White, very young, and extremely thin. That is the image most conjure up when thinking of people with eating disorders. It’s just another false assumption about the meaning of fit, and the role that fat and food play in our lives. Recently researchers have been focusing their efforts on a demographic among whom eating disorders often go unnoticed: the overweight or obese.

A National Preoccupation with Thinness

Failing to recognize eating disorders in people with higher weights stems primarily from a pervasive cultural obsession with thinness, and the idea that thin is better than fat. One study put out earlier this year by researchers Lipson & Sonneville looks at over 9,700 students from 12 colleges. What they discovered was that body weight was the most persistent forecaster of eating disorder symptoms.

One report finding was particularly surprising: students with a BMI in the “underweight” range were at the lowest risk of developing an eating disorder. Instead, it was the students in the “overweight” and “obese” ranges who were at the highest risk. While a history of being overweight is common in patients who seek treatment for an eating disorder, they often are under-diagnosed, with typical eating disorder symptoms even encouraged by their doctors, who praise them for losing weight.

In other words, thinness has been so thoroughly embraced as the body ideal that extreme dieting and food obsessiveness are considered praiseworthy fixations. Overweight people who embrace habits that might otherwise indicate an eating disorder are instead seen as possessing an enviable self-control over food.

Targeting Symptoms, Not People

When people who are viewed as needing to lose a few pounds show signs of an eating disorder, like skipping meals, using supplements for weight loss, or excessive exercise, they tend to be rewarded. Eating disorder interventions and treatments are often targeted at people who are in the underweight range. People who are obese or overweight are more likely to be targeted with weight loss interventions. It may be time to take a fresh look at the behaviors and symptoms of overweight people as they apply to an eating disorder.

Millennials are leading the way in the fight against body shaming, and the rest of society is listening. It is the hope of eating disorder specialist that this move to stop fat shaming will lead to more people addressing the underlying emotional reasons for their poor relationship to food and weight.