Nearly 29 million Americans experience an eating disorder at some point in their lives. That is according to the leading nonprofit supporting those living with eating disorders and their families, the National Eating Disorders Association (NEDA).

Since the start of the COVID-19 pandemic, NEDA’s helpline has seen a 107 % increase in contacts. 

Kaylee Crockett, Ph.D., assistant professor, clinical health psychologist and clinical scientist in the UAB Department of Family and Community Medicine, said that though she hopes broader body acceptance will reduce the risk for eating disorders, the numbers are not surprising.

Kaylee Crockett, Ph.D.“We see pretty consistent prevalence of [eating disorders], despite increases in messaging on body acceptance,” Crockett said. “I think a lot has to change with ongoing body acceptance and inclusion of different body sizes and shapes in media.”

“It’s Time for Change” is the theme of this year’s Eating Disorder Awareness Week, which runs from February 27 to March 5. It is the organization’s 39th year promoting eating disorder awareness. The nonprofit stresses the importance of “Strength through Experience and Knowledge,” explaining EDAW 2023 is a chance to focus on “lived experiences and eating disorder education, which are the essential catalysts for awareness and change,” according to NEDA’s website.

The week of awareness includes thousands of events across the country and online.

Locally, Crockett promotes prevention efforts “by engaging children and families in healthy habits, promoting supportive communities and increasing access to [eating disorder] treatment.”

Clinical dietitian Caroline Cohen, Ph.D., R.D., L.D., also an assistant professor in the Department of Family and Community Medicine, warns of fad diets involving fasting.

Caroline Cohen, Ph.D., RD, LD“I think that actually gets to the larger point that, a lot of times it seems like, especially on social media, dieting and extreme dieting is normal and expected,” said Cohen. “That you have to fast in order to be healthy. I do think that it can be a little bit of an echo chamber of people saying, ‘Well, I fast and this is how I got this body, so you should do it too.’ And it just kind of perpetuates from there.”

Crocket explains social media does not necessarily cause an eating disorder but she says, “if someone is susceptible to an eating disorder then exposure to social media messaging that overvalues thinness and diet culture could contribute to an increased risk.”

There are three eating disorders, all of which are classified as mental health disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.

“Anorexia and Bulimia are diagnosed based on preoccupation with body image or fear of gaining weight,” said Crockett. “Binge eating disorder does not necessarily involve preoccupation with weight or body size, but involves embarrassment, shame or guilt following binge eating episodes.”

Cohen says it is important to remember it is possible to have an eating disorder without looking a certain way.

“Something that people miss is that, ‘Oh, she can't be anorexic because she has a normal BMI,’ where she doesn't look like she could have an eating disorder, whereas it's not necessarily just being underweight or overweight that really matters the most,” said Cohen.

In fact, many of the struggles someone with an eating disorder faces are invisible.

“Eating disorders often co-occur with other mental health disorders including anxiety, OCD, depression, and substance use disorders. People with eating disorders also have increased risk for suicide,” Crockett said.

According to NEDA, “eating disorders have the second highest mortality rate of all mental health disorders, surpassed only by opioid use disorder.”

“I think people assume we have a lot of self-control over what and how we eat. That is not true in eating disorders. This self-control is diminished and the disorder takes over. Messages like ‘just eat,’ ‘just stop eating so much’ or “just stop purging/using laxatives/over-exercising” can be unhelpful and shaming to those who are stuck in the cycle of an ED,” explained Crockett. “I also think people should know how exhausting, time consuming, and isolating ED’s can be. These disorders can feel all-consuming and can take an immense amount of mental energy, [leaving] individuals depleted to engage in other areas of their lives.”

If you think you or someone you care about may be suffering from an eating disorder, NEDA has a screening tool to help you determine whether you or someone else needs help.