You start counting calories. 2,000 a day, then 1,500, then 1,000. You count lower and lower until you get to the point where you are eating less than 500 calories a day and burning off more through excessive cardio. Maybe you use diet pills or drugs to stop feeling hungry, or sleep through meals so you don’t have to eat.

Eating disorders vary from person to person. They range from anorexia and binge eating to lesser known eating disorders, such as avoidant/resistant food intake disorder (ARFID). Every eating disorder comes in varying levels of severity and affect each person that struggles differently.

Eating disorders that focus around restricting calorie intake can develop for a number of reasons, many connected with the individual’s mental health. According to Eating Disorders Hope, any psychological, biological or societal negative stressor can lead to eating disorders. Having low self-confidence or facing bullying due to weight or appearance can bring people to develop an eating disorder to feel in control or to try and fix the supposed problem. Eating disorders can fluctuate in severity due to different moods, stress or anxiety.

These disorders don’t happen right away. Often, people who struggle with eating disorders start by dieting and counting calories, but allow their situation to progress to dangerous levels without even realizing the ramifications it has on their health. Eating disorders can get out of control quickly if people do not understand the dangers or do not see their problem as “serious” to their overall health.

Eastern Iowa High School student, who agreed to be interviewed if their identity was anonymous, recounts their struggle with anorexia.

“I basically just didn’t eat for long enough and I would take vitamins so I could be active and like kind of live my day, but eventually it got to one point where I passed out [for ten minutes] in the middle of the mall in Target and my mom freaked out,” the student said.

Eating disorders are not just overly restrictive diets. They involve excessive calorie-burning workouts, and can include the use of diet pills to prevent hunger or other pills and drugs to provide energy with the absence of nutrition.

“I was abusing Adderall not for the reason of school like most people, but because it helps you lose weight. It makes you not hungry, so I just wouldn’t eat for periods of time but still have energy,” the student said.

Those who struggle can feel like they can handle their problem on their own. Some believe that their condition is not life-threatening and that they do not need treatment. They can avoid getting help because they worry about causing problems for others by sharing their condition, or simply believe that their conditions does not affect anyone else directly and should therefore be kept to themselves.

After the student’s situation elevated to the point of fainting in the middle of the mall, they were put into an in-patient care for two weeks and worked with a therapist, psychiatrist and a nutritionist to help get back to a healthy lifestyle.

“The [in-patient] I went to . . . you have to sit at the dinner table and finish all of your food, and no one else at the table can leave until you finish,” the student said. “They lock the bathrooms for like 45 minutes at the end of the meal so people wouldn’t have the urge to throw up.”

Although in-patient treatments can be strict or hard to adapt to, the programs are designed to get those who struggle to a healthy daily habit of eating that will promote long-term change. Other treatment opportunities like therapy and working with a nutritionist help get back to healthy eating habits in a slower effective fashion.

Because of the stigma surrounding mental health and admitting to struggling, many people who struggle with eating disorders do not actively seek out medical help or therapy on their own. More often than not, no one besides the person struggling knows about their condition.

Eating disorders and mental health stigma can discourage those suffering to tell somebody about their struggle. Not getting treatment can often worsen the situation, or can let it progress for longer periods of time than is healthy.

Treatment should have been the next choice for Eastern Iowa High School teacher who agreed to be interviewed if their identity remained anonymous. This teacher struggled with anorexia in high school.

“I never did get treatment for it, and that was not my recommended course of action. I think that anyone struggling with anorexia should get treatment . . . With the stigma that exists with admitting that you have an eating disorder or any sort of mental illness, people keep it to themselves and I just think that, while that might feel like a safe option, it is really so much better to get help if you can,” the teacher said.

This stigma surrounding eating disorders puts those who struggle in a position of fear or anxiety when it comes to admitting to their condition or asking for help. Only one third of those struggling with anorexia get treatment, despite it being the eating disorder resulting in the largest fatality rate of all mental illnesses. Only 6% of those who struggle with bulimia get help. This stigma not only hurts the access to therapy and other help; it also affects what peers know and can learn about eating disorders.

“I was fortunate because there are a lot of people that struggle with anorexia that don’t have that rational processing of it. Like they can’t be like ‘Oh, this is unhealthy for me so I’ll stop.’ They can’t stop, and I think that’s where there are a lot of people much less fortunate than I was,” the teacher said.

It is easier for an eating disorder to go unnoticed because of the low education and little access to facts that peers have about eating disorders, and the misunderstandings that come with that.

Students that have an eating disorder may also feel unsafe or may not be sure who they can turn to in order to share their condition and get help. This can be due in part to the fact that eating disorders are commonly a one-person problem or condition, or that people do not fully understand eating disorders.

Big misunderstandings with eating disorders make it harder for people to believe their situation will be taken seriously. It also makes it hard to improve on one’s own, when stigma and ignorance cloud the facts of eating disorders.

“I feel like as far as eating disorders go, there’s something that kind of sticks with you for a long time. I would say this is still something I hold with me to some degree . . . I feel like my relationship with food, even to this day, is really difficult,” the teacher said.

However, sometimes the only reason somebody does not reach out for help is because they do not know who to turn to. Although teenagers that struggle usually have close friends and family, they may be worried to approach them about their struggles because they wouldn’t understand or wouldn’t know how to help. Students may be uncomfortable turning to adults at school like teachers and school counselors because the relationships are more distant and impersonal.

With classes at West filled with up to 40 students per class period, and every teacher having up to five class periods, it is hard to build strong relationships with teachers. The ratio of counselors to students is also too large to build comfortable relationships.

“I feel like so many teacher/student relationships are so distant that a student just wouldn’t feel comfortable disclosing to a teacher that they were going through something and unfortunately I think that’s the case with the counselors as well. I’ve talked to a lot of students who say that they just don’t feel comfortable talking to counselors about things,” the teacher said.

Although education and stronger relationships between students and adults will greatly improve the resources someone struggling with an eating disorder has access to, an important first step in decreasing the stigma surrounding eating disorders and mental health issues is cutting down the unrealistic ideals and the stereotypes that exist today. According to the National Eating Disorders Association, 40-60% of girls at age six are worried about their weight or about becoming overweight. 69% of American elementary school-aged children say magazine pictures affect their opinion of a perfect or ideal body shape.

“I wish we were more accepting of the idea that there isn’t this ideal body type to have, and that we were accepting that different people have different natural shapes . . . so that we weren’t so judgmental when somebody didn’t look the way we think is ideal, especially since our ideal is not natural,” the teacher said.“I think that is the root of the problem, that we have this unnatural expectation of what people should look like.”

Editorial Policy: Some sources may wish to remain anonymous for a particular story, with valid reasons. The Editorial Board will decide if a source will be granted anonymity based on the content of the article. The Board recognizes that high school is a confined community of young adults and that some stories, while important to the community, may result in embarrassment or official sanctions, if anonymity is not granted. Once this decision is made, the Editorial Board will support and uphold its decision, whatever the pressure. Therefore, this is a serious and weighty decision.