When an anorexic claims to ‘feel fat’ even when emaciated, this phenomenon is far more complex than simply misjudging bodily dimensions. Another false premise is to consider body image disturbance as a causal factor in anorexia nervosa; we still don’t know whether it is a primary or secondary phenomenon (e.g., a consequence of self-starvation). It is equally simplistic to assume that cultural influences, such as the overvaluation of thinness, causes serious eating disorders like bulimia and anorexia nervosa. Anorexia nervosa, can only be understood from a multidimensional, biopsychosocial viewpoint. It is the final common pathway of a number of predisposing, precipitating, and perpetuating factors.
Stigma towards individuals with eating disorders, as experienced by sufferers, is common and associated with numerous adverse outcomes. The perceptions that eating disorders are trivial and self-inflicted should be a focus of destigmatization interventions. Efforts to reduce stigma towards individuals with bulimia nervosa may need to focus on perceptions of self-control, whereas efforts to reduce stigma towards males with eating disorders may need to focus on perceptions of masculinity/manhood.