In today’s world of online influencers and dating apps, people can feel significant pressure to adhere to unrealistic physical standards. For some, this can lead to eating disorders like bulimia, which can cause serious health issues.

Bulimia is most strongly associated with binging and purging. The common perception of those suffering from the condition is that they look frail and unhealthy.

But that’s not necessarily so. Many who struggle with bulimia are at average or above average body weight.

A recent University of Florida study showed how the stereotype of the super-thin bulimia patient has taken hold, even in the medical world.

The researchers recruited a nationwide sample of more than 200 mental health providers to read patient vignettes and choose a diagnosis.

The vignettes described fictitious patients who met the criteria for their respective disorders.

In one vignette, participants were randomly assigned one of two versions: One in which the patient was described as being at a healthy weight, and a second, in which the patient was described as having obesity.

Only about 25% of the providers were able to accurately diagnose bulimia in the patient with obesity.

The researchers said this is because bulimia does not fit in the box popular culture has put it in. Many who have bulimia don’t look sick nor do they purge. They might use excessive exercise to compensate for overeating.

The study’s authors said being able to distinguish between eating disorders is vital because it allows providers to offer the best possible treatment.

Sometimes, a picture — even a mental one — doesn’t tell the whole story.