The most common misconception about eating disorders is that they're all about vanity. Half the fun of perusing fashion magazines seems to be the mixture of envy and disdain people experience when looking at the anorexic models. It's as if these models are paid to flaunt their sickly bodies just for public titillation. The communal adulation of photos of sickly, starved women only reinforces the false premise that vanity drives eating disorders.
Accordingly, we as a society associate dieting and body weight with personal success, an ill-fated triumph now crossing gender and socioeconomic lines. It's not disputed whether most eating disorders start with a diet; they do. It's also a sad fact that a large swath of public praise these days is related to weight loss. Unbeknownst to most people, it's a fine line between dieting and getting an eating disorder; it's luck as to whether a diet is just a diet or triggers a cascade of events that results in an eating disorder. If we accept chronic starvation and weight loss as a fact of life, we also implicitly agree that it's ok for people, including kids, to be more susceptible to getting an eating disorder. For those who get sick, the urgency to restrict food, lose weight and maintain a low body weight is no longer a diet one can stop to tomorrow. It's an obsessive yet pointless set of symptoms of an illness that destroys lives. The need to maintain a low weight feels like an issue of life or death; nothing else in life matters. Vanity, the initial motivation, is a long forgotten dream.
Conflating vanity and eating disorders relegates someone already suffering from an illness to be seen as a self-centered, body-obsessed, shallow person. An illness downgraded to mere superficial folly turns eating disorders into a choice, as if trying out anorexia is just a whim. Why not starve and lose some weight and see if it suits you? The layperson uses anorexic and bulimic as throwaway adjectives to describe someone who skips a meal or loses weight or throws up once. It's a way to express envy and be dismissive at the same time, and to distort a serious illness into a social convention. The effect is to instantly ignore the mental and physical torture of diseases that destroy lives and have the highest mortality rate of any psychiatric disorder.
Hidden from view and intensely secretive, the person with an eating disorder hears every word. Eating disorders are classified as psychological disorders, not a medical ones. In an eating disordered mind, the relentless rules around eating dictate one's every move. Where to go? When to eat? What to eat? Whom to spend time with? The answers all come from the eating disorder as edicts that must be followed. The core psychological symptom of an eating disorder is to set up rules around food and weight, ones that affect and interfere with all aspects of life. The sick person is never allowed to say no to the rules for one simple yet powerful reason, an omnipresent, punishing thought that feels more true than anything, an incontrovertible fact. The truth is this: you, the sufferer, are an awful, terrible person. This fact vindicates every punishment an eating disorder can conceive of, and the person, fully compliant with being such an awful person, is compelled to follow every command, or else face the endless, punishing, horribly critical thoughts that will bombard their minds. There is no connection between this suffering and vanity.
Imagine this person overhearing friends, family or colleagues describing eating disorders as vanity. Imagine how these flippant remarks confirm that everyone believes that an eating disorder is your fault. How would these comments affect the person? The humiliation of feeling exposed, confirming the thought that you are a horrible person, followed by the psychological punishment meted out by the eating disorder would be devastating. In fact, this scenario occurs every day amongst unwitting groups of coworkers or friends unaware that someone with an eating disorder is sitting right next to them.
It almost appears as if society wants those with eating disorders to suffer in silence. Many people obsess over food and weight every day and lose time and productivity to this fruitless exercise, but, even so, don't have eating disorders. The vast majority of chronic dieters don't have the genetic make-up--the combination of the innate ability to starve triggering the onset of the punishing thoughts--to spiral into an eating disorder. Magazines, models and clothing stores all produce the propaganda for the masses. It's as if we all are supposed to be obsessed with food and weight. It's as if this is now considered normal.
The fortunate ones, those only stuck with an obsession but not an illness, need enough education to realize that food and weight conversations need to remain private. Recognizing the pain caused by passing, ignorant comments about eating disorders can help lead to more openness and less shame about having these illnesses.
Eating disorders have nothing to do with vanity. The sooner we accept anorexia and bulimia as diseases, the sooner we acknowledge that an eating disorder and a diet have nothing in common, the sooner we all can create a more open path to health for these patients and help prevent eating disorders in the first place.