My dear one,
Yes, you are dear to me even if you’re a stranger.
I feel so much tenderness toward you because I imagine you might be suffering in silence. It’s possible no one in your life has a clue about what you’re going through because they think they know what an eating disorder “looks like.”
And you don’t happen to look like that image they have in their mind: young, white, female, wealthy—and emaciated.1
They don’t know that eating disorders affect people across the lifespan and all racial identities. They don’t know that men and boys get these illnesses. They don’t know that food insecurity increases the risk of getting an eating disorder. They don’t know that only a tiny fraction (about 6%) of people with eating disorders are considered medically “underweight.” And they don’t know that BMI can’t tell you the severity of someone’s illness or even what kind of eating disorder they have.
Maybe a part of you wishes you did look like the “poster child.” Not just because the ED voice in your head says that is how you should look but because then maybe the outside world—your friends, your family, your doctors—would know something was wrong and help you get the care you need.
Maybe then they wouldn’t ignore your suffering. Maybe then they would stop praising your symptoms.
“You have so much discipline!”
“It’s great how you’re making healthy choices!”
“I wish I had your willpower!”
“You look amazing!”
Because unless you have protruding bones, our culture says you should keep going—and maybe go even harder. More steps. More protein. More weight-lifting.
Your loved ones may not realize that, for you, things have Already. Gone. Too. Far.
You don’t have to be wasting away to feel like you’re wasting your life stuck in a constant state of tormented negotiation with a part of your brain that has been taken over by a cruel task-master.
From the outside, they can’t see how you are controlled by compulsive, obsessive, intrusive thoughts about food, exercise, and your body.
The counting, the calculating, the tracking
The weighing, the body-checking, the mirror-obsessing
The secret late-night bingeing that brings temporary relief—and the physical pain and shame that flood you afterwards
The joyless, punishing exercise that earns you “trophies” on your fitness tracker
The other forms of purging you are so very skilled at hiding even from the people you live with
Because of diet culture and pervasive stereotypes about eating disorders, you can be seriously ill and absolutely miserable, and yet no one is expressing any concern. Unless you’re in a larger body, that is—in which case, they are probably encouraging ED thoughts and behaviors, ya know, for your health.
If a part of you is acknowledging that, yes, you do need help, I’m guessing another voice inside your head is whispering (or shouting) that you’re crazy to think you need support, let alone treatment. “You can’t possibly think you’re ‘sick enough’ to have an clinical eating disorder!"
Eating disorders lie and manipulate. They are mental illnesses, though they wreak havoc on the body even when it’s not always visible from the outside.2 And they affect the brain in ways that can keep you stuck in a state of rigid thinking, low self-worth, and other cognitive distortions.
If you’ve read this far, my hunch is you want to get better and get your life back. And so maybe you can receive what I’m about to write:
You don’t have to keep getting worse.
You deserve care, and you deserve it now.
There are eating disorder professionals out there who know that size doesn’t determine sickness, who won’t collude with your ED, and who can help your loved ones and other medical providers get they education they need to support you.
Not sure where to start? You can try one of these nonprofit organizations dedicated to helping people get care:
I wish you hope and healing. Recovery is possible, and it’s worth it.
Sincerely,
Oona Hanson
I spoke with New Zealand-based body image coach Emma Wright about parenting amidst relentless marketing of weight-loss drugs. You can listen here.
I don’t know if Ariana Grande has an eating disorder, but a lot of people assume she does, which in itself reinforces stereotypes. Just as eating disorders don’t have one “look,” extreme thinness doesn’t mean someone has anorexia.
Even bloodwork doesn’t always show signs of an eating disorder. If a medical provider dismisses your concerns based solely on labs, get a referral to a specialist.
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