First, it needs to be said that eating disorders are not the illness of middle class or exclusively white teenage girls like the media often portrays. The most recent statistics from the National Association of Anorexia Nervosa and Associated Disorders reveal that up to 30 million people in the United States suffer from an eating disorder. Of those 30 million, 10-15 percent are males. Only one in ten men and women will receive treatment, and of those, only 35 percent will receive treatment from a specialized facility. Finally, eating disorders have the highest mortality rate of any mental illness.

I was diagnosed with Anorexia Nervosa in the fall of 2012. My eating disorder developed at the end of my sophomore year of high school and lasted until I received treatment in the fall of my freshman year in college. In the two years I had an eating disorder, and in the two-and-a-half years in recovery, I have found that there are a lot people do not know about eating disorders. So here are a few key things to remember when talking about eating disorders, talking to someone with an eating disorder or when trying to give support to someone during their recovery.

Eating disorders are not a conscious decision.
When friends and family first realized I had an eating disorder most of them responded with statements along the lines of “Why are you doing this?” and “Can’t you just stop?” Now, I can only talk from my own experiences, but it’s not like I woke up one morning and thought to myself, Anorexia would be a good choice, lets do that. For most, it starts with eating less throughout the day or even skipping one meal entirely. Then it becomes skipping one meal and eating less at another and maybe even adding in exercise. The same thing happens again and again until one day you’re only consuming half a pretzel and a Diet Snapple. The worst assumption that anyone can make about eating disorders is that the person suffering has any control over it.

Eating disorders are isolating.
When someone is suffering from an eating disorder they will often distance themselves from any situations where food is the focus or where someone will notice how much they aren’t eating. For the majority of my senior year of high school I skipped lunch and sat in the library doing schoolwork. It wasn’t because I wanted to study more or get everything done ahead of time; I chose to go there because that way I didn’t have to sit at the lunch table and answer questions about why I wasn’t eating.

Eating disorders are stressful on relationships.
There tends to be a ripple effect on relationships with friends, family, teachers, employers and so on. In some way or another, they are all impacted by your eating disorder. Since I chose to sit alone in the library during lunch I lost touch with my friends during the week, and on the weekends, I would more often than not cancel plans because I didn’t want to face having to eat. To this day, one of my biggest regrets about my eating disorder and the damage it had on friendships is that it cost me one of my closest friends. I can’t hold a grudge because I understand that watching someone you care about go through something like this is hard. As with close friends, my family also suffered a lot watching me in those two years. There were arguments and lies almost daily. Lying about what I was eating and my health became second nature. I lied to concerned teachers and my boss, making up excuse after excuse. Individuals with eating disorders try to keep it hidden because of feelings of guilt, shame or not wanting someone to intervene. I looked at every lie I told as a white lie, that by lying I was in some way doing what was best for those concerned about me. None of the damage to relationships was intentional, and if I could go back I would change it, but eating disorders, whether it is anorexia, bulimia or binge eating, all have a way of becoming the only thing an individual can focus on, leading them to sacrifice their relationships.

Eating disorders are confusing.
As many can assume, at the root of most eating disorders are body image issues. Throughout life I was always heavier, even my pediatrician called me a “chubster.” It was something I knew, but chose not to focus on too much when I was younger. When I hit middle school and high school, it became more of an issue. Even after I had lost sixty pounds, I still saw the girl before the eating disorder. Friends and family would try to point out how thin I was, but I couldn't see it. Body dysmorphic disorder, the obsession with imaginary defects in appearance, goes hand-in-hand with eating disorders. Someone suffering from anorexia or bulimia could be 90 pounds and still see himself or herself as someone who is overweight. This is one of the hardest things to break during recovery. It’s almost as if the individual seeking treatment has to retrain their brain to look at food as energy not calories and to see themselves as they truly are, not what the disorder makes them see.

Think before you speak.
In my opinion one of the hardest things for people who have not had an eating disorder to understand is that while there is no right thing to say, there are many wrong things to say. The statements I heard most during my eating disorder were people telling me that they wished they were thin like me and asking how I stay so thin. To some people these might seem like compliments, but for those of us with eating disorders, they can make us sad or angry because deep down we know what it took to look like that and would never want someone else to experience it. Something that is often said jokingly is “You need a cheeseburger.” While yes, eating a meal would be best for them, this statement is more hurtful than you think. Comments that directly mention physical appearance are hard to hear as an individual with an eating disorder because it reinforces the idea that physical appearance is important.

This is in no way a complete list of what someone should know about eating disorders. It is more a list of things that stuck out to me most both as someone with an eating disorder and someone in recovery. Everyone’s experiences are not the same, so there may be some people who disagree with me, but hopefully this answers some questions you had about eating disorders.