Eating Disorders are Rising, Fatal and Ignored

They kill over 10,000 people per year, so why is research funding dwindling?

I’m writing an article right now about eating disorders — and it’s opened my eyes to some disturbing truths about a world I’ve not visited in years.

I had one for more than a decade. Millions of people have, and EDs are on the rise (though you’ve probably not heard about that given the litany of other psychiatric illnesses that have claimed a starring role in cultural conversations.)

Did you know that Anorexia rivals substance abuse disorder as the most fatal?

As much as people don’t understand addiction, they *really* don’t understand eating disorders. They’re pretty similar to addiction, by the way.

I’ll never forget ginning up the courage to tell my parents I thought I had one years ago. Once I blurted it out, they didn’t seem to believe me. It almost seemed like my serious admission confused them.

I don’t hold it against them — they were surprised and totally unfamiliar with this condition. But, soon after, my doctor pulled my mom aside one day and, without prompting, suggested I might have a problem. I think she finally took it seriously then, but it was still several years before I got any professional help.

It seems so simple:

Just eat.
Or stop eating.
Or stop throwing up.
Stop exercising 3 hours a day.
Stop taking laxatives.
Stop throwing up.
Stop starving all day and then binging at night.
Stop knowing the calorie content of a teaspoon of ranch dressing.
Stop calculating the hours of your day by the one cup of non-fat yogurt you’ll eat for lunch.

Sure, Jan. We’ll do that.

But it’s not that simple because eating disorders aren’t diseases of bad behavior; they’re mental illnesses. The brain is chemically altered and rewired to fear food, fat or loss of control.

For me, being fat became the ultimate problem. I wasn’t fat, but I could be if I didn’t watch out.

If I were fat, I would be nothing.

I could do nothing worthwhile.

I would not be respected or loved or admired.

I’d never find someone to marry.

Nothing I accomplished would matter.

It all started when I was 13; I can pinpoint it to the minute.

I was overseas on a mission trip, where we were fed well — and required to eat everything on our plate. That hadn’t been a problem for me the year before when I was on my first trip, but something had shifted.

My teammates, who were a little older, talked frequently about gaining weight from eating all the good food.

I had just gotten a second helping of biscuits and gravy when the conversation turned in that direction. One of our leaders said, “But Ericka and Adie (another girl, who was super thin), you guys definitely don’t have to worry about that!”

I think she included me because I was only 13, and maybe realized the commentary wasn’t great for young teens — but it was too late to backtrack.

I stared down at my plate and didn’t want to finish it. It felt like I put on five pounds just looking at the gravy. The next day, I started exercising, waking up to a series of push-ups, sit-ups and jumping jacks each day until the trip ended.

My letters home began to lament fears of weight gain, confessing I worried my clothes wouldn’t fit when I arrived home. I wrote, warning my parents that I might “look different” when I got home (I was gone all of two months).

The fear had taken hold, and my mind was forever altered that day. That it happened in an instant is what scares me the most. I know it had been building — cultural pressure, insecurity, puberty — but things seemed to click into place all at once.

A few weeks after arriving home, I started 8th grade — promptly growing 5 inches and losing 15 pounds. By then, I had turned food into a numbers game—meticulously tracking calories in and out—while others envied my thigh gap and flat stomach. The feeling and admiration were addicting.

Hardly any photos of me exist around this time, but here’s one:

From there, I spent many years restricting, binging, purging, obsessing, exercising, and hating myself. It’s not surprising this eventually morphed into other addictive tendencies.

Many women struggling with alcohol have a history of eating disorders.

Up to 35% of those dependent on alcohol or other drugs have also had eating disorders, a rate 11 times greater than the general population, according to the National Alliance for Eating Disorders.

This relentless focus on substance, feeling, and escape — isn’t easy to move away from when you train your mind and body for it in childhood.

People often say, “Everyone is too concerned with themselves to notice what’s wrong with you.”

But that didn’t make me feel better because I did notice other people’s imperfections, especially if they were weight-related. I noticed if someone had gained weight and judged them for it. I assumed the same would go for myself. That’s still the case sometimes (I hate to admit it.)

Eating disorders have been on the rise for two decades, spanning all demographics. They’re often seen as a “rich, white girl” problem, but that’s not the case anymore. Across gender, ethnicity, and class, eating disorders are more common than ever.

Some of the biggest triggers for this increase:

• Twenty years ago, social media launched us into a million problems.

• Struggle with gender identity (both men and women seeking to look like the opposite sex want to lose weight.)

• Healthy food obsession. It’s good to make healthy food choices, but it can become obsessive. I love MAHA, but it’s triggering for some.

• Diets & trends like Ozempic are creating more eating disorders. More EDs sparked today during perimenopause & menopause, too.

• Increasing rates of depression and anxiety in youth.

This probably doesn’t surprise anyone, but for those touched by eating disorders themselves or with family members, we should notice where it’s coming from.

Parents should recognize that a relentless focus on “healthy” foods could indicate to a child that certain foods are scary or “bad.” Dr. Najeeb Riaz, M.D. writes about it for Penn Medicine:

“Orthorexia can begin with eliminating something like gluten or sugar from your diet, and then progress to where the diet is very, very limited to a small selection of foods that do not meet your dietary needs.

Another example would be only eating foods that can be verified as being 100% organically grown, which can be difficult to confirm when it comes to every ingredient in a meal.”

You should also know about the stereotypes and myths. We often think of the waif-like woman in baggy leggings. This is Anorexia, the most deadly of eating disorders, but it is not the most common.

The most common condition is binge eating disorder, and most people who have it aren’t super thin. Only 6% of those diagnosed with EDs at all are medically underweight.

I was underweight for a couple of years until my eating disorder morphed into bulimia and binge eating. I also felt unable to stop that transformation. After that initial extreme weight loss, I then gained 60 pounds in less than a year when my disorder shifted.

Because I was highly underweight before, that 60 pounds brought me to a pretty normal weight for my height — but I felt so disgusting and began to panic. My binging was out of control.

This is me as I was gaining that weight:

That was when I finally sought help and entered an intensive, outpatient eating disorder therapy program. It was the first step to overcoming this hellacious condition, but it would still be years before I ate like a normal person.

Raising a Daughter

I have a daughter now. She is so sweet and little and innocent still. Because we don’t know all the root causes of eating disorders, I’m scared for her.

We try never to mention fat or skinny in our house. We don’t obsess over food, but getting kids to eat or eat healthy is an entire battle. It’s hard to make it wholly non-emotional or just “not a thing.” I’d be lying if I said I’ve never tried to persuade my kids to eat something because it’s good for them!

I’d do anything to keep her from it:

I talk about how too much sugar isn’t good for our bodies and mention that we should avoid red or blue-dyed foods. I talk about fruits and vegetables being so important and good for us. We eat plenty of sweets — too many — and I think it’s clear I sometimes have difficulty putting down the ice cream or chocolate. Same with my husband.

With alcohol, we just chucked it. They don’t see us drink (because I don’t at all and my husband does very rarely). We’ve spoken with them about how addiction is a part of our family history and that’s why we don’t drink and why they need to be very careful about that when they’re older.

But food is more complicated. And for girls, it feels scarier.

Why is food so charged with emotion for us?
Why do our bodies determine our mood?
Why do we see them as something to perfect, discipline, and command?
Why am I “fine” unless my weight exceeds a certain number?

It’s still there, that little voice that tells me I’m not good enough unless…and at this point, I’m guessing it will be there until the end.

What I learned while writing this article I wrote is this: Researching on eating disorders has lost funding, fewer public resources are available, and we’ve learned very little in the last 30 years about why or how people get eating disorders.

We’re not in a good place, so I’m talking about it. And you’ll hear a lot more about this in my upcoming article on it in the Wall Street Journal.

I don’t want more little girls to go through what I did. I don’t want any more women to transfer from one addiction (EDs) to another (alcohol) if we can stop it before it starts.

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