“They were asking for diet tips as my heart was giving out.”

“They” were not just friends or strangers whom author and anorexia nervosa survivor Carrie Arnold is referring to in her quest for recovery from anorexia nervosa that began in the 1980s. “They” were also the doctors and nurses who refused Ms. Arnold treatment at that time, all believing eating disorders to be a choice instead of the psychological illness each truly represents.

This myth of choice represents just one of many about eating disorders, which, despite the accessibility of credible, substantial information to the contrary, are considerably still misunderstood. And considering that at any particular point in time approximately 30 million Americans will meet the threshold for an eating disorder diagnosis, these serious illnesses cannot be underestimated.

What follows represents only a small number of misunderstood notions about this serious illness.

An eating disorder is a life choice, not a psychological illness.

Evidence has confirmed that the origins of eating disorders lay predominantly in an individual’s biological, genetic, and psychological natures that, together, form the crucial foundation on which all experiences, especially those involving trauma, play out during one’s life. Lacking effective coping mechanisms toward an eating disorder, an individual will quickly deteriorate both mentally and physically, including to the point of death.

What makes an eating disorder especially alarming is the likelihood of comorbidity, during which an individual experiences additional mental health issues, which have been documented as persisting even after the eating disorder is controlled. Obsessive-compulsive disorder (OCD), anxiety disorders, and major depressive disorders can manifest with eating disorders. Psychosis, a dangerous mental condition during which hallucinations or delusions of grandeur–extreme denial–can also occur and cause a person to avoid treatment.

But what most influences an individual to avoid treatment is the continued stigma that openly persists among all American demographics. Social media is a hotbed of bullying behavior based on one’s physical appearance, including “fat-shaming,” by which a person’s body size is ridiculed. For a time, some clothing and cosmetic producers would market to a people’s sense of shame toward their body, believing this would inspire them to become healthier. Clinical evidence continues to disprove such a theory to this day.

And while photo shopped images in mass media, which may overemphasize physical beauty for women and physical strength for men, are often cited as influential causes, there exists no clinical evidence validating this theory, nor does scientific proof even strongly suggest such images contribute more to the development of an eating disorder than do those more significant triggers previously mentioned.

An eating disorder is not a serious illness.

Eating disorders have the highest mortality rate of any mental illness, including major depression. Factoring in all eating disorders, roughly 20 percent of individuals will die without proper treatment.

Anorexia also has a mortality rate of almost 6 percent, and was long considered the only eating disorder that could directly lead to death due commonly to malnutrition-induced heart disease. However, recent studies have found bulimia to have an equally alarming mortality rate due to fatal chemical imbalances that result from excessive vomiting and the abuse of diuretics, including laxatives, which rid the body of the water required for it to function properly.

Binge-eating disorder for long has had a causal link to American obesity, from which a myriad of debilitating and potentially fatal conditions can occur, include diabetes, heart disease, and stroke.

Finally, anorexia’s physical and physiological effects have often been compared to those suffered by those with cancer. Other mental illnesses inflict symptoms common to other diseases that are traditionally considered significant or fatal: moderate depression exhibits symptoms mirroring those afflicted by multiple sclerosis, severe asthma, and chronic hepatitis B.

An eating disorder affects only wealthy, adolescent females.

Studies have shown Latina females to have anorexia rates comparable to their white counterparts, while Asian-American females tend to average higher incidences of anorexia. African-American females have the lowest cited rates. Pertaining to socioeconomic status, eating disorders have been shown to have a near-equal distribution.

Clinical research has revealed males to comprise roughly 1/3 of all individuals experiencing an eating disorder. For those in athletics, the pressures to achieve impractical standards can exploit a male’s vulnerabilities, priming him to experience other significant mental issues.

Of those who will experience an eating disorder in their lifetime, the notion that all or most of these persons are limited to one specific population illustrates in one respect how dire more education is needed on this topic.

Once these and other myths are laid further to rest, those living with an eating disorder can achieve more progress in their recovery. And recovery from eating disorders ispossible.

Carrie Arnold is living proof.