Contrary to what many may think, eating disorders are not just about food or dieting. Eating disorders are bio-psycho-social diseases that affect people of all genders and include anorexia nervosa, bulimia nervosa and binge eating disorder.

During Eating Disorders Awareness Week (Feb. 22-27), look at the numbers: 1 out of every 11 people in America will have an eating disorder at some point in their lifetime; overall, the socio-economic cost tops $65 billion each. Every 53 minutes, someone in America will die from an eating disorder-related cause. While risk is elevated among college students, they can affect people of all ages and are among the most stigmatized mental health issues. Eating disorders necessitate specialized care and treatment.

Stuart Murray, PsyD, director of the eating disorders program in the Department of Psychiatry and the Behavioral Sciences in the Keck School of Medicine of USC, provided some insight into who is affected, signs and symptoms and challenges of eating disorders. He was recently named by PubMed as the top expert for body image research in the world and among the Top 10 experts on eating disorders.

When we think about eating disorders, the typical image that most people have are of women who are visually very underweight. How accurately does this reflect the eating disorder population?

Most people think of young, affluent white women and that it is a passing fad or disorder of vanity.

But it is so much more than that.

What are some of the signs/symptoms to look for?

Some of the early signs may include:

  • Strict restriction of food intake.
  • Periodic episodes of overeating or losing control while eating.
  • Body dissatisfaction including constant mirror checking or avoiding mirrors because of how your body looks.
  • Food goes missing.
  • Drastic weight change.
  • Excessive calorie counting.
  • Compulsive exercise.

As the illness progresses, you might see drastic alterations to shape and body weight as well as medical issues.

How do eating disorders affect men and transgender individuals differently?

One in every 3 to 4 people with an eating disorder are men. Because the screening questions have been targeted to women – such as dissatisfaction with parts of their body or if they missed a menstrual cycle – it is only recently that we have looked at the differences with men and eating disorders.

While women are focused on thinness, men are more focused on muscularity. I have been working with other experts to develop a “the muscularity-oriented eating framework” to define the behaviors in men.

For transgender individuals, the prevalence of eating disorder symptoms is even higher, and is often intertwined with the unique minority stress facing transgender populations. In addition, the affirmation of one’s identity is often impacted by eating disorder symptoms. For instance, the loss of menses may impact the affirmation of a male gender identity in a birth-assigned female.

What are ways in which parents and peers can support individuals who might be struggling with an eating disorder?

If caught early, eating disorders can be successfully treated, but they need specialized treatment. If not caught early, medical issues can last several decades.

I can’t stress this enough. If you think that you might have an eating disorder, or suspect a friend or loved one is suffering from an eating disorder, please schedule an assessment. The prognosis is so much better if you get in early.

How can I get help

ONLINE OR BY PHONE: Contact the National Eating Disorders Association online or by phone at 800-931-2237.

FOR USC STUDENTS: For USC students seeking care, contact USC Student Health at or 213-740-9355 (WELL) to make an appointment to see a specialist in Counseling and Mental Health Services. All Counseling and Mental Health Services clinicians are faculty members in the Department of Psychiatry and the Behavioral Sciences at the Keck School of Medicine of USC.

Eating disorders are a biology-based illness and impact can be felt across all populations — men and women, including the transgender population (who are at very high risk), every ethnicity and age group.

— Laura Perry