Stigma

Stigma is part of the reality of eating disorders – be it for the person affected, for men and family members. More frequent stigmatisation has been associated with lower self-esteem, a longer duration of an eating disorder and more marked symptoms.

Underpinning factors and perceptions:

  • That an eating disorder is about personal responsibility and a lack of self-control, self-discipline
  • That someone is simply giving in to social pressure relating to thinness
  • That people affected by eating disorders are hard to communicate with and that they need to pull themselves together
  • That dating someone affected by an eating disorder may lead to negative experiences such as conflict
  • That friendship with someone with an eating disorder would feel under strain, or be difficult
  • People may maintain social distance from someone with an eating disorder due to concerns about close personal interactions for example, going to dinner or living with the person
  • Negative perceptions about someone’s intelligence, competence, that they were psychologically fragile
  • That people with bulimia were seen as more responsible for their eating disorder and more self-destructive than those with anorexia

Consequences of stigma:

  • A feeling that eating issues were dismissed or not taken seriously during a health assessment.
  • Not wishing to reveal difficulties to others and being unable to speak due to a fear of being judged.
  • That symptoms and concerns may be misinterpreted, dismissed, viewed as a sign of weakness or a ‘character flaw’.
  • Feelings of shame, guilt and embarrassment play a role in hindering disclosure, ultimately leading to a delay in seeking help.
  • Some individuals may avoid seeking counselling in part due to self-stigma and anticipated outcomes of attending this form of support.

Men:

Men affected by eating disorders may encounter barriers to treatment in part due to the perception that eating disorders primarily affect women. Consequently, some have hidden their experiences from others due to fear of how they might react. Worries about being laughed at, judged and misunderstood are also sometimes part of what men experience. Specific issues for men include depression and shame, excessive exercise to compensate for caloric intake, a ‘runaway diet’, muscle dysmorphia, use of steroids and growth hormones and substance abuse may be apparent in some cases. It may take some men months or years to recognise their experiences as being that of an eating disorder. The realisation may be precipitated by a crisis event or situation such as a marked deterioration in health. Some men have experienced self-harm, increasing isolation and uncertainty about how to seek help.

Family:

Stigma associated with eating disorders may contribute to the distress experienced by family members and carers. Researchers from the United Kingdom found that some family members may experience high levels of blame and shame, including hearing insensitive remarks. One study found that parents felt others tended to trivialise the issue. Close friends were empathetic and supportive, whilst acquaintances were perceived as less informed and parents were reluctant to discuss their experiences due to a fear of stigmatisation. Parents may experience feelings of helplessness, isolation, exhaustion and they may neglect their own needs. Feeling judged and stigmatised in their capacity as a parent may also be a part of their experiences.

References:

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Wingfield, N. et al. (2011). College students’ perceptions of individuals with anorexia and bulimia nervosa. International Journal of Eating Disorders, 44(4), 369-375.

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