EDUniversati

As long as we label eating disorders as belonging only to specific groups, we are contributing to loss of lives and loss of life potential for millions of people.

Failing to recognize boys and men, in particular, means:

👦🏻 we contribute to shame and stigma surrounding EDs in males, leading to lost opportunities to identify, diagnose, protect, treat, and support them

👦🏾 we lose the benefit of research that reflects the true population of folx affected by EDs - males historically have been represented in 1% of ED research)

👦🏽 we are communicating to boys and men that they can’t be sick, they don’t really need support, and that there is no place for them in treatment and recovery

👦🏼 we take away hope and increase their despair and suffering when they have no safe spaces to be vulnerable and ask for help even outside of mental illness and mental health

🩵Let’s do better for our boys & men 🩵

✨Recovery is possible for EVERYONE✨

This Food for Thought series has never been about shock value or clickbait. It’s meant to start a conversation - even if just an internal dialogue for a parent or a provider or someone who has an opinion on what EDs are and aren’t.

When I ran this post by one of my kids, the response was: it’s shocking, but it’s TRUE.

When I think about the opinion that EDs are a choice, I think of:

🎂 young children in the hospital for medical stabilization *not knowing why they are there*

🍰 teens who just wanted to follow the “good” Health or PE class advice and ended up having to drop out of school & sports bc of ED

🍕 adults who lose a large percentage of their quality of life potential because providers and parents told them when they were younger that they had to make the “choice” to get better first

✨Eating disorders are not a choice - no one, young or old, would ever choose this✨

Not all EDs look like hospitalizations and feeding tubes. Not all people with eating disorders look “unhealthy.” A lot of EDs fly under the radar, especially while “in development” as socially-acceptable behaviors, routines, interests, or lifestyles.

Trust your gut when it comes to your own health or your child’s. If something you’re doing feels overwhelming, oppressive, scary, exhausting, burdensome, or somehow just not right, get help. If your child no longer seems like themselves or you feel like you’re walking on eggshells with them, get help.

There is no such thing as “crying wolf” when it comes to EDs and disordered eating and exercise. You - or your child - always deserve support. Please don’t wait until you feel you present as “sick enough.”

The organizations listed in the last slide are:
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Going through your own recovery and/or supporting your child through their recovery journey can make the holidays an extremely challenging time. We feel that we should be making merry but the reality often is that we’re scared, we’re anxious, we’re exhausted from the hypervigilance. We want to have a “normal” holiday but our lives are anything but normal.

It can be even more difficult when we have other children to take care of and all of our focus is being concentrated on our recovering child. We worry about disappointing siblings, the holidays losing their luster, our ability to keep the magic alive.

If we’re also recovering, it’s one more layer to add on to the stress and pressure of making everything “right.”

There is no one right way to do the holidays when you and/or your child is recovering from an eating disorder.
✨Whatever you’re doing is okay
✨Your other children will be okay
✨One holiday season will not break your family

💫Lower your expectations for what you will do
💫Give yourself grace for what you can do
💫Whatever you’re capable of is good enough

Recovery is difficult AND you will get through it. You’re not alone, even if it feels like everyone is experiencing something you’re not - or you can’t. It’s NORMAL to feel this way and to experience the holidays like this. This season is not forever and there will be many more seasons of joy to come.

In the current context of eating disorder diagnosis, treatment, and insurance coverage, not thin enough can equal not sick or not “sick enough.”

Thin-bias or anti-fat bias are forms of weight stigma that have the potential to - and do in fact - prevent access to care and lifesaving treatment.

In our experience, praise for “healthy” behaviors in a slim body replaced what should have been recognition of a medically critical condition because being the opposite of ob*se was the valued by our provider (no doubt due to anti-ob*sity mandates and potentially due to their own unconscious immersion in diet culture).

When my son’s BMI actually reached the ob*se range - which was when he actually achieved optimal health for his body in recovery - the provider urged me to prevent further gain and encouraged weight loss to avoid his becoming fat.

Had I made the decision to follow this “advice,” my son might not be here today, may not have reached full adult male maturity, and would definitely not be as far along in recovery as he is today.

Weight stigma shows up in healthcare settings, education settings, and our personal lives all the time. Ours is only one experience and one perspective. If you’re curious about the concept of weight stigma, the harm it causes, and how you can avoid contributing to harm or avoid harm to yourself or your child, check out the resources provided by .

✨Eating disorders affect all bodies and all people deserve access to timely, inclusive treatment and equitable care✨

All awareness is good awareness. At the same time, we can always learn new or alternative ways to acknowledge and include by carefully considering the language we choose.

Yes, we’ve traditionally identified, diagnosed, treated and talked about females in the context of eating disorders; and yes, it’s possible prevalence in males has increased in recent decades (as possible as it is that it’s always been present, simply unidentified).

Regardless, it’s time to match our language to what we know occurs and what folks actually experience today.

Boys and men are not an “also” or a “too.”

Males are not so minimally representative in the eating disorder population that they occupy a tiny sliver.

The sooner we accept that all sexes and genders are affected by eating disorders, the faster we’ll see improvements in research, treatment, and outcomes. The fewer years - and lives - will be lost.

✨The language we choose is just one simple way to contribute✨

We know that when a person is ill with Anorexia Nervosa (AN) that:

-restricting
-compulsive exercise
-being unable to eat
-purging
-being secretive
-being combative
-engaging in risky behavior
-engaging in self-injurious behavior
-being unable to break routines or follow new ones
-being anxious, scared, depressed or angry
-being unable to make health supporting choices
-etc.

are all **SYMPTOMS** of their illness.

When we become frustrated with a person who is sick with AN because they exhibit the SYMPTOMS of their illness, we are experiencing a natural response to unwanted (or scary) behaviors in our loved one, patient or client.

If we find ourselves feeling this way, it helps to reorient our perspective and refocus on our understanding that someone with AN is:

-not being defiant
-not choosing to hurt you
-not willingly opposing their treatment plan

and most importantly, they NEED YOUR SUPPORT to become well.

Illness is not a choice.

Eating disorders, which are psychiatric illnesses, are never a choice.

When we wholly understand and believe this to be true, we can increase our own distress tolerance and patience and ultimately provide better support and more appropriate and compassionate care.

✨Recovery is possible✨

I created this schematic to describe how FBT (Family Based Treatment) is experienced by the parent or caregiver from a parent’s perspective.

Currently, when we look at the traditional FBT model, there is no dedicated provider solely for the caregiver. Although the typical team of providers (whether that includes a physician, psychiatrist, therapist, nurse, dietician or peer mentor) in ED treatment is built around supporting the patient (a child, teen or young adult in the case of FBT or FBT-TAY), there is no support solely for the person taking care of their child 24/7 365 year after year.

While the technical role of an FBT therapist includes supporting the caregiver in order for the caregiver to fulfill their role of refeeding or keeping their child safe, the focus is still primarily on the patient and the patient’s progress.

But who is looking after the “care and feeding” of the parent? That’s where the peer mentor for the caregiver comes in.

A caregiver peer mentor is someone who has gone through the lived experience of one of the most harrowing journeys a caregiver can face and come out the other side with the ability to support others earlier in the recovery process.

➡️ Q: Have you used a mentor or coach to help you support your child through eating disorder recovery? Were they helpful? Would you recommend others to incorporate this type of provider into their child’s care team?

I owe my sanity and much of my child’s recovery to the parent who guided me through the darkest of times. They were someone I could trust, someone I could believe, someone who cheered me on, and someone who shared the nitty gritty ins and outs of it all - someone who could say the “unsay-able” without the limitations others on the team were constrained by and with more clarity and accuracy.

✨With or without a team and with or without a parent coach or caregiver mentor, recovery for all of our kids is possible✨

For those who know someone who is caring for a loved one with an eating disorder, there is a lot you can do to show support even without understanding what they’re going through and without physically being present to provide support.

People don’t often think of eating disorders as “casserole illnesses,” deserving of a meal train and other parenting support like carpools and childcare for siblings, etc., but it truly is. The burden on caregivers to cook, clean, feed, supervise and keep loved ones safe is enormous. So much so that some caregivers whose children have had both cancer and an ED have said ED-caregiving is more taxing*.

For all the caregivers out there battling eating disorders for and with their loved ones, you are seen. You are not alone. You will get through this.

There is hope.

✨Recovery is possible✨

*Note: Suffering is never a contest nor is it valid only if it ranks relative to a subjective scale. The intent of this caption is to raise awareness for those unfamiliar with EDs who may assume EDs are discrete illnesses confined to a concrete duration or that there is an easy “cure.” The reality is that it’s common for these complex illnesses to take several years to reach remission and getting there requires consistent support over that entire period of time.

Another mindful reminder that the language we use makes a difference to those experiencing eating disorders and their supports.

Not mentioned in the slides: disordered eating sometimes may include elements of “control” for the person engaging in the disordered behaviors but a person with an active eating disorder is well beyond any element of intentional control and what a person not in their shoes views as a need for control is actually a symptom reflective of their being out of control.

Yes, there’s a spectrum and the lines are blurred between disordered eating and eating disorders, but it is absolutely clear that a person experiencing an eating disorder does not enjoy being in their illness and if they could exert “control,” it would be to rid themselves of the suffering forever.

Let’s stop blaming folks for their illness symptoms and work towards more understanding and compassionate methods of treating eating disorders as the serious psychiatric illnesses they are.

✨Recovery is possible✨

Boys and men make up at *least* 30% of the U.S. population experiencing eating disorders. That’s ~10 million males.

The number may be higher but unreported due to the stigma of eating disorders or the failure to be accurately diagnosed - it was not until the DSM-V (2013) that amenorrhea (loss of a period/menstrual cycle) was removed as a criterion for diagnosis.

If Anorexia Nervosa was observed and documented in the medical field by physicians in the Victorian Era - back in the 1800s - then why are we still so surprised in 2025 that our young boys and our men are falling ill?

Why does almost all of our scientific research only involve girls and women and the effects of this fatal illness on the female body? Why is there a total lack of support groups for male patients and their caregivers? Why is advertising and treatment primarily targeted to females?

In 1873, Queen Victoria’s physician, Sir William Gull, moved to the term, Anorexia Nervosa, from the previously used term, Anorexia Hysterica, precisely because AN is not a female illness.

Today, AN and all other eating disorders do not only affect girls and women. In fact the rates of boys and men experiencing eating disorders is on the rise.

Unlike females, who might be bolstered by the antidiet and body positivity or liberation movements, most boys and men do not have a safe space to go to or role models who haven’t fallen into the bigorexia- or orthorexia-promoting culture.

Parents, coaches, teachers, influencers, physicians, celebrities, and many more influences on young boys encourage dieting, overtraining at the gym and on the field, and taking dietary supplements, putting our boys at risk with nowhere to turn.

Being inclusive in our conversations, care, research and treatment will save so many lives and reduce so much suffering.

✨If you are a male reading this or a parent/caregiver of a male child, it’s never too late - get help now because RECOVERY IS POSSIBLE✨

Eating disorders are unique to each individual in terms of symptoms, presentation, severity, chronicity, the weight which is “healthy” for the particular person, etc.

One thing that is universal, however, is the majority of providers across the board deem children and teens as “weight restored” and encourage parents and caregivers to back off supporting their child through to full recovery at this magical weight.

“Weight restored” does not necessarily mean a child or teen has reached their body’s recovery weight. There is no one existing and officially accepted medical formula that can tell us what a child or teen’s recovery weight will be and the risk of stopping treatment too soon is too great to not keep going.

Eating disorders are not about weight AND without sufficient energy intake and energy stores, full remission is not possible.

Don’t settle for “better” or “looking normal” - hold out for fully recovered … whatever that weight might be.

✨Full recovery is possible✨