Can You Have an Eating Disorder Without Body Image Issues?

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Is it possible to have an eating disorder without having body image concerns?

The short answer is: yes.

Body image and eating disorders are often significantly interrelated, but not always. Not everyone who has an eating disorder has body image issues, and not everyone who has body image issue has an eating disorder. Learn more about the relationship between body image and eating disorders, and examples of situations where an eating disorder might exist irrespective of body image concerns.

The Prevalence of Body Image Issues and Eating Disorders

Unfortunately, negative body image is a common experience. Research estimates that up to 40% of women are not satisfied with their bodies, and up to 30% of men feel similarly. Other studies indicate that up to 61% of adolescents report experiencing body dissatisfaction at some level. Dissatisfaction with one’s body occurs for many individuals, regardless of gender or age.

In some instances, body image concerns set the stage for the development of an eating disorder. However, eating disorders don’t form overnight. An individual with a negative perception of their body might engage in disordered eating habits for a period of time. As those habits continue, an eating disorder may form.

While the reported instance of eating disorders is lower than the reported instance of body dissatisfaction, eating disorders remain a serious set of mental and physical health conditions that impact many people. Estimates project that more than 9% of the U.S. population will experience an eating disorder in their lifetime.

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Potential Non-Body Image Causes of an Eating Disorder

At their core, eating disorders are about far more than just food and body image. Eating disorders can involve a complex array of emotional, psychological, biological, and genetic factors. From an emotional and psychological perspective, stress or trauma can set the stage for the development of an eating disorder as a maladaptive coping mechanism. A family history of eating disorders can also increase one’s likelihood of experiencing an eating disorder themselves. Concurrent mental health conditions can also exacerbate the risk of developing an eating disorder. These examples are just several of many in which body image may play no role at all.

Types of Eating Disorders That Do Not Always Involve Body Image 

While the instance of body image concerns is not required to diagnose an eating disorder, some eating disorders are more closely associated with body image concerns than others. Anorexia, for example, is characterized by restriction of food or exercise excessively, often in pursuit of thinness and in fear of gaining weight. However, negative body image doesn’t have to coincide with an eating disorder.

For example, individuals who experience Avoidant Restrictive Food Intake Disorder (ARFID), may demonstrate extreme selectivity in what they eat, leading to significant weight loss or nutritional deficits, but may never express concerns about their body shape or size. While not a clinical diagnosis, “orthorexia,” or an obsession with “healthy” eating, may center around only eating foods deemed “pure,” or “healthy,” and might not involve concerns with one’s body image. These are just two of many examples in which eating disorders may be present without a co-occurring negative body image.

Know the Signs and Symptoms

Don’t allow the presence of negative body image, or the lack thereof, to serve as your single indicator as to whether a loved one might be experiencing an eating disorder. While body dissatisfaction may be related to an eating disorder, it also might not. Stay aware of other signs and symptoms beyond body image, including, but not limited to changes in one’s behavior around food, changes in eating patterns, excessive exercise, avoiding social situations surrounding food, and withdrawal from typical activities. While not an exhaustive list of symptoms, these behaviors could be signs of an eating disorder.

If you suspect that you or a loved one is struggling with an eating disorder, don’t wait to seek help. Reach out to an eating disorder treatment provider to receive an assessment and to learn more about your options.

Resources:

 1. Quittkat, Hartmann, Dusing, Buhlmann, Vocks, 2019

2.  Bornioli, Lewis-Smith, Slater, Bray, 2019

3.Deloitte Access Economics, 2020


About our Sponsor

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Reasons Eating Disorder Center offers a full continuum of care for patients struggling with anorexia, bulimia, binge-eating disorder, and co-occurring issues such as trauma symptoms, substance abuse, bipolar, borderline personality disorder, anxiety, obsessive-compulsive disorder, or depression.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published July 27, 2022 on EatingDisorderHope.com
Reviewed & Approved on July 27, 2022, by Jacquelyn Ekern MS, LPC