Eating Disorders Can Affect Anyone

Written By TAASC Malta

by Dr Erica Cini 1-3                                       

Affiliations: 1 East London NHS Foundation Trust, 2 King’s College London, 3 University College London   Licence: CC-BY-NC-ND

 

When people think about eating disorders, they often picture a specific group: young, white, affluent women. This stereotype is misleading. Contrary to common misconceptions, these disorders do not discriminate - they can affect anyone, regardless of age, gender, ethnicity, or socioeconomic status (Beat, 2025). It is important to challenge these outdated assumptions, to ensure prompt identification of those individuals who are suffering from this condition. Earlier recognition and timely evidence-based intervention lead to a better prognosis (Treasure et al., 2011).

Eating disorders are complex mental health conditions with serious physical and psychological consequences. Although there are seven recognised types of eating disorders, anorexia nervosa and bulimia nervosa are the most widely recognised. Both can have life-threatening effects, with anorexia nervosa having the highest mortality rate of any psychiatric disorder, even surpassing that of depression (Arcelus et al., 2011; Rundle et al., 2019).

Breaking the Stereotype: Who Actually Gets Eating Disorders?

For years, media portrayals of eating disorders have reinforced a narrow and inaccurate image (Bassett & Ewart, 2023). Research, on the other hand, tells a different story. Studies show that eating disorders impact people across all demographics, including men, older adults, race and ethnicity, and sexual orientation (Diemer et al., 2015; Sonneville & Lipson, 2018). Despite this, many groups remain overlooked in both research and treatment.

Gender and Sexual Orientation

While eating disorders are often perceived as predominantly affecting heterosexual females, individuals across the gender and sexual orientation spectrum are at risk. A third of individuals with eating disorders are male, and subclinical disordered eating behaviours occur at similar rates across genders (National Eating Disorders Association, n.d.). Boys and men are more likely to present with a desire for an increase in muscularity, than women (Nagata et al., 2020). Similarly, individuals in the LGBTQ+ community, face higher risks of developing eating disorder-related eating behaviours (Cao et al., 2022) and eating disorders when compared to their heterosexual cis-gender peers (Diemer et al., 2015). Factors such as discrimination, gender dysphoria, and societal pressures can contribute to eating disorder-related eating behaviours in LGBTQ+ populations (Cao et al., 2022). Therefore, inclusive and affirming healthcare practices are vital in supporting all individuals affected by eating disorders.

Culture and Eating Disorders: A Hidden Problem

Cultural background plays a significant role in the manifestation and perception of eating disorders. In many non-Western cultures, stigma surrounding mental health, combined with a lack of awareness, can lead to under-reporting and under-diagnosis (Rodgers et al., 2018). Ethnic minorities often encounter barriers to accessing treatment, including a lack of symptom recognition, cultural unawareness from healthcare providers and a lack of culturally tailored interventions (Cini et al., 2024). Research highlights that individuals from South Asian communities, for example, may exhibit eating disorder symptoms that differ from Western diagnostic criteria, underscoring the importance of culturally competent care (Cini et al., 2024).

Impact of Socioeconomic Status

Socioeconomic factors significantly influence the development and treatment of eating disorders. Individuals from lower socioeconomic backgrounds may experience limited access to healthcare resources, nutritious food, and education about healthy eating habits (Sonneville & Lipson, 2018). Financial constraints can exacerbate stress and anxiety, potentially triggering disordered eating behaviours as coping mechanisms (Rodgers et al., 2018). Food insecurity can be linked to binge eating disorder and obesity security (Rasmusson et al., 2018). Conversely, those from higher socioeconomic statuses may face societal pressures to maintain certain body images, leading to restrictive eating practices (Bassett & Ewart, 2023). Understanding these socioeconomic dimensions is essential for developing public health strategies that address these disparities.

The Role of Healthcare: Where We Need to Do Better

Healthcare providers play a pivotal role in the early detection and treatment of eating disorders. Training professionals to recognise the signs and symptoms across diverse populations is critical in moving beyond traditional stereotypes (Rodgers et al., 2018). Culturally competent care, which respects and acknowledges a patient's background and experiences, enhances the effectiveness of interventions is paramount (Cini et al., 2024). A holistic approach to healthcare, with a collaborative practice model amongst various multi-disciplinary team members, including psychiatrists, dietitians, therapists, mental health professionals, and the wider community support systems (e.g. school and social care) is essential.

Final Thoughts

Eating disorders are multifaceted conditions that transcend demographic boundaries. Awareness and education are crucial in dispelling myths and ensuring equitable access to care. By acknowledging that anyone can be affected by an eating disorder, healthcare can move towards more inclusive support systems and effective treatment modalities. Emphasising research and clinical practices that consider gender-related, cultural and socioeconomic factors will pave the way for more compassionate and comprehensive eating disorder care provision.

References

  1. Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Archives of general psychiatry, 68(7), 724–731. https://doi.org/10.1001/archgenpsychiatry.2011.74

  2. Bassett, L., & Ewart, M. (2023). Discrepancies between media portrayals and actual demographics of eating disorders in TV and film: Implications of representation. Journal of Eating Disorders, 11, Article 161. https://doi.org/10.1186/s40337-023-00892-y

  3. Beat. (2025). Eating disorders can affect anyone. https://edaw.beateatingdisorders.org.uk/eating-disorders-can-affect-anyone/

  4. Cini, E., Lewis, H. K., & Vasey, M. J. (2024). Cultural differences in eating disorders with particular emphasis on British South Asian communities. Cutting Edge Psychiatry in Practice, 6, 26-37.

  5. Cao, Z., Cini, E., Pellegrini, D., & Fragkos, K. C. (2022). The association between sexual orientation and eating disorders‐related eating behaviours in adolescents: A systematic review and meta‐analysis. European Eating Disorders Review, 31(1). https://doi.org/10.1002/erv.2952

  6. Diemer, E. W., Grant, J. D., Munn-Chernoff, M. A., Patterson, D. A., & Duncan, A. E. (2015). Gender identity, sexual orientation, and eating-related pathology in a national sample of college students. Journal of Adolescent Health, 57(2), 144–149. https://doi.org/10.1016/j.jadohealth.2015.03.003

  7. Nagata, J. M., Ganson, K. T., & Murray, S. B. (2020). Eating disorders in adolescent boys and young men: An update. Current Opinion in Pediatrics, 32(4), 476–481. https://doi.org/ 10.1097/MOP.0000000000000911

  8. National Eating Disorders Association. (n.d.). Eating disorders in men and boys. National Eating Disorders Association. Retrieved February 20, 2025, from https://www.nationaleatingdisorders.org/eating-disorders-in-men-and-boys/

  9. Rasmusson, G., Lydecker, J. A., Coffino, J. A., White, M. A., & Grilo, C. M. (2018). Household food insecurity is associated with binge-eating disorder and obesity. The International journal of eating disorders, 10.1002/eat.22990. Advance online publication. https://doi.org/10.1002/eat.22990

  10. Rodgers, R. F., Berry, R., & Franko, D. L. (2018). Eating Disorders in Ethnic Minorities: an Update. Current psychiatry reports, 20(10), 90. https://doi.org/10.1007/s11920-018-0938-3

  11. Rundle, S., & McIntyre, T. (2019). Eating disorders: An overview and statistics. National Eating Disorders Association. https://www.nationaleatingdisorders.org/

  12. Sonneville, K. R., & Lipson, S. K. (2018). Disparities in eating disorder diagnosis and treatment according to weight status, race/ethnicity, and socioeconomic background in U.S. college students. International Journal of Eating Disorders, 51(6), 518–526. https://doi.org/10.1002/eat.22846

  13. Treasure, J., & Russell, G. F. M. (2011). The case for early intervention in anorexia nervosa. The British Journal of Psychiatry, 199(1), 5–7. https://doi.org/10.1192/bjp.bp.110.087585

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