NARRATION: For decades, Hollywood has exploited our morbid fascination with eating disorders in one dramatic film after another. But the facts are that an estimated 30 million Americans will suffer some form of eating disorder in their lifetimes.
CARRIE ARNOLD: Something in your brain and in your body, says, no, no, no, wait a minute. Starving is bad, starving will kill you. But for me I felt calm for the first time that I could ever remember.
NARRATION: Given the grim statistics and media attention, why are there still so many misconceptions about eating disorders?
AYANNA BATES: No one knows that you can die from it, no one knows youre slowly killing yourself.
NARRATION: Throughout the 1970s pop artists Karen Carpenter and her brother Richard sold tens of millions of records. Karens distinctive voice propelled them to a celebrity status enjoyed by few.
ARCHIVAL:KAREN CARPENTER (SINGING):Talking to myself and feeling old.
RANDY SCHMIDT (AUTHOR, LITTLE GIRL BLUE: THE LIFE OF KAREN CARPENTER): Its one of those instant-radio kinds of voices.You hear it, and in two seconds of it, you immediately recognize who it is. And, hers was an unmistakable voice.
ARCHIVAL:KAREN CARPENTER (SINGING): Rainy days and Mondays always get me down.
NARRATION:But behind that voice, Karen Carpenter battled a serious illness and was literally starving herself to death.
RANDY SCHMIDT: On the outside, we didnt see that for a number of years. It was around 1975 that people really started to take notice of her, of her weight lossand to the point of being emaciated.
ARCHIVAL (BBC, 10-22-81):SUE LAWLEY: Well, Karen and Richard thats the first weve heard from you in three years. Its the first time youve sung together live now in five years. Why? Where have you been? Whats been happening?KAREN CARPENTER: Well, we decided to take a small vacation, take some time off.
RANDY SCHMIDT: The interview where Sue Lawley asks her were you suffering fromthe Slimmers disease is what, what she called it, anorexia nervosa.
ARCHIVAL (BBC, 10-22-81):SUE LAWLEY: There were rumors though you were suffering from the slimmers disease, anorexia nervosa, was that right?
RANDY SCHMIDT: The look of terror on Karens face is very telling
ARCHIVAL (BBC, 10-22-81):KAREN CARPENTER: No, I was just pooped. I was just tired out.SUE LAWLEY: But you did get down- you went down to about six stone in weight, didnt you?
RANDY SCHMIDT: She didnt want to admit it.
ARCHIVAL (BBC, 10-22-81):KAREN CARPENTER: I have no idea what six stone weight is.
RANDY SCHMIDT: So she lied, and became very defensive.
ARCHIVAL (BBC, 10-22-81):SUE LAWLEY: I think about 84 pounds.KAREN CARPENTER: No.SUE LAWLEY: No?KAREN CARPENTER: No.
RANDY SCHMIDT: The family was trying to deal with it in an outside sort of way. All she needed to do was eat, in their opinion, and everything would be fine.
NARRATION: In a desperate attempt to lose weight, Carpenter took multiple medications, including laxatives and a syrup called ipecac, which induced vomiting. By 1982 she weighed only 77 pounds and had to be admitted to the hospital.
RANDY SCHMIDT: They were able to put 30 pounds on her, but that was from an intravenous feeding, basically.
NARRATION: But the damage had been done.
ARCHIVAL (2-4-83):MAGGI SCURA: A big shock in the music world tonight and to the family and friends of Karen Carpenter.
ARCHIVAL (NBC NEWS, 2-4-83):TOM BROKAW: The pop-singing star, died today of cardiac arrest. She was just 32 years old.
NARRATION: Carpenter quickly became the poster girl for an entire disorder, launching stereotypes that persist today.
ARCHIVAL (MOVIE CLIP):DAUGHTER: Mother, how can anybody be too thin? Women are supposed to be thin now.MOTHER: Be sensible about it!DAUGHTER: I am being sensible!
CARRIE ARNOLD: When you look at movies about eating disorders typically you see its movies about anorexia the protagonist is young, white, and emaciated. Theres typically some sort of family dysfunction thats seen as a cause of the disorder. And so, you know, you get this narrow view of what eating disorders are.
NARRATION:Carrie Arnold developed anorexia as a teenager and has written extensively about it. She says we also hear very little about men who suffer and make up about a third of those who develop eating disorders.
CARRIE ARNOLD: Its less common for men to come forward and say to their doctor, You know, I think I have a problem with food. Because its seen as quote/unquote a womans thing. And so, its hard to know whether its an issue of it being actually less frequent among males or whether its just not recognized.
NARRATION: And men are not the only ones whose disorders go unrecognized.
AYANNA BATES: We dont get talked about enough and its not just African Americans. Theres Hispanic, there are Asian Americans struggling with eating disorders.
NARRATION: At the age of 13 Ayanna Bates says her anxiety became so great that she stopped eating.
AYANNA BATES: Starving was used to hurt myself and it was also used for control. So Im like, wow. I did this for two days. Let me see if I can do it for two more days.It was like an exciting feeling because it felt like at the time that was the only thing I was good at. So it gave me a sense of empowerment.
NARRATION: But she soon learned that the complexity of eating disorders, and the lack of understanding that they afflict minorities, have made it harder for patients to get diagnosed.
AYANNA BATES: One African American story I found wasshe was struggling with binge eating disorder and the doctor says, oh, no. Thats not binge eating disorder. Thats not an eating disorder, youre just overweight and youre just overeating because youre fat. And she was refused treatment because of that.
NARRATION: Dr. Evelyn Attia, a leading researcher in the field, says that while some treatment for eating disorders has advanced, myths continue, often leading to devastating consequences.
EVELYN ATTIA (DIRECTOR, CENTER FOR EATING DISORDERS AT NEW YORK PRESBYTERIAN HOSPITAL): Anorexia nervosa, bulimia nervosa, binge eating disorder. All of those conditions are not equally associated with high rates of death. Anorexia nervosa is, with certainty and a significant percentage of the deaths associated with these disorders are due to suicide, so that connection is an important one, its a frightening one.
NARRATION:In fact, the suicide rate for people suffering from eating disorders is one of the highest among mental illnesses.
AYANNA BATES: People dont know that it could be a way to slowly kill yourself. Thats why I was using my eating disorder, I hoped that if I starved myself long enough that I wouldnt wake up the next morning
EVELYN ATTIA: Theres been increasing understanding over the last several decades that this is a serious psychiatric illness. This is a brain-based disorder.
NARRATION: And still research funding for eating disorders remains far lower than other serious mental illnesses.
(GRAPH) RESEARCH FUNDS, 2017/ENACTED
Illness:Depression: $430,000,000Schizophrenia: $268,000,000Bipolar Disorder: $95,000,000Eating disorders $30,000,000
CARRIE ARNOLD: I think some of it is that eating disorders are still largely seen as a choice. And so, you know, why would you need to research something that someone could just eat and, you know, get over it?
NARRATION: In a society long-obsessed with thinness, and where you can find online communities that cheer on anorexic weight loss, Carrie Arnold says its no wonder the public isnt getting the message about eating disorders.
CARRIE ARNOLD:I was really pale; my skin was kind of grayish-yellow. My hair was falling out, my clothes were falling off. And yet at the same time Id get questions of people asking me, you know, How did you do it?Like, they were asking me for diet tips even as, you know, my heart was giving out. And so there just a lot of misunderstanding.