5 Common Questions about Eating Disorders Answered
Although so many people suffer from eating disorders, there is still a lot that people don’t know as well as many gaps in research. I’ve written this post as a guide to help people who struggle with eating disorders or who want to learn more about this illness to help a family member or loved one.
What is an eating disorder?
An eating disorder is a serious illness that drives someone to change their food intake, eating behaviors, or priorities to a degree that clinically impairs their quality of life. Eating disorders often derive from body dissatisfaction, the unhappiness with one’s size and shape stemming from society’s preoccupation with thinness. However, some eating disorders can also exist and thrive completely separate from poor body image. Disordered eating, or inappropriate behaviors associated with eating, food, and bodies, can often lead to eating disorders but are not yet at the point where they clinically impair one’s life. Many people develop disordered eating habits because they desire to lose weight. Without proper intervention, these behaviors can spiral into a disorder that requires professional attention.
What causes eating disorders?
A number of factors can contribute to the development of an eating disorder. Some people are biologically predisposed while others are influenced by their environment. Folks who are high functioning, perfectionistic, and anxious are at higher risk than others. Eating disorders often also coincide with trauma.
It is important to remember that eating disorders often begin as an attempt to cope with something else. Think of eating disorders as monsters that come along and said, “this is how we are going to cope with __. You need me to get through this.” Over time, you began to believe that you cannot function without the disorder.
I emphasize to every one of my clients that while no one would develop such a serious illness on purpose, dieting, purging, or other ED behaviors initially seem very appealing, especially to people who are struggling.
Imagine that you are an adolescent female juggling high school academic and social stress, college applications, and your first relationship. You may never form the explicit thought, “I will diet to cope with all this stress” but somewhere along the way, you realize that preoccupation with your weight makes the other triggers more manageable. You finally have some control in your life whereas before you felt so helpless.
While this is a fabricated example, I’ve heard countless similar origin stories from my clients. Only when we understand how eating disorders weasel their way into peoples’ lives we can have empathy when these people have such a hard time letting the disorder go. Eating disorders can seem like someone’s absolute best friend and worst enemy at the same time.
How can you tell if someone has an eating disorder?
In short, you cannot determine if someone has this disease simply by looking at them. It’s a misconception that eating disorders or people who have eating disorders “look” like anything. People often stereotype EDs as only existing in thin, white, female bodies. In reality, anyone can suffer from an eating disorder, and they exist in all body types, races, genders, sexual orientations, and religions. Another misconception about eating disorders is that they only exist in women. Men and boys also suffer from this illness and experience their own pressures and messages about the ideal body type.
Behaviors, rather than appearances, are much more accurate indicators of this illness. A person with an eating disorder may talk about food incessantly but avoid eating in public, excessively diet or exercise, consume large amounts of food in private, or purge in between meals. Significant weight loss can be an indicator of ED, but as I mentioned above, eating disorders occur in smaller bodies, large bodies, and everything in between.
In my opinion, our society has a huge problem of medical providers assuming that patients in larger bodies cannot have eating disorders. It is so common for doctors to recommend weight loss for their larger patients rather than taking the time to screen for eating disorders. I’ve had several patients report to me that without any knowledge of their behaviors, trauma history, or mental health diagnoses, medical providers had suggested they simply lose weight. Here’s a Buzzfeed article that highlights this upsetting trend.
Can eating disorders be “cured” or will the person suffer for the rest of their life?
Many people think about eating disorders like addictions such as alcoholism or drug addiction. Common wisdom states that alcoholics will always be addicted to alcohol and thus should always identify that way. Eating disorders, thankfully, are different. According to the NEDA nine truths, it is completely possible to treat and cure an eating disorder. As I write this, I meet none of the criteria of Anorexia, although several years ago I was seriously ill. That being said, being cured from an eating disorder does not mean we are suddenly plucked out of our weight obsessed, fat-phobic culture. It takes daily work to navigate all the messages about bodies that bombard us on a daily basis. I’ve written a more extensive post on living post ED that you can read here:
Eating disorders are also incredibly manipulative and have embedded themselves in their victims’ lives, making it very hard to recover. One should consider whether there is a secondary gain to holding on to an eating disorder. What does the eating disorder help with? Eating disorders make people miserable, but they also help people cope with uncertain, chaotic, or even abusive environments. Eating disorders, while terrible and deadly, can provide a sense of order in an otherwise chaotic situation. It is important to develop healthier, more sustainable coping skills before discontinuing the eating disorder behaviors. For instance, imagine the child that copes with her parent’s constant fighting and yelling by purging at night while they sleep. Then let’s say that one of her parents hears her vomiting at night and locks all the doors to the bathrooms in the house from the hours of 7pm to 7am. Sure, the eating disorder behavior has been eliminated (atleast in the short term) but the volatile situation in the home still remains. The parents still yell and scream and make verbal threats toward each other, and the little girl still overhears. Except now, she is without a way to cope. What do you think she may turn to? Without the ability to purge she may now turn to even more harmful behaviors such as self-harm.
What is eating disorder treatment like?
There are different categories or levels of eating disorder treatment depending on the severity of the illness. These levels range from inpatient treatment (around the clock supervision and medical care) to outpatient treatment, which is what I provide.
Outpatient treatment involves regular psychotherapy, dietitian support, and ideally meeting with a medical provider trained in this field. Best practice in the treatment of eating disorders involves a treatment team approach, so a patient should expect to meet with at least three providers and expect to have labs drawn, weight checks, and possibly a meal plan to follow. The eating disorder counselor (or therapist) will focus on the patient’s mental health with the goal of understanding how the illness emerged and what maintains it. I’ve written a more in depth article about eating disorder treatment for adolescents that you can read here.
I am an eating disorder and trauma counselor in Winston Salem, NC and would be happy to schedule an appointment with you, answer any questions, or help you find the right treatment option. Contact me at taylor@nourishedandknowncounseling.com.