.  For those with a genetic vulnerability to an eating disorder, the dieting and exercise behaviours that result from negative body image are akin to lighting the fuse of a time bomb.

The Mission Australia National Youth Survey highlights negative body image as one of the top three significant personal concerns of young Australians. Self-esteem issues, anxiety, withdrawal, depression are all known components of negative body image, and a starting point for clinical eating disorders.

There is a woeful lack of adequate treatment for people with eating disorders, both within hospitals and for the longer duration in community based care.  Multidisciplinary treatment involving psychiatry, medicine, and dietetics is crucial and it needs to be accessible in adequate dosages.  Most importantly, with very high relapse rates, community based recovery support services must also be available for the longer term.

[1] Swanson, Crow, Le Grange, Swendsen & Merikangas, 2011
[2] Butterfly Foundation’s Paying the Price report, by Deloitte Access Economics


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Article contributed to the newsletter Perspectives - August 2014. Please note that this article is from an individual contributor and does not necessarily reflect the views of Mental Health Australia

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