Eating disorders often begin early in life, some say in infancy. Today, we hear various rumors and stereotypes attached with eating disorders. How do you know what is true? Can you tell from the outside that someone has an eating disorder? Isn’t it only because they are obsessed with what they look like? Why can’t they just eat?
For someone struggling with an eating disorder, those questions and assumptions are incredibly difficult to hear. An eating disorder is so much more than just the food. Sadly, eating disorders have the highest mortality rate of any mental health illness (National Eating Disorders Association, 2016). Thus, eating disorders are a major issue and must be understood so we can support those struggling with this illness.
In my experiences within the eating disorder field, I received the privilege to work with incredibly strong and resilient individuals fighting to overcome their eating disorder. To be honest, it is hard to see someone in the depths of their eating disorder as they struggle to put the goal of recovery first. To put recovery first means to put themselves first, put health first, put loving themselves and their body first, and to put first treating themselves with great self-worth. It is rewarding to witness and assist in the process of someone deeply in the midst of their eating disorder fight back and become healthy physically, mentally, and emotionally.
Let’s first address some of the misconceptions people have with regard to eating disorders. No, eating disorders are not just about the food and the solution is not just for them to eat. It’s not that straightforward. An eating disorder might be the response of someone struggling with deeper issues. If the eating disorder did not do something for that individual and serve a purpose, then they would not keep returning to it like an old pal. It’s what is underlying the various eating disorder behaviors that keep this nasty cycle going.
Eating disorders are not caused by one sole thing. Eating disorders are a storm of various factors and emotions that can build up to become an eating disorder. To name a few potential influential factors: family chaos, family issues, relationship struggles, stress, anxiety, depression, low self-esteem, negative body-image, poor self-worth, insecurities, addictions, trauma, bullying, relationship with food, among many other factors.
One thing that plays a large role in eating disorders is control. Everything else in life may feel out of control, but eating, not eating, throwing up, or binging they can control. This they have a hold on, this they can feel as though they have a grasp on something. I tend to associate eating disorders with a storm because in the storm of life, the eating disorder is his or her way to feel like he or she has control or a say in what is going on.
Here is an example to paint a picture of how an eating disorder may unfold and continue to be maintained: A young girl begins middle school and struggles to adjust to the pressures faced in this environment. She tries to make friends, but she does not feel accepted. She begins to be bullied by her peers, being made fun of for her clothes, appearance, weight, and style. It feels like no matter what she does, she can’t seem to make friends or fit in. She feels isolated and stressed because she doesn’t know how to handle this. She feels out of control and helpless because nothing she wants is going her way. She started to hate her body and thought that the best way to look thinner would be to make herself throw up. At school, she began to go to the bathroom after lunch to throw up her food. She finds purging her food to be a relief and an escape. She is noticing physical benefits of appearing thinner and found that being thinner helped her fit in with the popular crowd. It becomes natural for her to purge every day and this, what has now become an eating disorder, has become what she believes is her constant companion and the only thing she can trust.
Eating disorders can start out with what we call disordered eating. Disordered eating can look many different ways: it can be seen as dieting, restricting food, avoiding food, becoming a picky eater and eliminating foods, throwing up food, excessively exercising to cancel out the food intake, eating a lot in a short amount of time, with or without subsequently throwing it up. These ways and others can be considered disordered eating. Now listen closely: just because I said these can be considered disordered eating does not mean that it is an eating disorder. Re-read that last sentence again so we are all on the same page. Eating disorder indicates disordered eating, but disordered eating does not indicate eating disorder.
Those who struggle with an eating disorder usually do not realize all that plays into it. If you were to ask someone whom you know struggles with this disorder if they desire control and avoid their emotions by using eating disorder behaviors, they may not understand what you’re asking. A lot of treatment includes therapy, which helps each person see what is going on underneath the eating disorder behaviors and understand why it is so hard to stop. To gain insight and awareness is the first step to change. You know the phrase, “You can’t see the forest through the trees”? I finally understood that phrase when working with eating disorder clients discussing change and motivation. As the counselor, it was a huge concept for me to grasp and to better empathize with them on their journey towards recovery.
Cynthia Bulik is an incredibly well known professor in the world of eating disorders. She wrote a research article breaking down myths versus reality when it comes to this mental illness. Bulik (2016) explores the complexities of eating disorders and the various influential factors at work in the presence of this disorder. Bulik (2016) also mentions how false notions about eating disorders can be harmful as we try to increase accurate and informed public knowledge on this topic. If you want to study up a bit in this field and learn about future research possibilities, check out her research article (link below).
Sure, it’d be nice to understand eating disorders as clean cut and straightforward, but to do that is to completely ignore and invalidate everyone experiencing an eating disorder. It’s just not true. Yeah, that means eating disorders and understanding them are messy and complicated, and that’s life.
Bulik, C. M. (2016). Towards a science of eating disorders: Replacing myths with realities: The fourth Birgit Olsson lecture. Nordic Journal of Psychiatry, 70(3), 224-230. doi:10.3109/08039488.2015.1074284
National Eating Disorders Association. (2016). National eating disorders association. Retrieved from https://www.nationaleatingdisorders.org/learn/general-information/faqs