Eating Disorders Often Not Diagnosed In Time in Obese People


When clinicians and dietitians speak of eating disorders, most people think of a rail-thin female struggling to become model-thin. However, eating disorders may grip even those with an ordinary BMI. Eating disorders can affect anyone, regardless of their size and, in fact, obese individuals are just as susceptible to eating disorders as anyone else in the population.   

Looks Can Be Deceiving  

Unfortunately, because of the stereotypes portraying individuals with eating disorders invariably as women whose rib cages are visible, individuals with eating disorders may remain undiagnosed for extended periods of time. This can literally be deadly; too rapid a drop in weight, even if the individual’s BMI does not indicate that he is underweight, can lead to a trip to the emergency room or worse. One study even suggested that eating disorders are delayed an average of nine months among individuals who were once overweight. This contrasts sharply with diagnoses in those who were never overweight. This is very concerning, since delayed diagnoses measurably worsen the prognosis of the disorder.  

Closer Than You May Think  

It is tempting to think of overweight individuals as having the opposite problem of those with eating disorders. The latter is seen as simply being unusually restrictive in their dietary habits, whereas the former are seen as unusually excessive in their eating habits. However, the two groups may have more in common than is initially evident. In fact, obese people who undergo bariatric surgery may find themselves going to the opposite extreme and adopting a diet that is unhealthily, or even dangerously, restrictive.   

In fact, the same factors that predispose you to an eating disorder may put you in danger of becoming obese. Being inordinately influenced by the media’s ideal of thinness, as well as a proneness to dieting behavior, may be as likely to predispose you to developing an eating disorder as it may to obesity. Both groups are also more likely to place too great an emphasis on their weight.   

Weight Suppression

Both groups are likewise prone to what is known as “weight suppression.” This refers to the difference between your current weight and your highest weight since reaching adult height. The greater the difference, the greater the susceptibility to eating disorders such as anorexia and bulimia. Weight-suppressed individuals, in addition to being unusually predisposed to eating disorders, are also unusually predisposed to gaining weight in the future. Excessive exercise, deliberately induced vomiting, fasting and laxative abuse may all be linked with the kind of binge-eating that typically results in rapid weight gain. Thus, obesity may, ironically, sometimes be indicative of an eating disorder during one extreme of the weight suppression yo-yo.