What Happens When You’re Not “Thin Enough” To Get Help For An Eating Disorder?

Alexa Giardino

I frequently talk about the issues facing men, minorities, and older adults with eating disorders that can prevent treatment or diagnosis of these dangerous mental illnesses. However, there is another group who often gets overlooked: the “not skinny enough”.

Even in the medical community, weight is often (and wrongly) used as the best and easiest way to identify eating disorders in patients. Aside from specialists, many doctors and other medical professionals regularly overlook eating disorders because the patient doesn’t look like the skeletally-thin stereotype of someone living with anorexia or bulimia.

While dangerously low weight can be a sign that a person is living with a severe eating disorder, it is far from the most accurate sign or symptom. The biggest issue is that the majority of people living with eating disorders do not reach this overly thin frame until they are in the most dangerous stages of the disorder, where their life is in immediate danger. If anything, significant and sudden changes of weight are a much more reliable predictor of individuals who may have an eating disorder than just a simple reading of a scale.

Additionally, the idea that overall weight is indicative of an eating disorder comes from a misunderstanding of how eating disorders develop and appear. It assumes that all eating disorders are similar to anorexia, which causes a person to starve themselves of food.

Bulimia, binge eating disorder, and other clinically recognized forms of disordered eating all manifest themselves in unique ways. They can even vary from person-to-person. While those with bulimia do go through periods of abstaining from food, the disorder is also characterized by intermittent excessive binge eating of food. In the case of binge-eating disorder, a patient may be average or overweight as they compulsively indulge in regular overeating.

For National Eating Disorder Awareness Week, I want to highlight this issue with a personal story from a woman who struggled to get the help she needed because she didn’t look like the stereotypical image of an eating disorder patient.

In a piece published on Narrative.ly, Natalia Keogan details 22-year-old Alexa Giardino’s fight to get help for the eating disorder which plagued her life for years. Even after she realized she had a problem Giardino says she couldn’t get anyone around her to believe she was bulimic – including her doctors.

“My first therapist straight-up told me, ‘I don’t think you have an eating disorder, you just have anxiety,’” Giardino said. “I had tried telling her about how I was making myself purge, but she completely brushed it off, and it was such an invalidating experience.”

In many cases, Giardino says her friends and peers in college even celebrated her weight loss. Some were jealous about her increasingly slim appearance and her social media posts from the period show comment after comment praising her appearance.

“I still wasn’t thin enough for people to realize I was struggling,” Giardino says. “And you know what? I look at that picture, and I know I was just too thin.”

In the end, it wasn’t her weight which made Giardino’s family begin to suspect something was wrong. Instead, it was her increasingly serious depression and anxiety that made her mother start to push for Giardino to find another therapist.

“It was really validating when I got to my new therapist, to have this big, two-hundred-pound man sitting down with me and saying ‘I’m going to diagnose you with bulimia,’” Giardino says. “That was the first time I felt validated. I thought I would never fit that criteria.”

Giardino’s experience is indicative of a phenomenon that affects many men and women both in the U.S. and internationally. Until the public and medical community are educated about the complex, subtle, and dangerous ways eating disorder manifest in individuals, there will continue to be countless people who can’t get proper treatment for the disorder destroying their bodies.

“We all still look very different,” Giardino says. “We all have been heavy, or thin, or maybe not. Some of us have stayed the same weight our entire lives. There is no one narrative for an eating disorder.”

Read more from Keogan’s article about Giardino from Narrative.ly.

If you think you or someone you know may be living with an eating disorder, call us at (888) 298-4673. We can answer any questions you have and see if treatment is right for you.

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