May is Mental Health Awareness Month. Eating disorders are serious mental illnesses that often present alongside other mental health concerns like anxiety, depression, and psychological distress. To help raise awareness of eating disorders and mental health, we present ten myths (and facts) about eating disorders based on current research from MSU and other researchers around the world.

Megan Mikhail is a graduate student in the MSU Psychology Department’s Clinical Science program. Megan’s research on eating disorders and disadvantaged populations earned the 2022 College of Social Science Graduate Student Researcher award.

Myth 1: Eating disorders only affect women and girls

Fact: It’s true that eating disorders and disordered eating behaviors like binge eating are more common in females than males. In fact, a 2013 study from Dr. Kelly Klump showed that even female rats have more binge eating-like behaviors than male rats, suggesting a biological basis for sex differences in risk. A major reason is hormonal differences. Males experience higher testosterone levels prenatally, which is thought to be protective against eating disorders. However, boys and men do experience eating disorders, with one recent study published in Current Opinion in Pediatrics estimating over 10% of adolescent boys experience clinically significant disordered eating. Research also shows that boys and men are less likely to have their eating disorders recognized and be able to access treatment.

Myth 2: You have to be underweight to have an eating disorder

Fact: Eating disorders affect people of all weights and body shapes, and most people with an eating disorder are not underweight. Eating disorder behaviors like food restriction, purging or excessive exercise can negatively impact a person’s physical and mental health regardless of their weight, with recent research in the International Journal of Eating Disorders showing increased risk of psychological and medical complications even in people who are not technically underweight. This same research suggests some people’s bodies are healthiest at a higher weight, and it is possible to be at a weight that is too low for your own body even if you are not “underweight” based on weight charts that average across the population.

Myth 3: People of color rarely experience eating disorders

Fact: My own 2021 review published in International Journal of Eating Disorders showed that there are few differences in rates of eating disorders across race or ethnicity in the United States in population-based research (i.e., research with people who represent the general population rather than just people who seek treatment). In fact, some stressors disproportionately experienced by people of color, such as race-based prejudice or living in a disadvantaged neighborhood (which is more common for people of color due to discriminatory policies like redlining), are associated with increased eating disorder risk. However, eating disorders sometimes look different for people from different cultures. For example, people with eating disorders in Asian countries may report eating less due to stomach pain or bloating rather than body image concerns.

Myth 4: Only teenagers experience eating disorders

Fact: Rates of eating disorders increase significantly at puberty. However, younger and older people also experience eating disorders — there is no age limit for having an eating disorder. Recent research in the International Journal of Eating Disorders suggests the hormonal changes accompanying menopause in females may be associated with increased eating disorder risk. While we know eating disorders can occur at many life stages, few studies have focused on eating disorders in midlife or older adults. More research is needed on the experiences and needs of older people with eating disorders.

Myth 5: Eating disorders are a recent, Western phenomenon

Fact: Eating disorders have been around for a very long time. The term “anorexia nervosa” was first used in medical literature in 1874. Historical cases of syndromes that look very much like eating disorders (even if they weren’t called that yet) can be found even earlier, potentially going back as far as the 1300s. Eating disorders also occur in all regions of the world.

Myth 6: Eating disorders are entirely caused by sociocultural factors

Fact: While sociocultural stressors are important, biological factors also play an important role in the development of eating disorders. A recent review published in Nature Neuroscience suggests over 50% of the variance in those who develop an eating disorder is due to genetic factors. Recent studies show that eating disorders share genes with conditions like diabetes, autoimmune diseases and gastrointestinal disorders, suggesting they may be best conceptualized as neuro-gastro-metabolic disorders.

Myth 7: Eating disorders only impact eating

Fact: Eating disorder symptoms can severely stress a person’s body, leading to physical symptoms like tiredness, weakness, hair loss, heart problems and others. Because the brain is a part of the body, people with active eating disorders also often experience other mental health symptoms like negative moods, obsessive thinking and irritability. Luckily, most or all of these symptoms can be reversed with treatment and adequate nutrition.

Myth 8: Families are to blame for eating disorders.

Fact: Research shows that eating disorders can run in families due to genetic reasons, not because parents or family members cause eating disorders. Families can be a vital resource in helping young (and older) people overcome an eating disorder. The most effective treatments for eating disorders in youth actively involve family members in a young person’s recovery process.

Myth 9: Eating disorders aren’t that serious.

Fact: Eating disorders are among the deadliest of all mental health conditions. An eating disorder can negatively impact a person’s entire life, including their physical health, their ability to fully participate in school or work, their self-esteem and their social relationships. People with eating disorders are also at higher risk for other mental health concerns, such as anxiety disorders, depression and obsessive-compulsive disorder, in part because these conditions share genes with eating disorders.

Myth 10: You can’t ever really recover from an eating disorder.

Fact: Although eating disorders are serious illnesses, people can and do recover. While early intervention is helpful in limiting the negative impact an eating disorder has on a person’s life, people can recover even when they have experienced an eating disorder for many years. Eating disorder survivors have many strengths, and some people who have overcome an eating disorder later chose to become researchers or therapists to help others with eating disorders.

This story originally appeared on the Department of Psychology website.