Eating disorders are one of the few conditions where people can be visibly unwell and still get complimented for it. That is what makes them so dangerous. In South Africa, like everywhere else, thinness is treated like discipline, appetite is treated like weakness, and self denial is treated like character. You can be starving and still be told you look amazing. You can be purging and still be praised for “willpower.” You can be spiralling and still look like you have your life together.
If you want a topic that strikes a nerve on social media, this is it. Because the public story is always the same, eating disorders are rare, they only happen to teenage girls, they are about vanity, and they are fixed by “just eating.” Those myths protect the disorder, shame the person suffering, and keep families confused until the situation is medically dangerous.
Eating disorders are not a trend. They are not a phase. They are not a lifestyle. They are mental health conditions with real physical risk, and they often overlap with anxiety, depression, addiction, trauma, and obsessive thinking. You do not have to be underweight to be at risk. You do not have to look sick to be sick. And you do not recover by being shouted at over a plate of food.
The myth that eating disorders are only about food
Food is the visible part, but it is not the core. Eating disorders are often about control, emotional regulation, and coping. When a person feels powerless, overwhelmed, unsafe, or ashamed, controlling food can become the way they feel strong. It becomes a ritual that gives them certainty when everything else feels chaotic.
That is why recovery is not simply “eat more.” Eating more might be medically necessary, but the mental system that drives restriction, bingeing, purging, or obsessive exercise does not disappear because someone eats a sandwich. The disorder exists to manage emotion, and if you remove the coping without replacing it, the person will find another way to cope, often by tightening the disorder or shifting into substances, self harm, or compulsive behaviours.
Families often miss this because they focus on the physical signs and assume the solution is obvious. It is not obvious. It is complex, and it needs real treatment.
Wellness culture with a darker edge
South Africa has its own flavour of the problem, because we have a wellness culture that looks healthy on the surface and becomes dangerous when it turns obsessive.
The language is socially protected. People do not say I am starving myself. They say I am cutting carbs. They do not say I am controlling my body because I feel out of control. They say I am just being disciplined. They do not say I have a compulsive relationship with exercise. They say they are on a fitness grind. They do not say I am purging. They say I have a sensitive stomach. They do not say I am terrified of weight gain. They say they are just trying to be healthy.
This is why eating disorders hide so well. They can sit inside gym culture, “clean eating,” influencer wellness content, and diet challenges, and the person is praised while they get worse. If a person is losing weight quickly, many people will cheer before they ask why.
Not the textbook version
People expect eating disorders to look like a stereotype, a very thin teenage girl who refuses to eat. That stereotype exists, but it is not the whole picture. Some people restrict and become underweight. Some people binge and purge and maintain a “normal” body size. Some people exercise compulsively and look fit while their body is breaking down. Some people cycle between restriction and bingeing and live in constant shame. Some people obsess over food so much that their life becomes smaller and smaller, because restaurants, family meals, holidays, and celebrations become anxiety triggers.
The real signs are often behavioural and emotional. The person becomes irritable around food. They become secretive. They avoid eating with others. They cut food groups and create rigid rules. They measure everything. They talk about calories constantly. They become anxious when plans involve eating. They start disappearing after meals. They become obsessed with body checking. They become defensive when questioned. They may lie about what they ate. They may insist they already ate. They may become controlling around meal times.
Families often notice the mood changes before they notice the food. That is because eating disorders change the nervous system. Starving the body affects sleep, mood, concentration, and emotional stability. A hungry brain does not behave like a calm brain.
Why people do not take binge eating seriously
Binge eating is often dismissed because people confuse it with overeating. Bingeing is not about being greedy. It is often about emotional flooding and loss of control. People binge when they are stressed, ashamed, lonely, anxious, or overwhelmed, and they often binge in secret. They then feel disgusted, swear they will never do it again, and tighten restriction the next day. That restriction increases the urge to binge again. The cycle becomes self feeding.
The shame around binge eating is brutal because people blame the person’s character. They call them lazy. They call them undisciplined. They tell them to just stop eating junk. Those comments do not help. They push the behaviour deeper into secrecy, which increases the cycle.
Binge eating can carry serious health consequences, but the mental suffering is often the most immediate danger. People who binge often feel trapped and hopeless, and that hopelessness can lead to depression and self harm. If society treats binge eating like a joke, people do not reach out for help until the damage is severe.
Eating disorders and substance use
One of the most important conversations to have is the overlap between eating disorders and addiction. They often sit together because they run on the same engines, control, shame, compulsive behaviour, and the need to escape emotion quickly.
Some people use stimulants to suppress appetite. Some use alcohol to cope with hunger and anxiety. Some use laxatives and diet pills as part of the disorder. Some shift from food control into substances when food control stops working. Some stop using substances and develop an eating disorder because the brain still needs a compulsive outlet.
This is why treatment needs to be honest and integrated. If a person has both issues, treating one while ignoring the other is a setup for relapse into either food behaviours or substances. Families should not treat eating disorders as separate from addiction. They often overlap, and the emotional roots are similar.
Medical stability and emotional work
Recovery is not a quick mindset shift. It usually involves medical assessment, nutritional rehabilitation, psychological treatment, and ongoing support. People can face serious physical risks, heart issues, electrolyte imbalances, organ strain, and dangerous complications from purging or severe restriction. This is why eating disorders are not safe to handle as a family project.
Psychologically, the work is about building emotional regulation without the disorder. The person needs to learn how to tolerate discomfort without reaching for restriction, bingeing, purging, or compulsive exercise. They need to untangle identity from body size. They need to challenge the obsessive thoughts that keep the disorder alive. They need to build a life that is not organised around food, fear, and control.
Families often need support too, because living with an eating disorder can make a home anxious and reactive. The goal is not to create a perfect family. The goal is to create a stable environment where recovery has a chance.
The nerve that needs to be hit
If you want the conversation that actually matters, it is this. Our culture rewards eating disorder thinking. We praise restraint. We admire “discipline” that looks like starvation. We turn food into morality and bodies into status. We call normal eating “cheating.” We call hunger weakness. We make jokes about weight gain like it is failure. Then we act shocked when people develop disorders.
Eating disorders are not only personal problems. They are social problems too. They are amplified by a culture that treats bodies like a public project. If we want fewer eating disorders, we need to stop worshipping the behaviours that create them.
If you are struggling, or if someone close to you is, the most important move is to stop minimising and stop trying to fix it with comments. Get professional help. Speak honestly. Treat it as serious, because it is. A person does not need to be visibly collapsing to be at risk. The earlier you act, the better the outcome tends to be. Eating disorders are not about being vain. They are about being trapped. And the trap is often applauded until it becomes impossible to hide.
