Breaking the Silence: What Everyone Should Know About Eating Disorders

By Michelle Kim Leff, M.D., M.B.A., Jocelyn Sudds-Allen, M.P.H., and Laura K. Grubb, M.D., M.P.H. | SAMHSA |

Nearly 1 in 10 people in the U.S. will have an eating disorder during the course of their lifetime. Some of these conditions can be serious, and potentially even fatal. It’s critical to break the silence and raise awareness about this public health problem. This week marks National Eating Disorders Awareness Week, a time to increase understanding, reduce stigma, and share messages of support and hope for those impacted. It also provides an opportunity to highlight available resources for those looking for help. With treatment and long-term recovery supports, most individuals with an eating disorder can make a full recovery.

Understanding Eating Disorders

Eating disorders are mental health conditions that involve persistent and disruptive attitudes, behaviors, and emotions toward eating. Eating disorders often involve an unhealthy perception of one’s weight and food intake. There are four common eating disorders: anorexia nervosa, binge eating disorder, bulimia nervosa, and avoidant/restrictive food intake disorder.

Eating disorders can have a serious impact on individual health and well-being. People with eating disorders are at a higher risk for suicide and medical complications. It is also very common for people with eating disorders to have other serious mental health conditions and substance use disorders. Nearly all people with a lifetime diagnosis of an eating disorder have a co-occurring psychiatric disorder, most often a mood disorder, anxiety disorder, or substance use disorder.

In addition, people with eating disorders have a 5-6 times higher rate of suicide attempts than those without an eating disorder. Each year, more than 10,000 deaths are the direct result of an eating disorder – that’s one death every 52 minutes. That’s why prevention and early intervention efforts are so important. The sooner the signs of these illnesses are recognized and addressed through treatment, the greater the likelihood of long-term recovery.

Here are some common myths and related facts.

MYTH 1: People with eating disorders are only concerned about their physical appearance and “choose” unhealthy eating habits.

FACTS: Like other behavioral health challenges, eating disorders are complex medical and mental health conditions with risk factors that people don’t choose. Genetics, sex, age, developmental stage, neurobiology, personality traits, trauma, stressors, sociocultural appearance ideals, diet culture, childhood experiences, peers, parents, and media influences are all factors that may predispose individuals to develop a distorted body image or an eating disorder. People with eating disorders may have obsessive thoughts about their body size/shape and food. Distress related to these thoughts may drive them to repeat behaviors like binging food, purging, limiting food or types of food, etc. Those affected often feel a lack of control over their thoughts and behaviors.

MYTH 2: Eating disorders only affect young women.

FACTS: Eating disorders can affect anyone regardless of age, sex, body size, demographics, geographic location, or socioeconomic status. Disordered eating, such as unhealthy dieting, binging, or purging, is nearly as common in men as women. Men make up about one-third of those diagnosed with an eating disorder.

MYTH 3: People with eating disorders appear to be underweight or ill.

FACTS: People with eating disorders have a wide range of body types and health. Only 6% of those with eating disorders are considered “underweight.”

Someone of average weight or above average weight could be struggling with an eating disorder. Behaviors including (but not limited to) skipping meals, dieting, overeating, only eating certain foods, extreme exercising, and excessive worry about size or appearance, may suggest disordered eating or an eating disorder.

Diagnosing an eating disorder is complex and includes holistic comprehensive physical and psychological evaluations that require the expertise of a health care professional to consider age, genetics, family history, eating and exercise habits, and for young people, a range of developmental factors associated with puberty and growth histories.

SAMHSA’s Commitment to Addressing Eating Disorders

SAMHSA is dedicated to improving the prevention, detection, and treatment of eating disorders nationwide. SAMHSA’s Eating Disorder Center of Excellence provides health care practitioners, family caregivers and community members with new tools, high-quality training, and technical assistance so they are able to recognize the signs and ensure that people with eating disorders are identified, treated, and supported in recovery. The Mental Health Awareness Training grant program is helping to increase awareness of eating disorders as part of its larger mental health promotion and prevention efforts.

SAMHSA also has played a role in national efforts to study the impact of social media use on youth, including whether it contributes to disordered eating. In 2024, the Kids Online Health and Safety Task Force – co-led by SAMHSA and the U.S. Department of Commerce’s National Telecommunications and Information Administration – released “Best Practices for Families and Guidance for Industry,” (no longer available online) which outlines the benefits and potential harms of online use, including the promotion of eating disorders. The comprehensive report features testimonials from parents and youth, including some who experienced eating disorders after sustained exposure to certain content.

And for those in distress, SAMHSA’s 988 Suicide & Crisis Lifeline provides free and confidential support (by call, text, or chat) 24 hours a day, 7 days a week, across the United States.

What You Can Do About Eating Disorders

You can make a difference – during National Eating Disorder Awareness Week now (and always) — in several ways, including sharing SAMHSA’s resources and helping raise awareness.

• Educate yourself on eating disorders and learn the differences between the myths and facts.
• Engage in prevention efforts and help promote or encourage healthy approaches towards eating and positive body image.
• Support a loved one by actively listening, and showing empathy, patience, and understanding. We know this can be a difficult conversation. Find a safe and comfortable environment for your loved one. Stick to facts, but be honest and caring. Help ensure your loved one feels heard and validated, and encourage them to seek professional help because recovery is possible.

By taking these steps, you can foster a strong understanding, break the silence surrounding eating disorders, and build a supportive community where anyone struggling with an eating disorder feels seen, heard, and valued. Together, we can pave the way for healing and hope.