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Recent research challenges the common perception that eating disorders predominantly result in healthy weight or under healthy weight. For instance, Swenne (2016) found that girls with restrictive eating disorders (limiting food intake to an extreme degree) who were previously overweight might present with a near-normal BMI (Body Mass Index, a measure of body fat based on height and weight), yet still experience significant medical and psychological issues. Additionally, Nagata et al. (2018) reported that over healthy weight or obese (having excess body weight or fat) young adults have a higher prevalence (more common occurrence) of disordered eating behaviours compared to their healthy weight or underweight counterparts. This is further supported by McCuen‐Wurst et al. (2018), who noted that disorders like binge-eating disorder (BED, characterized by frequent episodes of eating large amounts of food) and night-eating syndrome (NES, characterized by excessive nighttime food consumption) are often associated with being overweight and/or obese, leading to weight gain and increased risk of metabolic dysfunction (problems with the body’s process of converting food into energy).

Tanofsky-Kraff et al. (2004) observed that overweight children with eating disorders exhibit more disordered eating cognitions (thoughts) and behaviours than healthy weight children. Similarly, Sawyer et al. (2016) highlighted that atypical anorexia nervosa (an eating disorder characterized by significant weight loss and fear of gaining weight, but not necessarily resulting in underweight) leads to a significant number of adolescents being over healthy weight or obese, with severe physical and psychological illness or disease. These findings underscore the importance of recognizing that eating disorders can manifest across a spectrum of body weights, challenging the stereotype that they only occur in individuals who are underweight or of healthy weight.

People suffering from bulimia nervosa engage in binge eating behaviour that is followed by an attempt to compensate in three ways for the large amount of food consumed. Individuals will either purge the food by inducing vomiting or use laxatives to expel the food. Some affected individuals engage in excessive amounts of exercise to compensate for their binges.

Bulimia is associated with many adverse health consequences that can include kidney failure, heart failure, and tooth decay. In addition, these individuals often suffer from anxiety and depression, and they are at an increased risk for substance abuse (Mayo Clinic, 2012b). Recent research indicates that the prevalence of bulimia nervosa varies, with 0.1% to 2.6% of men and 0.6% to 10% of women experiencing the disorder in their lifetime (Elgin & Pritchard, 2006; Hudson et al., 2007; Keski-Rahkonen et al., 2008; Mohler-Kuo et al., 2016; Sandberg & Erford, 2013; Silén & Keski-Rahkonen, 2022; Thiels & Garthe, 2000).

As of the 2013 release of the Diagnostic and Statistical Manual, fifth edition, binge eating disorder is recognized by the American Psychiatric Association (APA). Unlike with bulimia, eating binges are not followed by compensatory behaviour, such as purging, but they are followed by distress, including feelings of guilt and embarrassment. The resulting psychological distress distinguishes binge eating disorder from overeating (American Psychiatric Association [APA], 2013).

Anorexia nervosa is an eating disorder characterized by the maintenance of a body weight well below average through starvation and/or excessive exercise. Individuals suffering from anorexia nervosa often have a distorted body image, referenced in literature as a type of body dysmorphia, meaning that they view themselves as overweight even though they are not. Like bulimia nervosa, anorexia nervosa is associated with a number of significant negative health outcomes: bone loss, heart failure, kidney failure, amenorrhea (cessation of the menstrual period), reduced function of the gonads, and in extreme cases, death. Furthermore, there is an increased risk for a number of psychological problems, which include anxiety disorders, mood disorders, and substance abuse (Mayo Clinic, 2012a). Estimates of the prevalence of anorexia nervosa vary from study to study but generally range from just under one percent to just over four percent in women. Generally, prevalence rates are considerably lower for men (Smink et al., 2012).

While both anorexia and bulimia nervosa occur in men and women of many different cultures, White females from European/Settler societies tend to be the most at-risk population. Recent research indicates that females between the ages of 15 and 19 are most at risk, and it has long been suspected that these eating disorders are culturally-bound phenomena that are related to messages of a thin ideal often portrayed in popular media and the fashion world (Smink et al., 2012). While social factors play an important role in the development of eating disorders, there is also evidence that genetic factors may predispose people to these disorders (Collier & Treasure, 2004).

Canadian Statistics on Eating Disorders

1. Eating Disorders and Mortality: Eating disorders are among the deadliest mental health conditions. In Canada, they affect around 25 million people who are 15 years or older (Bonder & Mantler, 2015).
2. Death Rate: About 8.4% of people with eating disorders die because of these conditions. This rate is especially high, nearly 15%, for women between the ages of 25 and 29 (C. Emborg, 1999).
3. Suicide Risk: Suicide is a leading cause of death among people with eating disorders. This risk remains high for at least eight years after they first seek help (G. Patton, 1988).
4. Frequency of Deaths: In Canada, at least one person dies every 62 minutes due to complications from an eating disorder (Pallanti & Salerno, 2020).
5. Hospitalized Cases: In a study from Ontario in 1995, more than 90% of people hospitalized for anorexia and bulimia were women (Gucciardi et al., 2004).
6. Mortality Rate for Anorexia Nervosa: In one study, the mortality rate for patients with anorexia nervosa was found to be 10.5, which is a statistical measure indicating a high risk of death (Birmingham et al., 2005).

These statistics highlight the severe impact of eating disorders, particularly on women, and the high risk of death associated with these conditions. They underscore the importance of recognising and treating eating disorders effectively.

Eating disorders have traditionally been viewed as psychological disorders characterized by abnormal eating habits, often linked to issues of control and self-esteem. Newer theories expand this view by incorporating the role of societal pressures and gender norms. Malson and Burns (2009) suggest that eating disorders should be understood in the context of cultural norms around body image and the societal expectations placed on women. Young women in our society are inundated with images of extremely thin models (sometimes accurately depicted and sometimes digitally altered to make them look even thinner). These images may contribute to eating disorders. (credit: Peter Duhon). This perspective highlights how cultural pressures to conform to certain body standards can contribute to the development of eating disorders. Additionally, feminist theories advocate for a more detailed understanding of eating disorders that goes beyond individual pathology and considers the broader social and cultural dynamics at play (Colăcel, 2016).