Almost 50% of people with eating disorders meet the criteria for depression. Only 1 in 10 men and women with eating disorders receive treatment. Only 35% of people that get treatment for eating disorders get it from a specialized facility for eating disorders. Almost thirty million people suffer from an eating disorder in the US. Eating disorders have the highest mortality rate of any mental illness.

“Fat” by Caroline Rothstein

I am not fat.

It took me 22 years to purge words on a page.

The same way I purged my body into stomach ulcers,

Popped eye blood vessels,

And missing tooth enamel.

22 years to tell the tale of my bulimic

And anorexic eating disordered hell

And I’ve walked barefoot

Through tiled deserts of bathrooms

To find the mirage of my distorted body image

Looking up at me from the tainted water in the toilet.

I used to daydream

About freedom

I used to daydream

About appreciated the abundance of food around me

I used to daydream

About eating dinner without wanting to kill myself.

And that like this society I wish to heal and explain

I too someday would change.

So I’ve unchained the melody of my dirge-sung soul

And patched layers of carbon candle wax

To mend the stomach holes.

I’m free.

Free from sticking out of algebra and trigonometry

To vomit elegantly into a toilet paper filled toilet

During a busy passing period

So that no one could hear me.

Free from credit cards that pay for wasted food

Crumbled into white garbage bags

In the gutter across the street from my driveway.

Free from dry skin and shedding hair

Bleeding skin and death scares

Because food gave me power to inject order into a world of chaos.

Food

Gave me the love and security

I was afraid to find in sexuality.

Food

Could remedy the abandonment

I felt from my father’s excessive traveling

To pay for the excessive amounts of money

I would vomit in the toilet.

This is not a poem about struggling

Through the thousands of breakfasts,

Lunches,

And dinners

When thousands struggle without breakfast,

Lunch,

And dinner.

This is not a poem about millions of tears

As my fear encrusted fingers lay mangled

Shaking

Twitching on the bathroom floor

With fear and insecurity

When millions of children are held captive

Shaking with fear and no security.

This is not a poem about the guilt

Of a privileged disorder

Because I was often told I was selfish

For an uncontrollable force

Coaxing me to stick my fingers down my throat.

This is a poem about context.

How I can’t formulate linguistically eight blocks

The deadly pain that lived inside me.

About playing Russian roulette with my esophagus

As my gun-barreled fingers

Triggered tragedy down my throat.

About self-deprecating stares

In the mirror of a red-faced terrorist

Hijacking my digestive system from within

About how my eyes have learned

To make love to the lower left corner of my torso

And the sun

Sets

In the crevices of the cellulite

Of my thunder thighs

This is a poem

About the regurgitated traumas

I cannot digest

And at best

This is a poem about how I am

Not

Fat

Words such as “fat” can negatively impact anyone. A more recent example, and one I grew up with, was Demi Lovato.

“The days in treatment Demi Lovato calls some of her darkest ones. The teen singer sat down with me for her first TV interview since heading to treatment and starting over. She also has some shocking things to say about the pressure she was under like many former child stars, the toll it took on her, and what got Demi through it all.

“She’s famous for her winning smile and her and her wholesome charm. For the little girl from Dallas, Texas, the desire to perform was home grown. Her mom, Diana, was an aspiring country singer and Dallas Cowboy’s cheerleader. And for her daughter, Demi, it was the classic hit musical, Camp Rock that catapulted her talent to stardom.

“Demi was living a teenager’s dream—movies, her own television show, gold records, and dating teen heartthrob, Joe Jonas—but away from the spotlight, a hidden shame. Before her rise to fame, Demi spent years battling an eating disorder. She said it all started in early childhood when bullies constantly teased her and called her fat.”

“I’m a very strong advocate for anti-bullying but I’ve never been able to say ‘this is why.’ I am such an advocate for it because ever since I was bullied until now, I’ve suffered an eating disorder from the things that were said to me."

“Did it lead to a form of depression?”

“Yes. Definitely.”

“Can you explain more about that period of your life?”

“That period of my life that I went through was really dark and I became very depressed and my only way of really coping with it was through my eating disorder, so I just stopped eating and that was my way of coping with it.

“Her depression would eventually lead to urges to cut herself.”

“I’ve suffered from… cross-addictions over the past few years. I was trying to control my eating disorder, trying to get help for it and when I tried to control those things the urges [to cut] came up. So, for me, that was ok to do that [cut] because I wasn’t throwing up anymore.”

“Last fall, Demi checked into a residential treatment center, Timberline Knolls.

“What was the darkest point for you?”

“I can’t really pinpoint a darkest point for me because over the past few years I’ve had… so many. I guess my darkest period was going into treatment for those first forty-eight hours and not having any contact with the outside world. Even letting some people know I was in there. I couldn’t. I couldn’t talk to anyone and I was just kind of shocked to be in such a different environment.”

“It was there she learned a shocking new diagnosis; Demi was bipolar.”

“I had no idea that I was even bipolar until I went into treatment. I was actually manic a lot of the time that I would take on work loads and I would say ‘Yes I can do this, I can do this, I can do this,’ I would be conquering the world but then I would come crashing down, and I would be more depressed than ever.”

“During three months of in-patient treatment, Demi learned new ways to manage her emotions.”

“Today I’m learning how to cope with issues and cope with urges and things like that in healthy ways. Like I’ve picked up knitting. I like, who would ever thought that I knit on a Saturday night? Like watching TV? Like, I totally do, I’m a knitter.”

“Lovato says it was the thought of her little sister, Madison, the young star of Desperate Housewives, that got her through her darkest days of treatment.”

“I had to think of her, all the time when I was really, really rough but I just kept on thinking, ‘OK set this example for your little sister.’ And even though it might be hard to, like, wake up in the morning—there were days where I just didn’t want to get out of bed—and looking at a picture of my little sister on my little bulletin board was one of the things that kept me going.”

“For Demi, there is hope for all for what she once battled, alone.”

“If I can prevent one person, today, from having the wrong friends, from cutting for the first time, to embarking on a horrible long journey with an eating disorder, if I can just change one life with this message by saying, ‘Don’t go there,’ then I’m done.”

But it isn’t just girls and women that are victimized. Body shaming and bullying can have adverse effects on boys and men, too.

(Brian Williams) “Back now, as we mentioned, with a warning for parents about the dangerous and even deadly eating disorders usually associated with teenage girls, as you’re about to see, anorexia does not discriminate. Our report tonight from our chief medical editor, Dr. Nancy Snyderman.”

(Dr. Nancy Snyderman) “Thomas Lee Warschefsky, TJ to family and friends, a straight A student and exceptional athlete, and a boy secretly obsessed with diet and exercise in the hopes of achieving the perfect body.”

(TJ’s mother, Susan Barry) “He wanted a six-pack. He wanted rock-hard abs. he wanted muscles. That’s how it all started.”

(Dr. Nancy Snyderman) “It was anorexia nervosa, a life-threatening eating disorder. For eight years, TJ starved himself and exercised compulsively. Eventually, he stopped eating for up to twenty-hours a day while exercising close to five.”

(TJ’s mother, Susan Barry) “He would ask us, beg us ‘Please don’t tell anybody. It’s so embarrassing-everybody thinks this is a girl’s disease.”

(Dr. Nancy Snyderman) “TJ died in the middle of his nightly routine, doing 1000 sit-ups. Weighing just seventy-eight pounds, his heart gave out.”

(TJ’s mother, Susan Barry) “The look in his eyes, the last pictures he took of himself on his camera, it wasn’t TJ- it was not my son.”

(Dr. Nancy Snyderman) “TJ is the new face of anorexia, now an equal opportunity disease. At least one million males in this country suffer from eating disorders, dying to be thin. Experts say it takes a certain kind of personality to go to this extreme.”

(James Lock) “It’s very unusual for someone to come into my office for an assessment of anorexia if they do not have straight A’s, and this is true for boys and this is true for girls. And in sports, these are great athletes usually that drive themselves to the next level…”

(Dr. Nancy Snyderman) “Doctors like psychiatrist James Lock believe that kids strive for the same airbrushed perfection they see in the mass media. And while girls obsess over calories and weight, boys concentrate on muscle mass and fat index.

(James Lock) “They [boys] come later to treatment therefore they’ve had more time to lose weight so they’re physically sicker…”

(Dr. Nancy Snyderman) “Avi Sinai was ten when his family first realized he was losing weight. His family knew he was in trouble when, in a matter of weeks, Avi went from being a picky eater to having a psychosomatic illness—he couldn’t swallow solid food.”

(Nancy Sinai, Avi’s mother) “I felt I was up against death and I was watching my child potentially die on me, so I was fighting to save him.”

(Dr. Nancy Snyderman) “Even after two lengthy stays in a treatment center, Avi, now fourteen, admits he still struggles with feelings of a distorted body image.”

(Avi Sinai) “I definitely sometimes, you know, when I’m looking at myself I say, ‘aw I’m so fat.”

(Dr. Nancy Snyderman) “But for now, food is not his enemy.”

(Avi Sinai) “After not eating for a few years, everything seems so good, like I love burritos, ice cream, kubaneh—which is like a Yemenite food, and pizza, and all sorts of stuff.”

The media can have a lasting negative effect on all sorts of people and body image. One example of this is Donna, 27, who refuses to have a Facebook or Instagram account. It’s one way to protect herself. As someone who suffered from bulimia from age 12 to 25, and endured its agonizing effects—dental erosion, swollen glands, loss of her period, and a half a dozen or so hospitalizations—her will to live is far greater than the allure of social media. In high school, she took part in online discussion forums where people compared weights, binged together,  and helped one another avoid eating.

“I was affected by it. Now, I don’t like to compare. Facebook and Instagram are very image-driven, so I try to avoid that.”

Pro-ana, pro anorexia, and pro-mia, pro bulimia, websites have existed since the inception of the Internet. Social media sites such as Facebook, Twitter, Tumblr, and Pinterest have given these communities a global platform on which to share ideas and photographs. Users support one another’s self-destructive behaviors through shared tips and tricks and promote the notion of an eating disorder as a lifestyle choice, not a serious mental illness. ‘We live in a culture where eating disorders thrive because of the messages we’re exposed to,’ said Claire Mysco, head of the Youth Outreach for the National Eating Disorders Association, ‘Social media heightens that exposure.’

Eating disorders are a daily struggle for 10 millions females and one million males in the United States. Four out of ten people have either experienced an eating disorder or of knew someone who has. Over a lifetime, point nine percent of women will struggle with anorexia, 1.5% of women will struggle with bulimia, 3.5% of women will struggle with binge-eating disorder. Point three percent of men will struggle with anorexia, point five percent of men will struggle with bulimia, and two percent of men will struggle with binge-eating disorders.

The feedback I got was this:

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