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An estimated 30 million people in the United States have an eating disorder. The majority of them do not receive professional care. Many experience shame and stigma because of their illness, and many struggle all alone.

By educating ourselves and others, we can work to reduce stigma and to better understand these complex illnesses that affect so many. Here are five myths and facts about eating disorders.

Myth: Eating disorders affect only thin, young, white women.

Fact: This is the stereotypical image of eating disorders—a thin, young, white woman. It is this woman we’ve seen in media depictions of these disorders and heard about most in common chatter. Even within the field, research has historically focused on clients who fit this profile, in part because white women were (and still are) the most likely to receive care.

But this narrow demographic does not accurately reflect the diversity of those who experience these illnesses. Far from it. Eating disorders affect people of all ages, races, genders, sexual orientations, body sizes, classes, and abilities. They’re not just a “teenager’s problem” or a “white girl’s problem.” They’re not something that affects only wealthy people, or only cisgender people, or only people of any other social group. Eating disorders don’t discriminate in these ways; they span across all social categories.

We know that eating disorders can and do affect people of all ages.

They’re not a “teenage phase.” They’re not a “teenager’s problem.” They’re mental health conditions that impact children and adults as well.

We also know that teenagers are particularly susceptible to developing these illnesses. Research shows that the average age of onset is between 16 and 18 years, and eating disorders occur in nearly three percent of 13- to 18-year-olds.

It’s clear that eating disorders often develop during the adolescent and teenage years—but why?

Eating disorders are brain-based illnesses involving food and body that are severe and can become life-threatening. These illnesses typically involve food restriction or overconsumption, body image issues, and altered food behaviors like eating in secret or skipping meals. Eating disorders also frequently include compensatory behaviors like overexercising, which puts gym and coaches in a unique spot to catch eating disorders. In order for gyms and coaches to successfully recognize and address eating disorders, they must first be aware of their common signs and symptoms.

Eating Disorder Signs and Symptoms

Eating disorders are serious illnesses that affect eating habits and desires and cause severe distress about food, weight, size, and shape. Eating disorders can affect anyone, regardless of their gender, race, age, or any other demographic categorization. The five types of eating disorders include anorexia, bulimia, binge eating disorder, OSFED, and ARFID. Signs and symptoms of eating disorders that gyms and coaches may be able to spot include:

Individuals who struggle with compulsive overeating typically eat excessive amounts of food—but not because they are hungry. These individuals eat to feel better, to cope with negative emotions. However, upon eating, the opposite happens. They feel a loss of control, shame, guilt, and as if they lack willpower. From there, the cycle of overeating begins again.

What exactly is compulsive overeating?

Compulsive overeating is a description of an eating disorder behavior, but it is not a diagnosis in itself. Typically, individuals who engage in compulsive overeating are diagnosed with bulimia if they engage in purging or binge eating disorder if no purging behaviors are present.

Eating disorders are real, complex illnesses that can cause serious harm. Eating disorders are characterized by a disturbance in an individual’s eating and food behaviors or self-perception. Common warning signs of eating disorders are extreme weight changes, altered eating behaviors, or an intense fixation on food and body talk. Eating disorders are biologically-based brain illnesses that are affected by environmental, social, and psychological factors. This means that illness is not caused by one specific factor, but rather by a series of factors in an individual’s unique life experience.

Types of Eating Disorders

Due to the complexity of eating disorders, the DSM-5 divides eating disorders into the following five categories:

Anorexia Nervosa. Anorexia is noted by extreme food restriction that causes dramatic and prolonged weight loss. It often presents with body dysmorphia and a genuine fear of food.

Avoidant/Restrictive Food Intake Disorder (ARFID). ARFID includes feeding or eating disorders that involve a lack of interest in or an avoidance of certain foods that result in a failure to meet nutritional needs. ARFID, unlike anorexia, does not include a drive for thinness.

Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by a disturbance in eating or feeding behaviors that results in significant weight loss, nutritional deficiency, or difficulty maintaining a normal day-to-day life. ARFID was previously known as selective eating disorder (SED) but was renamed to more accurately encompass the disorder.

ARFID can affect individuals of any age, race, gender, or any other demographic categorization. ARFID often co-occurs with other mental health diagnoses such as anxiety disorders or obsessive-compulsive disorder. Like any other eating disorder, ARFID is not a choice and is considered to be a severe illness that requires professional treatment. It is also important to note that ARFID does not stem from a lack of access to food and is not related to an individual’s cultural upbringing.

What Makes ARFID Different From Anorexia?

ARFID is often confused with anorexia due to the weight loss associated with the illness and the pattern of restrictive eating. However, those suffering from ARFID do not share the same desire for thinness or body dysmorphic thoughts that those with anorexia experience. To note this difference, someone with ARFID may abstain from eating due to tastes and textures of foods being intolerable as opposed to someone with anorexia who may abstain from eating due to a desire to lose weight and alter their body shape.