When Alysse Dalessandro was only 12 years old, she found herself enrolled in Weight Watchers.

As she lost weight, no one questioned her.

“I was starving myself to do it,” she says. The worst part? She was essentially rewarded for depriving herself of food. The program taught her restrictive eating habits. Dalessandro walked away with a binge eating disorder that went undetected for 16 years, in part because, for a long time, the plus-size fashion blogger didn’t think she had one. When she brought up the possibility of having an eating disorder, “no one understood or believed me. It caused me to question if I really did,” Dalessandro says.

“I thought that an eating disorder would only show in your physical appearance by being very thin,” says Dalessandro, who is currently in treatment. “I feel that belief is very common because of how the media wants us to look at fat bodies.”

Thirty million Americans will struggle with an eating disorder, according to the National Eating Disorders Association. Some of them are fat.

Throughout the years, a disturbing misconception has gone on in the media that in order to be suffering from an eating disorder, you must fit into an ideal body shape.

“The truth is that most marginalized bodies, with the exception of cisgender women, are thought not to be affected by eating disorders,” explains Melissa A. Fabello, a body acceptance activist and scholar. “The dirty little secret is that eating disorders affect people of all ages, genders, races, ethnicities, abilities, socioeconomic statuses and body weights and shapes.”

For fat folks, the narrative to lose weight is not an uncommon one. But during National Eating Disorder Awareness Week – which runs from Feb. 26 to March 4 – we rarely see coverage that centers around folks who are suffering in silence.

One reason why, Fabello says, is that weight loss is often congratulated, despite the means.

Natalie Hage, a plus-size model, started dieting when she was 9. She didn’t realize she had a binge eating disorder until her late teens. “I realized that I was doing it as a means to punish myself,” Hage shares.

When Hage lost weight, it was always celebrated. She would hide food in room, then eat and lie about it in deep episodes of guilt and shame.

“The hardest part about recovery for me has been unlearning the shame and guilt when it comes to food,” Hage says.

Eating disorders are not “diets gone wrong,” and they are not “simply about vanity,” says Kelsey Johnston, an outreach and education coordinator at the National Eating Disorder Information Center (NEDIC). In reality, eating disorders commonly co-occur with depression, anxiety, substance use and a history of trauma, Johnston explains.

Throughout Shilo George’s life, she was taught that fat people were “monsters.” So, as a kid, George tried very hard not to be a monster.

Her body was constantly under surveillance by adults. Her parents enrolled her into a weight loss program in 1988 with the hopes of teaching her the “good vs. bad” dichotomies of food. But rather than lose weight, it helped George develop an unhealthy relationship with food and further disassociate from her body. George endured mental and emotional abuse at the hands of her doctors and parents, she says.

But it wasn’t until her early 20s, after a sexual assault, that she began to recognize the symptoms of a binge eating disorder.

“I don’t know what took me so long to realize it was an eating disorder because that’s how I lived my life,” says George, who runs her own consulting business. “I didn’t see it as being a disorder, but as my own personal failing.”

Currently, she is enrolled in eye movement desensitization and reprocessing therapy (EMDR). The first round of EMDR helped George process her abuse and trauma. She has found it useful for treating her binge eating disorder, but it’s too early to say whether it will work longterm.

“I tried to get therapy just for my eating disorder, but the therapist was really only interested in me getting weight loss surgery,” George says. “I don’t know if [EMDR] will be helpful. ... It feels like I will never fix this or heal from it.”

According to the Eating Disorders Coalition for Research, Policy and Action, every 62 minutes, at least one person dies as a direct result of an eating disorder.

This is partly why seeking treatment is so important. But if the narrative around eating disorders is that they only impact a particular group, those who aren’t identified as high-risk might not seek a diagnosis, support or treatment.

Johnston of NEDIC says that as a society, we need to unlearn our assumptions about what we think eating disorders “look like” and represent eating disorders in a more inclusive way. Many people may not even recognize their own experiences as disordered eating because of misperceptions about the relationship between weight and eating disorders.

And when they do look for help, some health professionals aren’t educated about what recovery looks like for a fat person with an eating disorder.

Fabello believes that it’s hard for most fat folks to find medical and mental health professionals who take a “Health at Every Size” approach to their work and validate their experiences.

“No one should be put in a situation where their wellness teams don’t take them seriously,” Fabello says. “We need more eating disorder education for people to understand how they truly work.”

It’s also important to showcase that fat folks with eating disorders are valid and do exist.

“I think there’s a lot of stigma around eating disorders, so people really don’t share their experience that often,” Dalessandro says. “I hope that stories like this will help to open the minds and hearts of those who don’t see fat people with eating disorders as valid. We exist. Let’s dismantle fat stigma.”

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