What Most People Get Wrong about Eating Disorders
Eating disorders are often misunderstood, reduced to oversimplified stereotypes that fail to capture the complexity of these struggles.
Shelby Santin, a dietitian specializing in eating disorder recovery, works to challenge these misconceptions and help people overcome disordered eating every day.
With a philosophy rooted in the idea that food is more than just fuel—it's a way to connect with culture, family, and life—Shelby emphasizes compassion, nuance, and mental health in her approach. Read on to understand common misconceptions about eating disorders, uncover the realities behind them, and get insights from Shelby about how to better understand and support loved ones who are struggling.
Meet Shelby
Shelby grew up in an Italian family where food was central to life. From that upbringing, she developed a deep appreciation for the role food plays in connecting people to culture, family, and friends. This foundation shaped her philosophy that food is far more than just fuel—it's a way to enhance life and relationships.
Her career journey began in hospital settings and later progressed to working in a residential treatment facility for eating disorders, where she gained valuable experience in intensive care environments. Eventually, Shelby transitioned to private practice, drawn by the opportunity to build long-term relationships with her clients and offer more individualized, client-centered care. In her work, she collaborates with therapists and doctors to address not just nutrition but also the underlying mental health factors that contribute to disordered eating, creating a holistic and personalized path to recovery.
Is It Disordered Eating? How to Recognize the Signs
It can be hard to identify when eating behaviors move from healthy to disordered. Shelby explains that unlike a healthy relationship with food, disordered eating often feels stressful, overwhelming, or all-consuming. Signs can include constant thoughts about food, guilt or shame after eating, skipping meals, or following rigid food rules influenced by diet culture. If food begins to interfere with daily life—such as avoiding social situations, struggling to focus, or feeling isolated—it may indicate disordered eating.
In contrast, a healthy relationship with food is flexible and doesn't involve overthinking every choice. As Shelby notes, "Having a healthy relationship with food is more nuanced. It's not about finding the 'perfect' choice every time but simplifying nutrition and focusing on balance." If you or a loved one are constantly preoccupied with food or feel anxiety around eating, it's worth exploring these behaviors further and considering whether additional support might help.
5 Common Misconceptions about Eating Disorders
When trying to identify if you or someone you love might be experiencing disordered eating or an eating disorder, it helps to be aware of several common misconceptions.
Misconception #1: Eating disorders only affect thin young girls
Misconception: Eating disorders are often depicted as a condition exclusive to thin, young, white girls. Media portrayals and societal narratives reinforce this stereotype, creating the impression that these struggles are rare and only tied to a specific appearance or demographic. This narrow view minimizes the broad scope of eating disorders and can make it harder for those struggling to access care or recognize that their eating behaviors are disordered.
Reality: Eating disorders affect people of all body sizes, races, genders, and ages. Shelby explains, "Anyone can struggle regardless of what size, race, or gender you are. Everyone is at risk for developing a complicated relationship with food." She emphasizes that this misconception not only excludes many individuals from the conversation but also makes it harder for those outside the stereotype to seek help. "Many disordered eating patterns can be normalized or even celebrated in our society, if someone does not fit the stereotype." Shelby adds. Breaking down these stereotypes is essential to creating a more inclusive understanding of disordered eating and ensuring that anyone who needs support feels validated and empowered to seek it.
Misconception #2: Eating disorders are just about weight loss
Misconception: Eating disorders are often oversimplified as conditions where individuals severely restrict intake or strive for extreme weight loss. This reinforces the idea that these struggles can only be seen in certain body sizes or are only detrimental to health if you are at a low weight.
Reality: Eating disorders are far more nuanced and complex than simply not eating or losing weight. Individuals with eating disorders can exhibit many different eating behaviors that can be detrimental to physical and mental health. This could involve patterns like binge eating, chronic dieting, feelings of guilt or shame after eating, or a constant preoccupation with food. Shelby points out that these behaviors are often tied to deeper issues, saying, "It's not just about the food—eating disorders serve as coping skills and often there is an underlying aspect of trauma, negative life experiences, anxiety, depression or other mental health struggles entangled with someone's relationship with food."
Misconception #3: Eating disorders are rare
Misconception: Eating disorders are often thought of as uncommon. Media portrayals frequently frame them as isolated issues rather than widespread struggles, leading many to underestimate their prevalence.
Reality: Eating disorders are far more common than most people realize, and many cases go unrecognized. Shelby also points out that these struggles are often hidden due to stigma or misinformation. "People don't really understand what to look for, or at what point to seek help from a dietitian, mental health provider or doctor" she says, emphasizing the need to build awareness about eating disorder warning signs.
Misconception #4: Eating disorders are about vanity
Misconception: Eating disorders are sometimes dismissed as being about vanity or an obsession with appearance. This view reduces them to surface-level concerns, ignoring the deeper complexities behind these struggles.
Reality: Eating disorders are deeply connected to mental health and are often influenced by trauma, anxiety, or other life stressors. They often serve as coping mechanisms for managing difficult emotions or situations. Recognizing the mental health aspects of eating disorders is crucial to understanding their root causes and providing meaningful support.
Misconception #5: Recovery is straightforward — just follow a meal plan
Misconception: Many people believe that recovering from an eating disorder is as simple as following a prescribed meal plan or eating a certain way. This oversimplifies the recovery process and ignores the emotional and psychological work involved.
Reality: Recovery is a complex journey that requires addressing underlying mental health issues and working with a team of professionals including a Registered Dietitian, therapist and medical doctor. Shelby shares, "A lot of people think that prescribing a meal plan is my only role on the team, however that is only a very small part of the work I do with people." Instead, her approach focuses on exploring and increasing awareness around eating patterns and behaviors, exploring underlying factors that contributed to a complicated relationship with food and setting realistic, small goals that are aligned with someone's personal values.
Shelby explains that recovery often involves helping clients build a healthier relationship with food, not just changing what they eat. "It's about working through underlying things, like guilt, shame, or patterns that have been there for years," she says. True recovery is not one-size-fits-all but a personalized process that evolves over time, tailored to each person's unique needs and experiences.
Supporting Recovery
Understanding the truth about eating disorders is the first step toward offering meaningful support to loved ones. By challenging common misconceptions—like who is affected, what eating disorders look like, and what recovery entails—we can create a more compassionate and informed environment for those who are struggling.
Approaching loved ones with care, concern, and an open mind can make all the difference in encouraging them to seek help.
While recovery is a complex and deeply personal journey, it is absolutely possible. Shelby's work highlights that healing doesn't happen through quick fixes or rigid plans but through addressing underlying patterns, building a healthier relationship with food, and setting small, realistic goals aligned with individual values. With the right support system, including professionals and loved ones, recovery can lead to a life where food no longer feels overwhelming, but instead becomes a source of connection, nourishment, and joy.
Shelby Santin is a Registered Dietitian Nutritionist located in Falls Church, VA who offers nutrition services for adults and adolescents in eating disorder recovery in DC, MD, VA and WV.