Or Do All Eating Disorders Exist in All Body Sizes?
You feel like something is wrong, but you quickly distrust yourself because you have been raised to believe that eating disorders have a specific “look” or “size”, and in your own head and due to society, you feel like you are outside of what is “normal” on this front.
You have been taught to believe that someone who has anorexia nervosa must be extremely thin, the type of thing that everyone can agree on, that looks excessive, extreme, or even scares others. You have been taught (falsely so) that individuals in larger bodies are to blame, or that the only types of food patterns that would be considered an eating disorder are those associated with impulsivity & excessive consumption of foods, not limiting foods.
Please hear me when I say that all eating disorders exist across the size spectrum. Full stop.
Anorexia Nervosa exists in bodies across the size spectrum, irregardless of weight changing. Another full stop.
“Atypical” Anorexia Is Actually Not Atypical at All.
In fact, many eating disorder providers deeply wish that the diagnostic criteria would change to be in alignment with reality. The vast majority of those dealing with moderate to severe eating disorders do not meet the criteria for anorexia nervosa, but only because of one data point- weight loss per the BMI metric. A data point that can signify significant weight changes, but one that is a stumbling block for everyone else who has an eating disorder.
During my time as an eating disorder therapist at an inpatient hospital for eating disorders, I was surprised when my biased beliefs proved to be very off-base because I too had a belief that eating disorders=anorexia and that anorexia only applied to people who were extremely thin. But at any given time, the vast majority of my caseload on the inpatient unit were individuals who were in varying body shapes & sizes. Some individuals had extreme behaviors & yet their body never changed in weight, shape, or size during the course of their illness.
Others experienced some shift in body shape
But still appeared to be in a similar size or in body shape/size or weight range that is consistent with the BMI range for their height. Some clients were in larger bodies and met the criteria for anorexia nervosa, having never engaged in any type of bingeing behaviors, even though the social stigma/bias associated with people in larger bodies is tied to eating excess food or bingeing. And yes, there were individuals who were visibly underweight per the standards of falling below the BMI for their height, and having the visible presentation of being underweight by those standards, and looking “extremely thin”.
Why Does This Matter?
When we are geared to believe that there is a predominant look to an eating disorder, then we can miss those who are struggling all around us. We can believe that we ourselves are “fine” if we are basing it on weight or body shape/size vs. the thought content & associated behaviors of an eating disorder. I am now an outpatient provider only, and during this phase of my career, the majority of clients I see believe that they have had their eating disorder for roughly “____ years” often 2-3 years is what I am told. And they are being honest with what they know to be true based on those societal norms.
But as we start to do the work of recovery, more times than not, they realize that their eating disorder actually began much sooner than they thought. This is because they were basing the onset of the disorder on either changes in weight or blatant shifts in behavior, when in reality the onset was much slower or seemed benign, such as dieting, counting calories, eliminating a food or food group, or being “healthy” by eating certain food types more consistently than in the past.
You Weren't Born Feeling Guilty About Food. You Learned It.
Diet culture is the presence of beliefs & behaviors that are so normalized that they are not seen as problematic, nor as risk factors or indicators of the start of an unhealthy relationship with food and as the gateway into an eating disorder. Diet culture has been tee’d up to seem like the normal thing to do, and that feeling guilty about food selections/amounts is inherent, when in reality it is a learned pattern based on the cultural norms of any given group. And if you question that thought, pay attention to kids ages 1-3; they do not talk about food in a way that has moral judgment attached to it. That is a learned belief set.
We have learned to talk about food/bodies in a way that places a moral hierarchy of which foods & bodies are “good” or to be sought after, and all others are not to be celebrated or valued equally. Diet culture has sold the narrative that health is connected to certain body types & unhealthy is connected to other body types, irregardless of health practices. In reality, all illnesses run the size spectrum, including people in short/tall and small/large body types. Healthy body patterns also exist across the full size spectrum, from small to large.
You Don't Have to Earn Your Way Into Eating Disorder Treatment
The myths are endless when it comes to what actually impacts an individual’s body shape & size and overall health. There are many factors, most notably genetics, access to food, chronic stress, illness, anti-fat bias/medical recommendations to “lose weight,” even though weight gain is almost guaranteed as a by-product of weight loss because our bodies are trying to maintain homeostasis and register weight loss as a “threat” or a “famine” and are doing their best to keep us alive.
I’ve found that people who have not lost weight in their eating disorder, and those in larger bodies, have significantly higher amounts of shame, guilt, fear, and anxiety about seeking professional help. They tend to hold beliefs that have been outlined: that eating disorders are only anorexia, and that anorexia is only present if someone is “underweight”. But the data just doesn’t back that up, and anyone who minimizes or tells you that you do not have an eating disorder, professional or otherwise, is likely under educated/misinformed on this topic.
Eating disorders have a range of behaviors including but not limited to:
Restricting or Avoiding Food
Amounts
Types
Categories
Compensating behaviors to maintain or lose weight:
Restricting food amounts
Needing to “earn” food
Purging
Laxatives or Diet Products
Intense or Excessive Guilt, Shame, or Fear
Extreme patterns:
Undereating
Binge Eating
Unable to cope with hard emotions with normalized food patterns that support your body's need for energy
Identity Focused on:
Health
Body shape or size
Exercise patterns
Excessive fears of judgment
Thought content during a day that circles back to food, exercise, body shape or size (in the absence of anti-fat bias/discrimination)
There are few “hills I will die on” as an eating disorder therapist in Utah & a fellow human, but one of those is that all bodies are good & deserving bodies.
Full Stop with deep conviction.
I Practice From the Health At Every Size® (HAES®) Movement.
There is no “look” or body type associated with eating disorders or eating disorder severity. There is no weight or weight gain/loss required to have an eating disorder. And I hope that you will read this & know that you deserve to get eating disorder treatment for your beliefs & behaviors right now. You do not need to wait until things are “better” or worse; the right provider will understand what you are dealing with and help you dig in on building a life that is free from the current struggles you’ve been facing.
People really can learn to have a healthy relationship with their food & their body. Our culture makes us think that we can only do so once we “arrive” at having the body it prescribes or that we have in our heads about how we “should” look. But my experience says otherwise. The work that we do in therapy can help you separate your beliefs from your behaviors, and learn new ways to be in a relationship with your body & food.
There is a better life outside of your eating disorder and the mental hoops you are jumping through all day long.
Ready to Begin Eating Disorder Treatment in Utah?
You do not have to look a certain way to deserve help. You do not have to have lost enough weight, scared enough people, or hit a low that others would recognize. If your thoughts about food and your body are taking up space in your life — that is enough. That matters. And you deserve care right now, exactly as you are.
Whether you are just beginning to wonder if what you are experiencing has a name, or you have known for a while but convinced yourself you do not qualify, eating disorder treatment in Utah is here for you. All of you. In the body you are in today.
At Inside Wellness, we are here to help you get there — without judgment, without a size requirement, and without making you prove how hard things have been.
Give us a call at 801-699-6161 or book a consultation
Learn more about working with an Eating Disorder Therapist in Utah
You do not have to wait until things get worse to ask for help — you deserve support right now.
Other Services Inside Wellness Offers in Provo and Salt Lake City, UT
Eating disorders rarely travel alone. They are often tangled up with body image distress, shame, anxiety, perfectionism, and a lifetime of messages about which bodies are worthy of care. At Inside Wellness, we offer more than eating disorder treatment in Utah. Alongside specialized eating disorder support, we provide body image therapy, anxiety therapy, support for perfectionism, online therapy, and therapy for burnout, all designed to address the full picture of what recovery actually requires.
Whether you are in a larger body and have been told your struggles do not count, you are somewhere in the middle and not sure if what you are experiencing qualifies, or you have simply been waiting for permission to ask for help — our team is here. You do not need to meet certain criteria before reaching out. Every body deserves support. Every person deserves care.
Visit our blog or FAQ to learn more about how therapy can help you build a life that is no longer run by your eating disorder.