Why are eating disorders still being misdiagnosed?

Eating disorders are both complex and diverse in their presentation and due to their very secretive nature are often difficult to detect and diagnose. Many people are reaching their fifties undiagnosed having lived many agonising years with their eating disorder. There is a real disconnect between the perception of eating disorders and the stark reality and this lack of awareness and knowledge creates barriers to people receiving an early diagnosis.

Many misconceptions and stereotypes still surround eating disorders such as the image of a young, painfully thin Anorexic girl, when in reality the majority of people with an eating disorder are not underweight. Lack of education and funding are intrinsically linked to a lack of diagnosis of these very complex mental illnesses. A person might present with anxiety, depression, weight worries and may even mention binging yet the eating disorder remains undiagnosed.

 There are a vast number of people not being treated because they are not deemed thin enough, their BMI doesn’t fit the dangerously low criteria which would entitle them to treatment. One of the frustrations therapists have is that once a patients BMI drops below a certain number it affects their cognitive function meaning they are unable to benefit from psychological support until their BMI increases. This is incredibly hard for the patient to achieve and so the vicious circle continues and sadly often spirals downwards and in worst cases can be fatal.

And conversely many people in larger bodies are not being diagnosed or treated either as they are labelled and shamed into losing weight without the appropriate psychological support and in some cases being referred to weight loss clubs where they are weighed in public weekly and told to improve their lifestyle which further perpetuates their low self esteem and in turn their eating disorder prevails. BEAT say that more people live with BED (binge eating disorder) than anorexia or bulimia but that only 1 in 4 people receive treatment.

 The loneliness experienced by many sufferers is often underplayed, isolation itself creating the perfect environment for the illness to thrive. The longer someone has an eating disorder, the more ingrained it becomes and recovery, although not impossible, is much harder. So, it is imperative that there is more education and awareness around these often dangerous illnesses.

Sadly the death rate for eating disorders remains higher than any other mental illness, and this is not always just from low weight it can also be from laxative abuse, or vomiting which can cause electrolyte imbalances, sometimes leading tragically to heart attacks.

The pandemic has caused a significant increase in eating disorders with many services and charities struggling to keep up with the demand. It is therefore more important than ever that people are being properly acknowledged when they take that first, very brave step to reach out for help, it’s vital that they have access to suitable treatment and support which they so desperately need and deserve to prevent a life long struggle and to start them on the road to recovery. The disparity between the great need for early diagnosis and the reality of delayed or misdiagnosis needs to urgently change through greater education and awareness.