Distorted view

Depictions of people with eating disorders are extremely narrow. This can have serious consequences for those who dont fit the stereotype.

A composite image shows six people posing for individual portraits. They include: a young, slender white woman; a young, thin Black person; two larger-bodied white women; a young, slim, white man; and a young, athletic, South Asian man.

Photographer Hannah Crease-Maclean interviewed and took portraits of six Saskatchewan residents who feel they don't fit the stereotypical portrayal of people with eating disorders.Photos: Hannah Crease-Maclean/Graphic design: Fred Demers

Natascia Lypny With files from Hannah Crease-Maclean Sep. 18, 2022

This article discusses eating disorders. Scroll down for a list of resources if you or someone you know needs help.

Female. White. Young. Thin to the point of bones protruding.

Thats likely what you imagine when you think of someone with an eating disorder.

Thats only one severe aspect of many eating disorders, says Sarah Hails.

Despite eating disorders being a mental illness, the focus tends to be on specific physical manifestations, excluding a wide swath of those impacted.

It can look completely healthy. It can look morbidly obese. It can look just a little curvy here and there. Or you could still be really small and frail So it doesnt have any one look or another, Hails says.

An estimated one million Canadians meet the diagnostic criteria for a form of eating disorder, according to Statistics Canada. But these harmful tropes about what an eating disorder looks like mean some people may not identify as having one or are reluctant to get help.

Hails, a 27-year-old from Saskatoon, doesnt match the physical stereotype of someone with an eating disorder.

None of the people who volunteered to be photographed for this article do.

False thinking around size

Eating disorders dont discriminate, says Sophia Khan, a registered dietician in Saskatoon. You cant always tell someone has an eating disorder just by looking at them.

Yet many people, including health professionals, base their initial assessment on size. Khan says this sometimes leads to people in larger bodies being missed.

There is the false thinking that those with eating disorders are thin, or there is the thinking that thinness equates severity.

For Julie Gobeil, the opposite was true. The 36-year-olds unhealthy relationship with food began at a young age and turned severe in her mid-twenties. She struggled with binge eating and purging. She lost weight as a result and was praised for it.

A larger-bodied, white woman stares at the camera from behind clear-plastic glasses. She has shoulder-length, wavy brown hair and is wearing a multi-coloured and multi-patterned dress. — Julie Gobeil, 36, has struggled with binge eating from a young age. (Hannah Crease-Maclean)

Concerned about the health consequences, she eventually stopped purging but continued to deal with binge eating and gained weight. She then worried people wouldnt believe she was facing an eating disorder.

We really need to unlearn our biases against fat people and equating thinness with health, which, in my experience, has not only not been true, but the exact opposite has been true, she says.

The thinner Ive been, the unhealthier Ive been.

Binge eating disorder is the most common form of the illness, yet it isnt reflected in the media nearly as much as anorexia or bulimia, says Sydney Luther. Like Gobeil, the 30-year-old from Saskatoon thinks that lack of understanding comes from prejudice against being overweight.

A young, larger-bodied, white woman sits on the ground outside, leaning against a brick wall. She is wearing a mauve, sleeveless romper. — 'The stereotype that binge eating is a choice, specifically, is one that has been quite harmful to me because there isn't the understanding that this is a medical condition, this is a mental illness, and it is compulsive, and it is out of my control in a lot of ways,' says Sydney Luther. (Hannah Crease-Maclean)

Luther says her eating disorder first cropped up when she moved away for university and had trouble adjusting. She started eating less to lose weight. That led to binge eating and subsequently gaining weight.

I think it took me a few years to realize that what was happening was an eating disorder, she says.

The evidence doesnt support the body size stereotype for those with eating disorders. A study of Canadian adolescents diagnosed with eating disorders found less than six per cent of them could be classified as medically underweight. A multi-country study of people with binge eating disorder found a quarter had a body mass index within the normal range.

Sick enough

Even someone in a smaller body can be impacted by the pervasive, narrow perception of what eating disorders look like.

As a young, white, female dancer, Ocean Tonn feels her experience echoes a common media portrayal of someone with the illness. At the same time, she says not being thin enough has stopped me from having people recognize my disorder.

A young, slender, white woman leans against a wall with her arms crossed, looking off to the right. She has long blonde hair, and wears a black cropped tank top and denim shorts. — Ocean Tonn, 18, says she grew up around diet culture and people who struggled with disordered behaviours related to food and body image. (Hannah Crease-Maclean)

The 18-year-old from Weyburn, Sask., says doctors pointed to her healthy weight and clean lab results when she was struggling the most with her disorder and sought help.

Your physical body doesnt show how sick you are. Eating disorders are a mental illness, not a physical illness, says Tonn. I feel like so many people view them as being a physical illness when really you can be insanely sick and in your worst, but your physical body doesnt change.

A drive for muscularity

Jeffrey Grant Crawford doesnt think hes the kind of person people would expect to struggle with eating disorders. The main reason? Hes a man.

I think it made it less likely that I recognize that in myself and maybe for other people that cared about me to recognize it, Crawford said.

The 33-year-old from Saskatoon has faced an eating disorder since his last year of high school, when he developed an obsession with eating healthy. He also got into running and modelling, and has felt the pressure to fit a certain aesthetic as a gay man.

A tall, slim, white man sits on stairs, staring at the camera. — Jeffrey Grant Crawford says he was surrounded by diet culture as a kid. He remembers learning about trans fats in Grade 12 led him to researching more about nutrition, and ultimately excluding a lot of foods from his diet. (Hannah Crease-Maclean)

Men are woefully underrepresented in conversations about eating disorders, despite them constituting up to 20 per cent of those impacted, according to the National Eating Disorder Information Centre.

Part of the issue is a lack of research on men with eating disorders. What does exist has shown that the illness can express itself differently in men.

Physique ideals depicted in the media can lead to men developing a drive for muscularity: a desire to gain weight to increase muscle mass while decreasing body fat. So, if men are assessed based on common female symptoms, their eating disorder might be missed or mischaracterized.

When Aakashdeep Mundi moved to Canada from India as a teen, he was determined to fit in at school. He joined the football team and, insecure about his size, started eating to build muscle mass.

Years later, he got into climbing and his goals swung in the other direction.

In both cases, people praised his behaviour and physical changes, because they were perceived as choices made in the pursuit of athleticism and health. Crawford experienced the same, commended for his willpower.

A young, South Asian man sits on a bench, looking to the left. He is wearing track pants and a sweatshirt. — Aakashdeep Mundi, 24, says he didn't acknowledge he had an eating disorder until about a year ago. Men are underrepresented on this topic, and the mental illness can express itself differently in men than people of other genders, making it more difficult to recognize. (Hannah Crease-Maclean)

My definition of an eating disorder, Mundi now realizes, is when your food only serves as a means to an end instead of something that you actually can cherish and enjoy as well.

Now 24, he says he didnt acknowledge he had an eating disorder until about a year ago.

If you dont even identify the problem, how will you ask for help fixing it?

Lack of diversity

Mundi said being a person of colour also made it less likely to see himself reflected.

Despite research suggesting the prevalence of eating disorders is consistent across ethnic groups, white people are overrepresented in studies and media on the topic.

Mundi noted the harmful effects on body image of how white, North American ideals dominate the conversation here. It ignores the fact that people from different ethnic and racial backgrounds have a variety of body types and are more easily (or not) able to change their body shape.

A young Black person leans against a stone pillar. Their long hair is in twists, and they're wearing a navy velvet dress. — Sarah Hails has learned a lot about how trauma and other mental illness can influence and coincide with eating disoders. (Hannah Crease-Maclean)

Hails, who is Black, didnt grow up around many people of colour, so their reference point was primarily white girls and they felt their body stood apart. Hails began to restrict their eating around the age of 15 to achieve an unattainable goal.

I was always just so angry at my body for existing in the shape that it was.

Misconceptions pervade medical community

These arent the only folks missing from the conversation.

Older people are rarely reflected in depictions of eating disorders, yet community-based studies have found more than three per cent of women aged 60 and older experience them, the same percentage as women of all ages.

There have also been calls for more attention to LGBTQ people facing eating disorders, as studies have shown they are more prone to them.

These gaps in knowledge extend to the medical community.

There hasnt been a lot of urgency from medical professionals in treating it, says Luther, referring to her binge eating disorder. To me it feels like, Well, youre not dying of starvation, so its fine. And so Ive had to do a lot of advocating for myself.

A young, slender, white woman sits against a wall with her hands hooked around her knee. She has long blonde hair, and wears a black cropped tank top and denim shorts. She is smiling. — A big motivator in Ocean Tonn's recovery is not wanting to pass on disordered eating behaviours to her future children. (Hannah Crease-Maclean)

Jeffrey Grant Crawford's hope: to 'live a happier, fuller life,' one in which he is 'more at ease and comfortable with myself, regardless of what size I am,' and to have more flexibility around eating. (Hannah Crease-Maclean)

Hails agrees that a fear of not being believed creates a barrier, but I know thats not healthy to work myself to be a certain size to access help.

These misconceptions can have serious consequences. According to the BridgePoint Center for Eating Disorders in Saskatchewan, only 10 per cent of people with an eating disorder seek help. Eating disorders also have the highest overall mortality rate of any mental illness.

What needs to be done

Khan advocates for health professionals learning more about eating disorders in general, including who they affect and how the illness can express itself. Shed also like to see more diversity in the research conducted and whos working in the field.

The Canadian Eating Disorders Strategy calls for improving curricula for health-care professionals on eating disorders, better education of the public, addressing gaps in best practices and research for certain populations and disorder types, and developing culturally appropriate services for marginalized groups.

That education piece is really important so that people know that no matter what size I am, no matter what colour I am, no matter what my life experiences, if Im struggling with an eating disorder, I deserve care, I deserve support just as much as anyone else, says Khan.

A young Black person leans against a window outside, smiling at the camera. Their long, brown hair is in twists. They're wearing a navy velvet dress. — Sarah Hails says it was eye-opening to learn about avoidant/restrictive food intake disorder or ARFID, a newer eating disorder diagnosis. Like anorexia, people with ARFID are extremely picky and restrictive about what they eat, but they aren't concerned with their physical appearance.

A larger-bodied, white woman smiles at the camera. She has shoulder-length, wavy brown hair and is wearing a multi-coloured and multi-patterned dress. — Julie Gobeil says it's important to follow people with a variety of body shapes and sizes on social media.

A young, South Asian man smiles softly at the camera. He has shoulder-length brown hair. — Aakashdeep Mundi is encouraged by seeing larger-bodied climbers do well in the sport and get attention in the media.

A young, larger-bodied, white woman sits on deep stone steps outside. She has long brown hair and is wearing a mauve, sleeveless romper. — On Instagram, Sydney Luther posts about fatphobia and eating disorders.

images expandThese folks find hope in the changes in eating disorder and body image depictions and conversations they're beginning to see online.

Mundi wants men and the harmful effects of striving for the bodybuilder physique reflected more often in the media.

Luther would like to see a major television show feature a storyline about a bigger-bodied person struggling with an eating disorder.

And Gobeil encourages people to diversify who they follow on social media, especially when it comes to body size.

The younger generation, it does give me hope. I think theyre just less judgmental, more accepting, Gobeil says.

I do think there is a movement happening for more body acceptance and the concept of health at every size.

Consultant: Keara Lubchenko

Copy editor: Sean Trembath

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