Can I Have An Eating Disorder If I’m Not “Underweight”?

By: Jennifer Rollin, LCSW-C, Therapist & Founder of The Eating Disorder Center

No one seems concerned about her. Doctors don’t ask many questions. Friends tell her she looks great. Family members assume everything is fine. She appears to be “functioning” on the outside.

But inside, things feel anything but fine.

Food takes up a massive amount of space in her mind. She thinks about what she ate. What she shouldn’t eat. What she needs to make up for tomorrow. She plans meals. Replays meals. Judges herself after eating.

The thoughts feel constant.
Loud.
Relentless.

She wonders if she’s allowed to ask for help.
She wonders if she’s “sick enough.”

If she doesn’t look emaciated.
If her weight doesn’t fit the stereotype.
If she’s still functioning.

She wonders if this really counts.


Most People With Eating Disorders Are Not “Underweight”

Here is something many people don’t know.

Less than 6% of people with eating disorders are considered medically underweight.

This statistic comes from population-based research cited by organizations such as BEAT Eating Disorders and ANAD (National Association of Anorexia Nervosa & Associated Disorders).

Let that sink in.

That means the vast majority of people with eating disorders exist in bodies of many different sizes. Many suffer for years without being recognized or taken seriously.

Eating disorders are mental illnesses, you can seriously struggle at any weight. 

It’s also important to note that someone may still be weight suppressed even if they are not medically considered “underweight” by BMI standards (which are horribly flawed and problematic).


Weight Tells Us Very Little About Suffering

Weight does not tell us:

How much someone is restricting.
How often they are bingeing or purging.
How compulsive their exercise is.
How distressed they feel around food.
How loud the eating disorder voice has become.

Two people can weigh the same and have completely different internal experiences.

One may feel neutral around food.
The other may feel consumed by it.

Weight does not measure suffering.


BMI Is a Deeply Flawed Tool

BMI is sometimes used as a shortcut to decide who is “sick enough.”

And it is deeply problematic.

BMI was never designed to assess individual health. It does not account for genetics, body composition, race, sex, muscle mass, trauma history, or the effects of restriction and weight cycling.

It also reinforces the dangerous idea that thinness equals health and that people in larger bodies cannot be seriously ill.


What a Serious Eating Disorder Can Look Like at Any Weight

A serious eating disorder may show up as:

• Constant preoccupation with food or body image
• Rigid food rules or fear foods
• Binge eating, purging, or cycles of restriction
• Compulsive exercise or panic when rest is needed
• Guilt, shame, or anxiety after eating
• A sense that food or weight controls your mood or self-worth

You may “look fine’’ on the outside.

On the inside, you feel trapped.
Exhausted.
Consumed.


Functioning Does Not Mean You Are Okay

Many people with eating disorders are able to “function” in some ways.

They work.
They care for others.
They meet expectations.
They appear “together.”

But functioning is not the same as living.

And suffering in silence does not make the eating disorder less serious.


You Do Not Have to Hit Rock Bottom

You do not need to lose more weight (or any weight!).
You do not need to get worse.
You do not need to prove your pain.

If your relationship with food feels distressing, compulsive, or overwhelming, that is reason enough to seek help.

Eating disorder therapy is not reserved for people at a certain weight.

It is for people who are struggling.


Recovery Is Possible at Any Weight

I have worked with many people in bodies of all sizes who questioned whether they deserved help. People who worried they were taking up space meant for someone “sicker.”

And I have watched them heal.

Recovery is not about changing your body.

It is about quieting the noise.
Reclaiming your mental space.
Learning how to eat without fear.
And building a life that is no longer dominated by food rules or self-criticism.

If you are asking yourself this question, can I have a serious eating disorder at any weight, the answer is yes.

And you are completely deserving of help and recovery.

Schedule a FREE 15-minute consultation to explore how eating disorder therapy or recovery coaching can help you to find freedom.

🌟 Available in MD, VA, DC, PA, FL, and CA for eating disorder therapy
🌍 Offering recovery coaching worldwide​

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Jennifer Rollin, MSW, LCSW-C (she/her), is an award-winning eating disorder therapist and the founder of The Eating Disorder Center, a specialized therapy practice for eating disorders and body image concerns. Jennifer uses ACT, CBT, and DBT to help clients find freedom from eating disorders and body image struggles.  Jennifer is recognized as a leading eating disorder expert and was named one of the top professionals in the field by a premier treatment center. She is the recipient of the Best of Bethesda Award for Best Individual Therapist (2025) and the Best of Rockville Award (2020–2024). She helps clients to live full, meaningful lives, beyond food and body image concerns.

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The Eating Disorder Center is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping children, teens, and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Silver Spring, Germantown, and Washington, D.C. We also provide eating disorder therapy in Arlington, Virginia and virtually throughout Virginia. Additionally, we offer eating disorder therapy virtually in Florida, Pennsylvania, and California. We provide eating disorder and EMDR trauma therapy in Rockville, Maryland and virtually throughout Maryland and Virginia. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com