Eating Disorders and Neurodiversity: Beyond Body Image

What do we miss when we assume that eating disorders are just about appearance?

Nicole M. Luongo


Not an accurate representation of my eating disorder. Photo Credit: Priscilla Du Preez via Unsplash

“Common — sense” narratives about eating disorders often refer to body image. To outsiders, those of us with anorexia, bulimia, binge — eating disorder, or some combination thereof are pathologically afraid of fatness, so much so that we we sacrifice our mental and physical health to maintain a desired body weight and shape.

This assumption is wrong for a few reasons: First, people in “socially unacceptable” bodies may have legitimate reasons to alter their appearance. Fatness is stigmatized, and institutional practices normalize discrimination on the basis of weight. Wanting humane treatment isn’t “disordered,” and until we dismantle the negative connotations associated with fatness, many of which have severe, deleterious consequences, some fat people will seek safety by changing their bodies in ways that aren’t “healthy” or sustainable.

Next, not all people with eating disorders are emaciated. In fact, many if not most are categorized as “normal” or “over — weight” according to the very problematic Body Mass Index (BMI) scale. Does this indicate that some us are failures? Are we a group of cosplayers — not sick enough (yet) to achieve the elusive goal of thinness, but doggedly committed to trying even as our efforts aren’t rewarded?

Maybe. Or is it more plausible that for some of us, body image isn’t actually that important?

“Wait a minute,” you may be thinking. “We know that eating disorders are symptomatic of deeper problems — no one thinks that someone starves themselves, exercises compulsively, binges, or purges just to amend their appearance!” This may be true, but even “deeper” analyses of disordered eating regurgitate (pun intended) generic tropes about low self — esteem and the desire for “control.” As someone who is fond of precise theorizing, these assertions are too vague to be meaningful.

Let’s interrogate, for instance, the claim that people with eating disorders are yearning for control: How are we operationalizing control as a variable? Clinical studies on eating disorders are contradictory because researchers haven’t developed a standardized way to measure