Eating Disorders and Living in a Larger Body

For many years I, like many, struggled with disordered eating patterns. I would cycle through diets, over exercise, restrict, and then binge. When I was in a smaller body I would be praised for my “discipline” and commitment to exercise. When in a larger body, my body and disordered eating patterns (though pervasive) went unnoticed. My doctor would talk with me about my weight (a huge trigger for my disordered eating) and often encourage dieting and restriction, which often would re-set my disordered eating patterns.

In our society and culture, we often fixate on people with smaller bodies and their eating disorders. Many books, movies (like “To The Bone”), and research studies about eating disorders center thin people’s experiences. Despite the high prevalence of people in larger bodies struggling with eating disorders and disordered eating, they are often overlooked and under-treated. The disparity in both diagnosis and treatment for people in larger bodies points to a systemic problem in health care: fat bias and widespread stigma. The eating disorder stereotype (white small bodied women) is a form of erasure and oppression. This harmful stereotype not only limits the access to care people in larger bodies have, it also contributes to racial discrimination in eating disorder treatment.

One myth that perpetuates people in larger bodies gaining access to care is the idea that people with higher weights only have binge eating disorders. People in larger bodies struggle with atypical anorexia and bulimia at the same rate as people in smaller bodies. It is also important to note that the risk for folks in larger bodies is just as serious as the risk of people struggling with an ED at lower weights (Appolinario et al., 2022; Whitelaw et al., 2018). Another sad truth is that people in larger bodies are often not believed by their doctors or families. Even if they describe eating disorder patterns, they will often be praised and encouraged to continue to restrict.

If you are in a larger body and struggling with disordered eating or an eating disorder, know that your pain and experience matters. Please, please reach out to a mental health therapist who practices Health at Every Size and pushes back on anti-fat bias. With compassionate care, social awareness, and community support, recovery is possible.