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Eating Disorders

Is Holiday Eating Causing You Stress?

Make a New Year’s resolution to start recovery if you have an eating disorder.

Key points

  • Eating disorders are complex mental health issues that can become chronic or fatal if not treated.
  • Three-quarters of people with an eating disorder don’t ask for help. Often, they are in denial or think no one will understand.
  • Early intervention with an eating disorder makes full recovery more likely.
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by Gia Marson, Ed.D.

Eating disorders are complex mental health issues that can cause a range of unhealthy eating habits to develop.

Many times, an eating disorder comes on slowly and without awareness, causing a person to think they’re just picky or have rigid habits around food. This thinking can be especially prevalent during the holidays when gatherings are centered around food and eating rituals. But denying the risk posed by an eating disorder can be dangerous—for some people, an eating disorder can lead to hopelessness and even be fatal.

Fortunately, recovery from eating disorders is possible. And research shows that early intervention is key. So if you or someone you know may have an eating disorder, it’s important to get help as early as possible.

"Early identification and treatment improves the speed of recovery, reduces symptoms to a greater extent and improves the likelihood of staying free of the illness. For example, when adolescents with anorexia nervosa are given family-based treatment within the first three years of the illness onset they have a much greater likelihood of recovery." — National Eating Disorders Association

The most common barriers to early intervention

Only one in four individuals with eating disorders seek help. That means three-quarters of all people suffering from an eating disorder do so in silence. Why is that? Recent studies have found some common barriers people with eating disorders often face when seeking help:

  • Cost of treatment
  • Access to treatment through the healthcare system
  • The stigma associated with eating disorders
  • Denial of being in need of help or even having an eating disorder
  • The perception that others won’t understand or be able to help

Of these, denial and the perception that others can’t help are the two largest barriers to getting treatment.

Barrier: Denying that you have an eating disorder or need help or thinking that you are not sick enough.

People with severe eating disorders often don’t believe that they have a problem and don't think they need support for the disorder. Ironically, often patients are able to recognize eating disorders in other individuals but not in themselves.

Specifically, individuals with anorexia nervosa (characterized by extreme food restriction and a deep fear of gaining weight) may not have a clear perception of how little nutrition they are getting or how that deficit is harming them. Another form of denial for people with anorexia nervosa can be the belief that their weight is not low enough or they are not sick enough to warrant medical, nutritional, or psychological treatment.

Those with bulimia nervosa (characterized by a cycle of binge eating and purging or other compensatory behaviors) may normalize their symptoms due to the frequency with which they occur, especially if their weight has not been severely impacted. And, most individuals with binge eating disorder (characterized by eating large amounts of food when they're not hungry, very quickly, until they're uncomfortable) blame themselves, experiencing shame about weight changes and for losing control around food. That shame leads to denial when it goes along with the belief that binge eating is a failure of willpower, not a disorder.

"The most important thing we can do is not only admit it to ourselves but then to reach out for that help. The first step is exposing that secret and that struggle..." — Candace Cameron Bure

Barrier: Believing that others won’t understand or be able to help.

Keeping the eating disorder a secret reduces the chance of getting support from close friends and family. This isolation can lead to a whole host of problems. For nearly everyone with an eating disorder, the negative effects extend beyond impaired nutrition to adverse impacts on physiological functioning, the gut-brain connection, hormone regulation, emotional awareness or reactivity, stress, concentration, mood, and relationships.

With the potential for so many multidimensional consequences, a person with an eating disorder may feel as if it would be impossible for another person to understand what is happening or be able to help. The good news is that a strong social support system can be one of the best pillars of recovery.

Full recovery from an eating disorder is possible

Overcoming these significant barriers early on is important because studies show that the sooner a person can begin treatment, the better the chance of lasting recovery. Although an eating disorder is much more complex than a set of negative habits, the longer that the unhealthy behaviors are in place, the more entrenched they may become and the harder they may be to let go.

Early intervention strategies can come in many forms. Here are a few ways to get help:

  • Curiosity. In an open, nonjudgmental way, ask yourself whether your eating or exercise gets in the way of your functioning. Does either cause harm to your health, life goals, or relationships? If so, how often and to what extent? If how you manage food or fitness leads to any functional impairment, you may have an eating disorder. Exploring your values, thinking patterns, and automatic behaviors can shed light on how dieting, over-exercising, or binge eating can undermine your relationships, work-life balance, and goals.
  • Awareness. Seek psychoeducation and facts about eating disorders from a professional organization such as the Academy for Eating Disorders, or get help from a medical or mental health professional or a book written by one.
  • Openness. Eating disorder thoughts and behaviors are often kept as secrets because individuals may be too scared to ask for help. Some may fear losing a reliable (though unhealthy) way of coping, while others may fear being judged. If this is your challenge, push yourself to unlock your secrets.
  • Social support. Help is out there, and you’re worthy of help. Relationships can offer the kindness and love we need to face difficulties, and that includes recovery from an eating disorder. Reach out to a trusted friend or family member.
  • Nutrition. Restoring nutritional health is vital–whether you believe you have a severe problem or not. Therefore, be willing to target your eating, exercise, or compensatory behaviors even if you are (or someone you know is) in denial or ambivalent. Nutritional health can lead to recovery first and awareness later.

Don’t wait. Get help for yourself or another right away. Remember that denial, isolation, and hopelessness, as well as the challenges inherent in accessing treatment, keep a person in a dangerous zone. Supportive relationships make a big difference when we are facing something hard, so please reach out for help. If accessing care is challenging, look for free online support groups or contact a free helpline such as the one offered by the National Eating Disorders Association. Early intervention is your path to a healthier future.


McAndrew, A. J., Menna, R., & Oldershaw, M. (2020). Disordered eating and barriers to help-seeking: A brief report. Eating Disorders, 30, 1–10.

Radunz, M., Ali, K., & Wade, T. D. (2022). Pathways to improve early intervention for eating disorders: Findings from a systematic review and meta-analysis. International Journal of Eating Disorders, 1–17.

Taquet, M., Geddes, J., Luciano, S., & Harrison, P. (2022). Incidence and outcomes of eating disorders during the COVID-19 pandemic. The British Journal of Psychiatry, 220(5), 262-264. https://doi: 10.1192/bjp.2021.105

Vitousek, K., Watson, S., & Wilson, G. T. (1998). Enhancing motivation for change in treatment-resistant eating disorders. Clinical Psychology Review, 18(4), 391–420.

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