Have you felt judged for your size? Do you alway wonder if that person you haven’t seen in a long time is looking at you now, thinking you “let yourself go” or you don’t care about your health, solely based on how you look?
Are you worried that they think you binge or have some sort of emotional eating concern because of your size?
Whether or not it’s true, these thoughts can make you feel so vulnerable and exposed! It’s made you question your size AND your health – maybe even wondering if “Is obesity an eating disorder?” Is it?
The fact that you’ve been taught to ask yourself that question is not only unfair, it’s wrong.
Health is not a size! Nor is disordered eating a size!
Perhaps weight bias and diet culture have been something that’s been around you all your life. If that’s the case, and chronic dieting and obsession with food have done a number on you, it’s not just you!
It very often starts in our family of origin. My own mother was prescribed and praised diets for years, since she was a kid. It completely impacted her self-esteem, her relationship with me and my sisters, and her health over the years.
My job as a registered dietitian and Intuitive Eating counselor is to set the record straight.
Let’s start by distinguishing body size from eating disorders.
is obesity an eating disorder?
Obesity is a classification of body size based on body mass index (BMI) (1). If you have been following me for a while, you know what I think about BMI.
BMI is bogus! It was never created to be a measure of health. Unfortunately, it was created with bias, yet healthcare providers continue to use it to measure your health risk. Ugh!
Obesity is certainly not an eating disorder in and of itself.
Body size itself is not a cause of eating disorders but being in a larger body can put you at a higher risk for developing one if you have a tendency toward eating disorders within you.
Your risk of developing an eating disorder depends on many factors – biological, psychological, and psycho-social.
With all those factors, how do you know if you have an eating disorder or not?
eating disorders aren’t marked by size
First of all, what comes to mind when you think of eating disorders?
You are not alone if you pictured a very thin, white, woman who might have anorexia. This is how eating disorders are presented in many public health campaigns and high school health class videos. But this is NOT the most typical Eating Disorder (ED).
Some of the other eating disorders I work with present VERY different, and can include:
- Binge eating – You eat a large volume of food in a short period of time and feel a loss of control to stop eating, followed by guilt/shame for overeating (4)
- Night eating syndrome – You wake several times in the night to eat
- Otherwise specified feeding or eating disorder (OSFED) – Considered a “catch-all” diagnosis. You may not meet ALL the diagnostic criteria for other eating disorders, but you still have a significant eating disorder (5)
- Orthorexia – Not yet an official eating disorder, but common. You over-restrict food groups, and have an obsession with “eating clean” or “healthy foods” that interrupts your mental or physical wellbeing. If you think your situation is “not bad enough” to seek support, listen to a former client talk about her journey overcoming orthorexia.
It may be hard to hear these criteria do in fact lend themselves to an eating disorder. You may have even been prescribed some of these disordered habits from a medical provider or diet program that felt safe.
Notice, too, how so many disordered eating behaviors have been normalized in diet culture as “good” or “bad” moral decisions.
For example, binges are often referred to as a “lack of willpower” and orthorexic tendencies are often referred to as “being good” or “clean eating”. It would make sense if maybe you didn’t even realize that things were that bad when it came to your relationship with food, but still — you just knew something was “off.”
Eating disorders can have a significant impact on all your body systems, including your heart, your digestion, your brain function, and your hormone regulation (6).
They are serious and can be life-threatening conditions if you don’t seek help (6).
But if you’re here, you are taking a first step toward healing.
I work with clients to prioritize their health values and heal their relationship with food over time.
Often this means taking a look into your past experiences with food and your values and ideas around food and your body.
chicken or the egg
Which came first, worrying about your size or going on a diet? Can you remember?
Many of my clients talk about going on Weight Watchers with their mom and being encouraged to “be good” or split salads as a means to prevent weight gain.
For some, it may go back further. You may not even remember the times in kindergarten when your teacher told you to “eat the healthy foods first” before eating that cookie in your lunch.
Eating disorders (ED) are not caused by parenting or diets – they’re multifactorial. But dieting sets the stage (and even teaches) for ED behaviors to take hold.
My mom was in a bigger body and she totally believed that preventing me and my sisters from becoming fat would protect us from harm. If we were skinny, we wouldn’t experience the bullying and difficulties she faced because of her bigger body. I think many mothers believe this, and so they teach their children to diet from a very young age.
We never learned to challenge the idea that fatness was bad when we were younger, which keeps that weight bias and diet cycle passing through generations. It means more of us are struggling with food and body image – and it doesn’t have to be this way!
Sadly, this is not a problem of our mother’s generation. Many people in larger bodies with ED do not get help. They hear “keep doing what you’re doing” and “you look amazing” by everyone, including their doctors, despite feeling totally overwhelmed and preoccupied with weight and food.
Many people feel like things aren’t “bad enough” to get help, which leads to chronic food guilt, depression and anxiety symptoms, and health issues related to dieting and weight cycling.
It’s hard, sticky work, but I believe we can be the generation that breaks the diet cycle.
I help my clients gain new perspectives on body size, health, and body diversity, and break the generational diet cycle to find freedom from diet culture and weight bias.
body diversity is real
It’s hard sometimes to have perspective with social media these days because much of the bodies you see celebrated belong to thin, white, affluent women. It can make you feel like they have the “right body” – or even way of life – compared to your own.
But thin is not the only way to be. Whether or not they are adequately represented, folks in larger bodies not only exist, they always have! Larger bodies are worthy of admiration and love – just like everyone else. We’re all just human.
Being in a larger body is guided by genetics, in part, alongside many other factors that go beyond your relationship with food and movement.
Believe it or not – there are fat people who exist with excellent nutrition, movement, and mental health.
Just as there are thin people who exist with poor nutrition, movement, and mental health.
Body size doesn’t say a thing about health or worth.
That being said, folks in larger bodies are targeted for dieting behaviors earlier on in their lives. This may lead to a higher proportion of ED and disordered eating as you are trained to think about food as “dangerous”, and set the stage to constantly be tallying up every bite. Sadly this often goes undetected.
Unfortunately, because of the criteria for eating disorders sometimes including low BMI, folks in bigger bodies often get missed.
On top of that, healthcare bias and insurance criteria often require a lower BMI to get help. Again, if you are in a bigger body, you get dismissed. Instead, you are targeted for weight loss drugs, programs, and surgeries which are unsafe interventions for those with eating disorders. And another post for another time — there is criticism these interventions may be unsafe in general as they are associated with physical harms like weight cycling, loss of muscle and bone mass, and long-term metabolic changes.
If you feel that you are not getting your healthcare concerns addressed because of your size, it may be time to look for a fat-friendly health professional so you can have the care you deserve.
Your size should not affect the care and attention you receive, or don’t receive!
reach out for support
If you are struggling with weight and food, you are not alone. The best thing you can do is seek support.
You can start by finding a primary care physician, registered dietitian, and/or therapist through a trusted organization like MEDA. They have a network of providers and treatment centers to help support you.
You can find me and other supportive, collaborative professionals here.
When you are ready to reach out, you can apply to work with me. I will meet you over a discovery call to help you navigate what would be the best kind of care and if we are a good fit to work together.