Eating disorders are complex mental illnesses with physical manifestations. A number of factors can contribute to the development of an eating disorder, including genetics and mental health as well as cultural factors. This is called the biopsychosocial model.
While eating disorders are serious and can have life-threatening complications, they are also treatable illnesses.
Many factors can influence the development of an eating disorder. These factors can be biological (genetic and biochemical), psychological (personality and mental health), and social (including cultural norms about food and appearance). Individuals who are struggling with their identity and self-image can be at risk, as can those who have experienced trauma. Because eating disorders and mental illness are still stigmatized, some people who have disordered eating may be secretive or ashamed and go to great lengths to hide their disorder.
If the way you eat and think about food interferes with your life and keeps you from enjoying life and moving forward, you may be experiencing disordered eating. Take it seriously and talk to someone who can help. You don’t need to wait for a diagnosis by a doctor.
The experience of living with an eating disorder can be different for each affected individual. Some people feel shame stemming from their symptoms or the way they eat, and so are secretive about food and eating. Some people experience other mental illnesses, such as anxiety, depression, obsessive-compulsive disorder, or post-traumatic stress disorder together with their eating disorder.
Eating disorders are as diverse as the people they affect.
Findings from the last Canadian Community Health Survey – Mental Health indicate that in 2012, over 113 000 individuals ages 15 and older were living with an eating disorder diagnosed by a health professional.
Statistics Canada. (n.d.). Table 13-10-0465-01 Mental health
International research indicates that the point prevalence of eating disorders ranges from 2.2% to 4.6%.
Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: A systematic literature review. The American Journal of Clinical Nutrition, 109(5), 1402–1413.
Based on prevalence data from international research, at any given time, an estimated 840,000 to 1,750,000 people in Canada have symptoms sufficient for an eating disorder diagnosis.View PDFFacts and Statistics
Children learn (unhealthy) mainstream attitudes towards food and weight at a very young age. In a study of five-year-old girls, a significant proportion of girls associated a diet with food restriction, weight-loss and thinness.
Abramovitz, B. A. & Birch, L. L. (2000). Five-year-old girls’ ideas about dieting are predicted by their mothers’ dieting. Journal of the American Dietetic Association, 100 (10), 1157-1163.
According to a 2002 survey, 28% of girls in grade nine and 29% in grade ten engaged in weight-loss behaviours.
Boyce, W. F. (2004). Young people in Canada: their health and well-being. Ottawa, Ontario: Health Canada
Fifty-eight percent of grade 9 and 10 girls are trying to lose weight, including 50% of “normal” weight (based on BMI) girls.
Raffoul, A., Leatherdale, S. T., & Kirkpatrick, S. I. (2018). Dieting predicts engagement in multiple risky behaviours among adolescent Canadian girls: A longitudinal analysis. Canadian Journal of Public Health, 109(1), 61-69.
In a survey of adolescents in grades 7–12, 30% of girls and 25% of boys reported teasing by peers about their weight. Such teasing has been found to persist in the home as well – 29% of girls and 16% of boys reported having been teased by a family member about their weight.
Eisenberg, M. E. & Neumark-Sztainer, D. (2003). Associations of Weight-Based Teasing and Emotional Well-Being Among Adolescents. Archives of Pediatrics & Adolescent Medicine, 157(6), 733-738.
Body-based teasing can have a serious impact on girls’ attitudes and behaviours. According to one study, girls who reported teasing by family members were 1.5 times more likely to engage in binge-eating and extreme weight control behaviours five years later.
Neumark-Sztainer, D. R., Wall, M. M., Haines, J. I., Story, M. T., Sherwood, N. E., van den Berg, P. A. (2007). Shared Risk and Protective Factors for Overweight and Disordered Eating in Adolescents. American Journal of Preventative Medicine, 33(5), 359-369.
"Overweight" and "obese" children (based on BMI) are more likely to be bullied than their "normal" weight peers. For example:
- In a survey of 11–16 year-olds, 10% of "normal"-weight children reported being bullied, compared to 15% of "overweight" and 23% of "obese" children
- "Obese" girls were 2.7 times more likely than normal weight girls to be verbally bullied on a regular basis and 3.4 times more likely to be excluded from group activities
Janssen, I., Craig, W. M., Boyce, W. F. & Pickett, W. (2004). Associations Between Overweight and Obesity With Bullying Behaviours in School-Age Children. Pediatrics, 113(5), 1187-1194.
In a study of 14–15 year old adolescents, girls who engaged in strict dieting practices:
- Were 18 times more likely to develop an ED within six months than non-dieters
- Had almost a 20% chance of developing an ED within one year
Girls who dieted moderately were five times more likely to develop an ED within six months than non-dieters.
Patton, G. C., Selzer, R., Coffey, C., Carlin, J. B. & Wolfe, R. (1999). Onset of adolescent eating disorders: population based cohort study over 3 years. British Medical Journal, 318, 765-768.
2.2% boys and 4.5% of girls in a large sample of Ontario adolescents met DSM-5 criteria for an ED.
Flament, M. F., Henderson, K., Buchholz, A., Obeid, N., Nguyen, H. N. T., Birmingham, M., & Goldfield, G. (2015). Weight status and DSM-5 diagnoses of eating disorders in adolescents from the community. Journal of the American Academy of Child & Adolescent Psychiatry, 54(5), 403–413. https://doi.org/10.1016/j.jaac.2015.01.020View PDF
Four percent of boys in grades nine and ten reported anabolic steroid use in a 2002 study, showing that body preoccupation and attempts to alter one’s body are issues affecting both men and women.
Boyce, W. F. (2004). Young people in Canada: their health and well-being. Ottawa, Ontario: Health Canada.
According to a Norwegian study, elite athletes demonstrate significantly higher rates of EDs compared to population controls. In one study, 20% of elite female athletes met the criteria for having an ED, compared to 9% of female controls. In men, 8% of elite male athletes met the criteria for having an ED, compared to 0.5% of male controls.
Female athletes competing in aesthetic sports (e.g. dance, gymnastics and figure skating) were found to be at the highest risk for EDs. Athletes competing in weight-class and endurance sports were also at elevated risk for EDs.
Sungot-Borgen, J. & Torstveit, M.K. (2004). Prevalence of Eating Disorders in Elite Athletes is Higher Than in the General Population. Clinical Journal of Sport Medicine, 14(1), 25-32.
In a survey of 1001 Canadian national team athletes, 16% of current athletes and 28% of retired athletes reported engaging in eating disorder behaviours.
Kerr, G., Willson, E., &Stirling, A. (2019). Prevalence of Maltreatment Among Current and Former National Team Athletes. https://athletescan.ca/wp-content/uploads/2014/03/prevalence_of_maltreatment_reporteng.pdfView Webinar
To clarify public understanding, the Academy for Eating Disorders, in collaboration with Dr. Cynthia Bulik, PhD, FAED, Professor at the University of North Carolina at Chapel Hill, produced “Nine Truths About Eating Disorders”. This document is based on a talk that Dr. Bulik delivered in 2014 entitled “9 Eating Disorders Myths Busted”.View PDF