Why we need to address the eating disorder no one talks about.

Today marks the inaugural World Eating Disorders Action Day, an occasion intended to spread accurate information and eradicate myths about eating disorders across the globe.

It comes at any interesting time in Australia, where our only eating disorder-dedicated support service, The Butterfly Foundation, could lose its funding under the Federal Department of Health’s restructuring of online mental health services. The plan is to ‘centralise’ mental health care – cutting support initiatives such as The Butterfly Foundation’s hotline.

Alongside the practical and symbolic implications of this funding decision is a vast misunderstanding of eating disorders and what they look like.

In popular culture, and by many well-intentioned campaigns, an ‘eating disorder’ almost always looks like a white, privileged, emaciated woman who refuses to eat. We tend to logically conflate ‘eating disorders’ and ‘anorexia nervosa’, despite the fact anorexia is actually the rarest of all eating disorders.

Watch the Nine Truths About Eating Disorders, courtesy of World Eating Disorders Action Day. (Post continues after video.)

Our cultural obsession with anorexia isn’t exactly surprising. It’s the most deadly of all psychiatric illnesses, and one of the only mental disorders you can really see. We’re collectively fascinated with restrictive eating behaviours and the concept that an otherwise healthy person could starve themselves to death. But how about other debilitating and far more common issues with eating?

Today of all days, it’s time for us to acknowledge the type of eating disorder no one talks about. The one you can’t always see from the outside. The one that describes people who may be underweight, but also might be a ‘normal’ weight, overweight or obese. The one that doesn’t perfectly fit into the clinical definition of anorexia or bulimia or binge eating disorder, but isn’t any less serious.

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OSFED, or Other Specified Feeding or Eating Disorder, is the classification that describes the majority of eating disorder sufferers.

Eating disorders don't always 'look' the way we expect them to. (Image: iStock)

It's the category left over for people who might have all the symptoms of anorexia, but not have a low enough BMI to constitute that diagnosis. It's the category for those whose weight fluctuates dramatically because of unhealthy eating behaviours, that don't fit clearly elsewhere.

It's the category for those who have some combination of the psychological, physical and behavioural signs of an eating disorder, but perhaps not a combination lay people would recognise.

It's the one we need to look at more closely, because it sheds light on the eating disorder sufferers who are routinely left out of the conversation.

On World Eating Disorders Action Day, we need to acknowledge that our rhetoric around eating disorders is entirely one dimensional.

Watch: Is anorexia nervosa genetic? (Post continues after video.)

In pop culture, these problems are routinely characterised by calorie restriction and extreme thinness - a representation that reflects an incredibly narrow definition of what constitutes an eating disorder.

So why is it that we avoid looking closely at binge eating? Or excessive exercise or purging in people who are normal weight, or overweight or obese? When was the last time you saw the eating issues of people in larger bodies taken seriously in the media as a mental health issue, rather than a physical one? When was the last time you saw their problems talked about compassionately, rather than disparagingly?

Perhaps it's because despite the sickness of it, thinness — even in its disordered form — is still revered and respected.

Today, we need to acknowledge the strong divide between the media’s portrayal of eating disorders and the lived reality of them.

It’s crucial that our messaging around eating disorders isn’t dominated by thinness – because the overwhelming majority of people who suffer from disordered eating aren’t extremely thin. Failing to represent sufferers accurately further stigmatises mental disorders that are already highly debilitating.

It's crucial for us to be empathetic and understanding of all mental health problems - even the ones we can't see.

So on World Eating Disorders Action Day, I hope we can broaden our understanding of eating disorders, to incorporate, and ultimately have compassion for, all those who suffer.

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