Denial and concealment of eating disorders: a retrospective survey

OBJECTIVE: To get an idea of how (ex-)patients deal with the recognition of an emergent eating disorder. METHOD: A retrospective survey was carried out via the websites of two organizations for (ex-)patients with an eating disorder. RESULTS: The respondents (N = 401) reported a variety of attempts to conceal their eating disorder: excuses to avoid eating together, methods to give the false impression of having eaten, avoidance of being weighed and falsifying weight. Often these methods were described as a deliberate strategy. Information about possible health risks had little or no impact on most respondents, who were familiar with the notion of eating disorder but did not apply it to themselves. Many believed they would have recognized their eating disorder earlier if they had met a clinician who was familiar with this disorder. CONCLUSION: Denial of illness together with concealment often reflects a deliberate refusal of self-disclosure within a specific interpersonal context.