Mental illnesses are often misunderstood, misinterpreted, and misrepresented in mainstream media, and eating disorders are no exception. In 2024, however, one show broke the mold: Heartstopper. After hinting at a main character’s mental health struggles since Season 1, the series carefully dealt with how Charlie Spring’s disordered eating was impacting him, both medically and emotionally, and how it was impacting his loved ones, who did not know how to help.
Netflix’s Heartstopper show is based on Alice Oseman’s award-winning graphic novel series. It follows the LGBTQIA+ romance between two teenage boys, Charlie Spring (Joe Locke) and Nick Nelson (Kit Conner). Charlie is a shy, openly gay student at an all-boys school, while Nick, a popular and athletic student, starts to develop feelings for Charlie after they become friends. The story explores themes of love, friendship, identity, and self-acceptance as Charlie and Nick navigate their feelings for each other and the challenges they face in a world that’s not always accepting of queer identities.
In the show’s third season, which debuted in 2024, Netflix and Oseman finally provided fans with an on-screen adaptation of one of the more controversial storylines from the graphic novel series: Charlie’s eating disorder, a topic that’s not often discussed in queer spaces despite the prevalence of disordered eating in the LGBTQ+ community.
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Eating Disorders in Real Life
Eating disorders—e.g., anorexia nervosa, bulimia nervosa, orthorexia, and avoidant/restrictive food intake disorder—are behavioral conditions that are characterized by severe, persistent disturbances in eating behaviors. While no one’s eating disorder is the same, those who have them commonly engage in behaviors like restricting their calorie intake, over-exercising, binging, purging, or only consuming a limited variety of ‘safe foods.’ Per the National Eating Disorder Association, nearly 30 million Americans will experience an eating disorder in their lifetime; worldwide, that number climbs to 70 million.
Eating disorders are among the most dangerous—and deadly—diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a handbook on mental health and brain-related conditions. Although studies have primarily focused on death rates in people struggling with anorexia and bulimia, these two conditions are considered to be the most deadly mental illnesses because of the high rates of self-harm and suicide in this population (partly due to the body’s inability to produce serotonin when it’s incredibly malnourished), as well as the adverse impacts of chronic malnutrition and dehydration on the human body and how it functions (early deaths can be blamed on heart issues, endocrine disorders, gastrointestinal disease, and refeeding/underfeeding syndromes).
For anorexia nervosa sufferers who are between the ages of 15 and 24, which is Charlie’s age bracket in the TV series, a 2011 meta-analysis found they are ten times more likely to die than their peers who don’t struggle with eating.
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Eating Disorders in Media
Eating disorders, in all their forms, are often portrayed in the media as only affecting young, middle-class, heterosexual white girls. However, this is a myth and a very harmful myth, as previously held misconceptions about who struggles and what those struggles look like can make it harder for friends, family, and medical professionals to identify a loved one who may be having a hard time.
In Heartstopper, for example, it took two seasons for Charlie’s friends, family, and teachers to identify his struggles with food, though viewers had already noticed that the character wasn’t eating. That’s because what we learn in the media about eating disorders and the reality of who’s at risk are in stark contrast.
Research shows that anyone can develop an eating disorder regardless of age, gender, ethnicity, or cultural background. According to the UK-based eating disorder nonprofit Beat (formerly the Eating Disorders Association), it’s believed that about a quarter of those who suffer from these conditions are male, like Charlie, with those identifying as trans and queer at higher risk.
Although anyone can get an eating disorder, some groups are at heightened risk. In 2007, a study found that gay and bisexual men are at “far higher risk” for eating disorders than their heterosexual counterparts. “It is not clear why gay men have high rates of eating disorders,” said study author Ilan H. Meyer, PhD, associate professor of clinical Sociomedical Sciences at the Mailman School of Public Health. “One theory is that the values and norms in the gay men’s community promote a body-centered focus and high expectations about physical appearance, so that, similar to what has been theorized about heterosexual women, they may feel pressure to maintain an ideal body image.”AAAAA
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LGBTQ+ Identity and Eating Disorders
The relationship between LGBTQ+ identity and eating disorders is complex and influenced by interrelated social, psychological, and cultural factors.
LGBTQ+ individuals often face discrimination, bullying, and social stigma, which can contribute to body dissatisfaction and poor self-esteem. The stress and trauma associated with these negative experiences can increase the likelihood of engaging in disordered eating behaviors to cope or gain control. Furthermore, some LGBTQ+ individuals may internalize the homophobia and/or transphobia they have experienced in their lifetimes. This desire to “fit in” or to be accepted by society and/or peers can lead to body dissatisfaction and overvaluing body image in defining one’s self-worth, both factors that make some people more susceptible to eating disorder behaviors.
In Heartstopper, Charlie meets the criteria for several of these risk factors. He was bullied and outed at school. He also has a history of self-harm, behaviors that he reveals to his boyfriend Nick in the graphic novels (and receives a brief mention in the TV series, too). Also, because of the relationship between anorexia and suicide, it’s essential to mention a plot element that ultimately didn’t make it into the graphic novels or TV series: Charlie attempts suicide in an unrevised edition of Oseman’s Heartstopper novel Solitaire.
Eventually, Charlie’s mental health issues require the character to seek inpatient treatment so that he can learn to cope with symptoms of obsessive-compulsive disorder and anorexia, which are commonly co-occurring disorders. After receiving a referral for treatment from his primary care doctor, Charlie must wait several months for placement at a facility, an unfortunately accurate depiction of the wait times for those seeking treatment for these deadly diseases. In the intervening time, his symptoms progress, leaving his loved ones at a loss about how to help him as he starves himself to death.
As someone who graduated from treatment on March 28, 2025, this grueling wait period and its impact on my friends and family was one of the most relatable parts of the story. As I re-watched the Season 3 scenes with my wife for this article, I could hear her trying to muffle her sobs, reliving having to see me in the ICU in a coma and on a ventilator thanks to malnutrition—though I was in remission at the time this occurred, years of binging and purging left my gastrointestinal track in shambles and destroyed my kidneys, leading to an acute brain injury known as encephalopathy (if you want to learn more about this condition, check out the Star Trek: The Next Generation episode “Future Imperfect”).
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The Trifecta: Trauma, Eating Disorders and Being Queer
But, like how Charlie’s trauma played a role in his eating disorder, so did mine. I relapsed after the brain injury; I think in large part due to the stress of my NDE, or near-death experience, which, unlike how they’re often portrayed in media, was not pleasant. As I appeared to lie there in a coma, internally, I was scrambling. Having attended a viewing of Deadpool 3 the night before “the incident,” I remember being surrounded by red and yellow lights, trying to claw myself out of a grave to Madonna’s “Like A Prayer”—an experience I would go on to relive in flashbacks when I awoke. And trust me, flashbacks to your own death are not pleasant experiences; it’s like getting the life sucked out of you repeatedly.
The complexity of the disease is precisely what Heartstopper got right, and I commend the show’s decision to consult with U.K. eating disorder charity Beat to show that eating disorders are more than cis, white teen girls’ problems; they impact other communities, too, at an even higher rate. Furthermore, according to the show’s press notes, they tried to portray the illness in a way that minimized on-screen moments potentially harmful to struggling viewers, making Season 3 a possible candidate for cinema therapy in eating disorder treatment (we, as in us queers with related diagnoses, watched it while I was in treatment and found it cathartic).
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In a Teen Vogue cover story last August, Connor remarked that Heartstopper is “setting blueprints for people to know how to treat these delicate situations,” and Season 3 proved that’s still the case.
As the founding principles of Eating Disorders Anonymous state, disordered eating is about feelings, not food. Many of us who suffer from eating disorders often try to control the uncontrollable—the external world and how we perceive its reaction to us—by attempting to manage the foods we eat and/or our body size. Overall, the intersection of LGBTQ+ identity and eating disorders is shaped by the experiences of marginalization, identity struggles, and societal pressures. Understanding and addressing these unique challenges is critical for improving mental health and body image in LGBTQ+ individuals, as well as providing appropriate and inclusive support for those dealing with eating disorders.
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