Tess Holliday Discusses the Stigma Behind an Atypical Anorexia Diagnosis

The characterization of “atypical” is arguably othering, especially for fat people. And it’s clear that eating disorders do not discriminate: “The stereotype of anorexia only affecting thin, white, upper-middle-class women couldn’t be further from the truth,” Rumsey says. “Eating disorders affect people of all body sizes, races, and gender identities.”

Yet, harmful stereotypes persist. In her 2022 essay for Today.com, Holliday wrote that when her dietitian first suggested she may have anorexia, she thought, “Do you see how fat I am? There’s no way that word could ever be attached to someone my size.” Her diagnosis was eventually confirmed by a psychologist—and going public about her experience ended up helping others: “So many people who are in larger bodies have messaged me and said, ‘I never thought I restricted until you started talking about this,’” she wrote.

The stigma can also take a toll in health care settings, especially when it comes to accurately identifying an eating disorder and getting the appropriate treatment plan in place. “The eating disorders of people at higher weights often go undiagnosed, and this group is less likely to receive treatment for their eating disorders compared to people at lower weights,” Rumsey says. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), people with “larger bodies are half as likely to be diagnosed with an eating disorder” compared to those who have a “normal weight” or are “underweight”—even though “larger body size,” in the organization’s words, is a risk factor for developing an eating disorder.

On top of that, fat folks are often praised for practicing potentially harmful behaviors, which can ultimately feed the cycle of self-harm. “When someone who has a larger body restricts calories, worries about what they’re eating, and eats less, they are often applauded for it,” Rumsey says. “Those behaviors in a higher-weight person are considered ‘healthy’ and encouraged, yet in someone who was thin, these behaviors would be diagnosed as an eating disorder.”

Lauren Smolar, the vice president of mission and education at the National Eating Disorder Association (NEDA), says it’s crucial to seek help if you’re experiencing any symptoms associated with eating disorders, regardless of what you look like, and that NEDA’s online screening tool can help point people in the right direction. “Recognize that you do not need to meet the criteria of anorexia nervosa to be deserving of care,” Smolar tells SELF. She adds that it’s important to get help early before certain damaging behaviors escalate.

That speaks to one reason why Holliday called on the public to do better. “When people look at larger-bodied individuals, they see us as less than, and we’re not less than,” she said on Today. “Health is not a moral compass.”

If you’re struggling with an eating disorder, you can find support and resources from the National Eating Disorder Association (NEDA). If you are in a crisis, you can text “NEDA” to 741741 to be connected with a trained volunteer at the Crisis Text Line for immediate support.

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