Eating disorders affect up to 10% of the US population. However, they only entered the public eye in the 70s, following musician Karen Carpenter’s death from anorexia nervosa complications. They have since gained recognition as dangerous conditions in the medical community. The problem is that both the medical community and general population only label an ED "severe" when the sufferer has visible complications. Of course, that makes no sense. Eating disorders are largely disorders of control. Neuropsychologically, EDs are most similar to Obsessive-Compulsive Disorder and specific phobias. The medical community does not decide to refuse treatment to someone with OCD based on the degree to which their hands are raw from washing or the height of their hoarding stacks. Any physical symptoms are secondary to the psychological symptoms.
Whether that’s restricting, binging, purging, or other behaviors, they are all ways of feeling more in control of one’s environment.
This year’s theme for NEDA Awareness Week is Come As You Are. In my view, NEDA’s message has two functions: First, it asks everyone to be unapologetically themselves. Secondly, and most importantly, "Come As You Are" highlights that everyone with an eating disorder has a right to be believed in their struggle and to receive proper treatment. For that reason, I’m forgoing the usual before/after picture on social media. I know I was suffering. You know that, too, because I claimed it. It does not matter what my weight was 4 years ago; how many calories I ate or didn’t ate is irrelevant; and my appearance in particular is not – and never was – an indicator of my sickness.
The fact is that you can never tell how "bad" an eating disorder is based on someone’s appearance. Furthermore, everyone has the right to come as they are to treatment. The severity of an eating disorder is only relevant to a treatment team; even then, it’s only important as a way to determine the best course of treatment. It’s almost integral to eating disorders that the sufferer believes they are not deserving of treatment until they are "sick enough." Everyone with an eating disorder is already sick enough. You don’t have to be underweight, on the verge of an esophageal rupture, or in danger of a heart attack to deserve treatment.