As National Eating Disorders Awareness Week (NEDA) comes to an end, many are still denied adequate support due to the weight-related stigmas surrounding eating disorders.

Emaciated body, dry and yellowish skin, thin hair, and sunken eyes. This is the description people often, and mistakenly, associate to someone suffering from an eating disorder. Yet, physical changes are only a side effect of these deadly conditions.

Indeed, not everyone affected by an eating disorder is severely underweight and these stereotypes might make them harder to spot, especially amongst older people, males and ethnic minorities. According to Beat, a UK eating disorder charity, more than 1.25 million people in the country are fighting every day against these mental disorders. In order to overcome these disorders, it is important to understand patients’ thoughts and feelings, rather than focusing on the way their body looks. 

“You can be any size and any shape and have an eating disorder and just because someone doesn’t look like a skeleton that doesn’t mean that they are not struggling with food,” says Hope Virgo, a 28-year-old mental health activist. 

Virgo is the author of Stand Tall Little Girl, a book in which she openly speaks about her struggles with anorexia and her raw recovery journey. 

Recent statistics from the NHS revealed that during the financial year 2017/18, more than 16,000 people were admitted to the hospital because of eating disorders, with the admissions almost doubling from 2012. One of the reasons behind the rise of these numbers is the lack of prompt intervention, which is due both to the shortage of funding and the insufficient awareness and understanding of eating disorders.

Virgo says that many people across the country have received letters from the NHS stating that their Body Mass Index (BMI) does not match the criteria for the outpatient services offered for eating disorders. Even if these people are turning to the NHS seeking help regarding their mental health, they are being rejected because of their physical appearance. Using BMIs as a tool for recognising these mental conditions can have a very negative impact on those suffering. Often, the fear of not being ‘thin enough’ leads them to hide their suffering until it is too late, says Virgo.

“It sadly means we’re failing individuals who need help and still experience the negative consequences of eating disorders, regardless of BMI, including low heart rate and blood pressure, psychiatric comorbidities and suicide idealisation,” says Isa Robinson, who is currently specialising in eating disorders and clinical nutrition. 

“The NHS needs to improve getting people treatment faster, especially for over 18s. Because at the moment we’re waiting until people are really unwell before giving treatment which allows the eating disorder to progress,” says Robinson.

After being rejected from services for not being underweight enough during a relapse, Virgo launched a Twitter campaign called #DumpTheScales in July 2018. Her aim is to tackle the NHS guidelines used to recognise eating disorders based on BMIs and invoking their services. “I’m hoping that the campaign is making headway in trying to make that long-term change happen,” says Virgo. 

Virgo currently attends conferences and visits schools to spread her message. Photo: Hope Virgo.

Virgo is currently fighting her battle in parliament, where MPs started discussing her case in December 2018. Her #DumpTheScales campaign hit the 100,000 signatures mark in February 2020. 

Moreover, experts are worried that social media pressure of wanting to always show the best version of yourself and comparing it to others increases the chances of deteriorating mental health.

“I don’t want to suggest that the rise of wellness and social media are the cause of eating disorders but I certainly don’t think they help,” says Robinson. “The promotion of an unrealistic body ideal and a righteous way of eating can lead to disordered relationships with exercise, food and perpetuate poor body image. Eventually, this can result in a full spectrum eating disorder.”

While more people are starting to be more conscious of the consequences of social media, the wellness industry, which includes nutrition, healthy eating, and weight-loss tips, is not regulated online and anyone on these platforms can give advice and promote potentially harmful ‘skinny teas’ or laxatives. 

“They should be banned and it’s completely unethical that influencers like Kim Kardashian are not only preaching unrealistic body standards but they are also promoting the use of laxatives without talking about any sort of risk associated with them such as rectal bleeding, vomiting, nausea,” says Katherine Kimber, a 28-year-old private nutritionist, who uses Instagram to fight against extreme diets. 

Many other people, like Kimber, are trying to demolish diet culture. However, in order to have a positive experience online, it is very important to diversify your feed and move away from triggering content. By doing so, social media can become good platforms to raise more awareness of eating disorders, where people can share their personal stories and not feel isolated.

People can find recovery journeys by using specific hashtags on Instagram.

Indeed, despite the high numbers of those affected, many feel lonely and hopeless because of the stigmas around eating disorders. For example, Rhiannon Williams, who is now a fully-recovered 20-year-old economics student describes her experience as frustrating. 

“Not many people around me knew what it was like having an eating disorder. At the end of the day, it’s a mental illness, and if you don’t go through it, it’s kind of hard to relate to,” says Williams. 

Now, Williams is a young Beat ambassador and not only does she use her Instagram account to speak up about eating disorders, but she also works actively by handing out leaflets to students around her campus and organising fundraisers.

“We really want to make sure that students know what eating disorders really are and break the stigma associated with what someone physically looks like,” says Williams.