This article is adapted from the original blog.

There are many things that all sufferers of an eating disorder have in common, whether they deal primarily with anorexia, bulimia, binge eating, or EDNOS (eating disorder not otherwise specified).   Many a book, lecture and website has been filled with a detailing of the commonalities, such as low self-esteem, bad body image, a history of painful life events, a lack of healthy coping skills, and not knowing how to get help.

As well, virtually all approaches to recovery from an eating disorder have things in common.  Therapists, doctors, inpatient professionals, nutritionists, co-sufferers and others usually recognize that everyone who wants to recover must address their fears, assumptions, and painful emotions.  They must challenge beliefs that have held them down for a long time.  They must show up to their treatment appointments and do the homework it takes to apply those lessons to their lives.  They must take stock of their physical health and work on improving it.

Unfortunately, the stereotype that is still prevalent is that everyone with an eating disorder is skinny and needs to gain weight.   The general public, which often includes the family members, friends, co-workers, fellow students, and others who know someone with an eating disorder, typically believes that eating disorders are about skeletal people who must gain weight in order to heal.

Restoring Weight Can Go In Two Directions

For millions, needing to gain weight in order to recover is necessary.  They are at a size that is not healthy for them, and they have to put in a lot of hard work, emotional upheaval, and dedication in order to adapt to a meal plan, change their average caloric intake, and restore weight. 

For millions of others, they also need to restore weight, but they do not need to gain weight.  They need to restore going down the scale, not up.  For them, this also includes a lot of hard work, emotional upheaval, and dedication in order to adapt to a meal plan, change their average caloric intake, and restore weight.

Sadly, this is news to many people.  As a society, we are so programmed to believe that needing to gain weight when sick with an eating disorder means the person really IS sick.  When someone needs to lose weight when sick with an eating disorder, eyebrows are raised and questions are asked.

A Fear of Losing Weight Is Real

The reality is that many people become overweight or morbidly obese due to their eating disorder.  Too often, the average non-sufferer assumes a good diet will cure all.  They believe that a person who has gone up the scale to a number that is unhealthy for them can separate out the actual eating disorder and approach it with the usual tactics (therapy, etc.), but then just go on a diet to address any physical health issues.  This does not take into account that a person with an eating disorder that is trying to lose weight for health reasons may experience difficult emotions such as fear, frustration, anger and anxiety, and the usual commercial diet plans with no emotional support will not work for them. 

Many people who have lived for a long time in a body that is too heavy for them and that they reached by having an active eating disorder deal with a fear of losing weight.  That fact alone is shocking to many people.  Those who don’t understand eating disorders think an overweight person who loses weight will feel nothing but joy and pride.  Those who have an eating disorder but have not experienced needing to restore weight going down the scale sometimes feel the same, and feel jealousy because that person “gets” to go on a diet.

Many a person gains a lot of weight through their eating disorder in a conscious or subconscious attempt to avoid sexual or romantic attention, due to molestation or rape that has occurred or is still occurring in their lives, or due to a fear of becoming involved in a sexual or romantic life in general.  Many people also deal with a fear of success, and to them reaching a healthy goal weight will mean success, so they self-sabotage.

Many people put off starting their lives over or making big changes or being happy at all until they reach a goal weight.  When they have a deep-rooted fear of having to actually start their lives over, make big changes or be happy, that makes for a lot of start-and-stops on meal plans.  For these reasons and many others, people who need to restore weight down the scale deserve to be understood and supported by their loved ones, treatment providers, and fellow sufferers, because not everyone with an eating disorder is skinny and needs to gain weight.

The myth that everyone with an eating disorder is underweight

Decades of stereotypes are still around, but the truth is a person of any size can have an eating disorder.