What I wish I had known about eating disorders sooner
How diet culture fuels disordered eating—and what we’re getting wrong about recovery.
The last time I wrote about eating disorders, I was shocked by how little engagement it got. Maybe that’s because most of us have a complicated relationship with our bodies. We’ve normalized restriction, because we see weight gain as the bigger problem. I’ve heard women say they wished they had an eating disorder and others angry they didn’t have the “willpower” to develop one.
But eating disorders are life-threatening illnesses. And the longer they persist, the harder they are to recover from. This is why awareness is so important.
And we are not immune in midlife.
Just like in puberty, the hormonal and physical changes of menopause, especially weight gain, can trigger body dissatisfaction, disordered eating, and the recurrence or even the onset of an eating disorder. The worst part is most of us don’t even see it.
As we recognize National Eating Disorders Awareness Week, I think it’s crucial to examine not just eating disorders themselves, but the growing societal pressures that fuel them.
While most of us recognize the link between diet culture and eating disorders, we often overlook how the societal focus on weight loss, especially in recent years, has intensified weight stigma and fueled disordered eating.
Of course, we have to talk about GLP-1 drugs like Ozempic. Originally developed to treat diabetes, these medications have exploded into pop culture, reshaping the conversation around weight and reinforcing the belief that thinness is essential, and now, fatness is a choice.
This weight-loss obsession isn’t just anecdotal—it’s something experts are concerned about. Lisa Hoffman, a registered dietitian specializing in eating disorders, explains: “Ozempic has only strengthened the societal focus on weight loss, ideal body weights, and the associated weight stigma. It reinforces the ‘thin dream’ and that all people [should] strive for thinness, no matter what the cost or consequence. The prevalence of eating disorders increases with more repeated societal messages that everyone needs to be thinner.”
Of course, adults aren’t the only ones paying attention. Last summer, my teen was shocked when she watched a classmate’s video on social media. Convinced she was fat, the girl had stolen her diabetic father's GLP-1 medication and filmed herself injecting it.
It was only a matter of time.
When we normalize, glamorize even, the use of these drugs, especially for those who don’t medically need them, it sends a powerful message.
Just look at this year’s awards season. Celebrities, already smaller than the vast majority of the population, are shrinking before our eyes with each award show appearance. Are they or aren’t they? The speculation alone is dangerous.
What message does this send? When will we say it’s too much?
I’ve seen firsthand how devastating these illnesses are. As a caregiver to not one but two loved ones with anorexia, now thankfully in recovery, I know how quickly a little weight loss can spiral into an all-consuming obsession. It took years of treatment, both inpatient at eating disorder facilities and outpatient with therapists, dietitians, and psychiatrists.
Whether you’re struggling yourself, supporting a loved one, or simply wanting to understand more, here’s what I wish I had known about eating disorders and their treatment.
10 things I’d wished I’d known about eating disorders
Eating disorders are life-threatening and should be taken seriously.
Many people just don’t understand how serious an eating disorder is. I saw this firsthand in eating disorder education classes. Too often, loved ones of sufferers minimize the severity of the illness and fail to make necessary changes at home. And I’m not judging here. It took me far too long to wake up and see just how serious anorexia was. Until the recent opioid crisis, eating disorders had the highest death rate of any mental illness, with anorexia being the deadliest.
People who don’t look like they have an eating disorder still can.
It’s important to acknowledge this one, especially in the fat phobic times we’re living in. People can suffer from eating disorders at all sizes. Sufferers are often misdiagnosed—especially if they are boys or men, people at higher weights, and even those at so-called “normal” weights. Less than six percent of people with eating disorders are medically classified as “underweight,” according to the Eating Recovery Center. Let that sink in.
Trust your intuition.
If you suspect an eating disorder, get help right away, ideally from a specialist trained to diagnose them. While pediatricians and general practitioners can be helpful, many lack the expertise to recognize eating disorders.
If I hadn’t already seen the signs of anorexia once before, I might have accepted the doctor’s suggestion that my loved one was simply depressed. Thankfully, I had already scheduled an appointment with a specialist—who confirmed my suspicions.
Many eating disorders begin from a place of “wanting to be healthy.”
We’ve been so conditioned to equate weight with health, we often fail to see the harm it can bring when it becomes too extreme. Eating disorder educator captured this perfectly in a letter to her ophthalmologist, who had suggested a diet might help when she asked about increased light sensitivity in perimenopause:
“A desire to ‘eat healthier’ or ‘eat clean’ has become one of the most common eating disorder origin stories. I see families almost every day who are fighting for their child’s life, when only a few months ago their teen or young adult just wanted to “eat healthier.”
The “why” of an eating disorder isn’t as important as the solution.
Eating disorders are complex and still widely misunderstood. They aren’t always about losing weight, though that is often a precursor. Many who suffer already have a genetic predisposition, and when one family member develops an eating disorder, the risk increases for others in the family as well. Because of this and because these illnesses become harder to treat the longer they persist, the why isn’t the priority—weight restoration is.
Your loved one is not themselves when they are malnourished.
If you're supporting a loved one with an eating disorder, remember, they are not themselves right now. And if you’re the one struggling, know this: your eating disorder is not you.
Malnutrition can cause irritability, secrecy, and even hostility—but that’s the illness talking. One of the most important shifts I made was to stop taking basically every thing personally. My loved one wasn’t making these choices—the eating disorder was. I even gave it a name, “Ed,” to help separate my person from the illness.
Healing requires support—whether for yourself or a loved one.
Eating disorders don’t just affect the sufferer; they impact everyone around them, especially caregivers and those living with them. The gold standard for treating anorexia in children and teens, Family-Based Therapy, requires caregivers to take an active role in recovery. This means supervising meals, being “the lead” on the care team, and refusing to accommodate disordered behaviors. It can be isolating, it’s exhausting—every meal can be a battle. But it’s also essential.
Whether you’re supporting someone in recovery or working to heal yourself, don’t go it alone. Getting the right support can make all the difference.
Recovery may challenge your own beliefs.
Supporting a loved one—or healing yourself—often means reexamining long-held beliefs about food, weight, and health. Diet culture is everywhere, often disguised as “healthy living.” Families navigating recovery may need to shift how they talk about food, exercise, and body image, because casual comments can reinforce disordered thinking.
Anorexia recovery requires full weight restoration.
One of the biggest reasons for relapse or even never fully recovering is inadequate weight restoration. Growth charts matter. If the sufferer was historically in a higher percentile, a so-called “normal” weight might still leave them in a malnourished state. Often, sufferers must gain more weight than they are expecting in order to fully recover.
It’s never too late to help yourself or a loved one.
Eating disorder recovery statistics are bleak, but full recovery is possible with proper treatment, support, and nourishment. If you or a loved one is struggling, trust your instincts. Push for care. Speak up, even when it’s uncomfortable. Even when it flies in the face of everything you’ve been taught about health and wellness over the years.
Getting help could save a life.
Now it’s your turn. If you’re an eating disorder specialist, what’s something you wish more people, either caregivers, clients, or the general public, understood about these illnesses? And for everyone else, what messages around weight and food have stuck with you over the years—for better or worse? Has any of it changed in midlife?
Two eating disorder books I highly recommend
Anorexia and other Eating Disorders: how to help your child eat well and be well by Eva Musby.
A must-read for caring for loved ones with anorexia. Written by a mother, it’s less clinical and more personal, and simply the most helpful information I received on the subject.
Recovery from Eating Disorders: Homeodynamic Recovery Method, A Step-by-Step Guide by Gwyneth Olwyn.
This is so helpful for adults with eating disorders or disordered eating. It explains why weight gain is critical to recovery and how weight stigma—yes, even in clinical settings and eating disorder treatment centers—prevents many from fully recovering.
Yes, I could go on a semaglutide regimen and probably would lose a significant amount of weight. According to recent research, about half of that would be muscle loss. Both skeletal and cardiac muscle. This and similar drugs are being implicated for damage to heart, liver, kidneys, and pancreas. (Is everyone too young to remember what a disaster Fen/Phen was?) Therefore, these drugs should not be taken for an extended period of time, but as soon as you go off them the pounds return, likely bringing friends with them.
I could just shove my hand in the blender and flip the switch. It would be a healthier choice.
This is such an important conversation, and I deeply appreciate the nuance you bring to it. The reality that eating disorders aren’t just about food—but about control, self-worth, and nervous system regulation—resonates so much. As someone who’s unlearning years of disconnect from my body, I see how easy it is to slip into harmful narratives, even in healing spaces. The reminder that recovery isn’t about discipline but about trust—trusting our bodies, our needs, our emotions—hits home. Thank you for sharing this.