This week is National Eating Disorder Awareness Week, and you might have seen some hashtags on Instagram like #neda and #nedawareness. This might be surprising to some, but eating disorders are some of the most misunderstood, stigmatized diagnoses out there. This week I was asked by a Emily, the owner of Babblings by Anxiety’s Elite (this blog), to write a post that addresses some of those things and though the challenge was a bit daunting, I was happy to give it a shot. I want to take some time to clarify some perspectives on eating disorders.
Disclaimer: I am not going to be spending time defining what an eating disorder is. That is something that I am sure Google would be more than happy to do for you!
Eating Disorders as a “Choice”.
Let’s come out swinging. This is one of the most hotly debated accusations out there right now. People who do not necessarily struggle with eating disorders quickly want to make this a behavioral issue:
“Can’t you just eat more?”
“Just stop throwing up. Simple.”
These are the comments people make when they do not fully understand that struggle. It is important to understand where these comments manifest though. Because there IS a choice element, like in every aspect of life. There is no benefit to pretending like people with the disorder have no power over their decisions, but that needs to be balanced with empathy and understanding that if it were that simple, the disorder simply would not exist!
Simply stated, we have control over our actions, but that’s it. Eating disorders are emotionally based. So saying, “Stop having an eating disorder” is the equivalent of saying, “Never feel anything that you do not want to.” Not going to happen.
Eating Disorders as a Diet-Gone-Too-Far.
I can see how this one comes about. The key component to Anorexia is not getting enough calories to sustain primary biological functions. And what do diets tell us to do? Eat less. There is some logic to this perspective, but we need to keep in mind that the word diet has been robbed of its original definition: To describe the break-down of what we ingest.
It is not healthy to over-eat, and it is not healthy to under-eat. Diet should represent a healthy view on food. Unfortunately in our society, dieting has become a sexy word to represent image and status. This is the beginning of the corruption that CAN lead to disordered eating.
Just be careful when you place judgments on words without taking the time to understand the intention behind them.
Eating Disorders as a Body Image Issue.
We’re moving into trickier ground here, because common sense tells us that there is some truth to this perspective. There is quite a bit of research that says there is a strong correlation between negative body image and developing eating disorders. The problem with stopping there is that it becomes a stigma that is not always accurate. A person can have a negative body image and not develop an eating disorder, and perhaps more surprisingly, it is actually possible to have a positive body image and still develop an eating disorder.
The difference that you need to understand here is the same as above, with the topic of choice: Eating disorders are not simple problems with simple solutions. I will reiterate this later but, if you believe (or know) that you have an eating disorder, please seek help!
Eating Disorders as a Mental Health Issue.
We’re getting somewhere now.
I say that because there is a general acceptance that mental health disorders do not have simple, “Just Fix It” attitudes attached to them. Yes, we do have a long way to go in this country in terms of accepting that mental health is extremely important… but there is also no doubt that band-aids do not fix depression. I think the more understanding that the general public has the eating disorders are genuine mental health issues, the more likely they will be to be empathetic to those that suffer.
It is also important to know that a HUGE percentage of people diagnosed with eating disorders are also diagnosed with another mental health disorder such as anxiety, depression, and even obsessive-compulsive disorder. Put simply, eating disorders are definitely mental health issues.
Eating Disorders as a Form of Perfectionism.
Bingo. This is what you need to know about Eating Disorders!
We all want control in our life. We want to feel like there is some order to the universe, and that we are not totally at the mercy of chance. It can be so easy to get so focused on control (getting it, keeping it, maintaining it) that we start believing that we cannot function without it.
- I am not going to get the job, so I just won’t apply.
- I know my parents are just going to get mad, I just won’t tell them the whole story.
- See, this is why I don’t date. I always get hurt.
These are forms of perfectionism. We refuse to try unless absolute success is guaranteed. I have heard arguments that this is a generational issue, but I will argue that that is a human issue. Fear of failure is natural, and it is a necessary journey in life to overcome it.
But…what if you had NO control in your life. No matter what you did, the normal safeties that are supposed to be provided for you in life seemed to fail. Wouldn’t you desperately grasp for any small amount of control you could find? Would you not become the world’s biggest self-critic (blog on this coming next week)? The answer is yes for you, yes for me, and yes for millions of people who have actually lived this story, and in return realized that their eating was the only thing they felt that they had control over.
Now, imagine asking the person who only feels control over eating, to give up that control. This is why the option of eating disorders being a choice is crazy. Of course they want to be healthy, but they also want to feel like they have power over their lives, and their disorder has provided that to them for so long. And with such shame over their feelings of helplessness, what tends to develop is a very strong sense of self-hatred.
*Emily has a wonderful first person account of challenging this experience here.
Eating Disorders as a Journey.
It’s not simple. It’s not easy. It’s painful and it’s scary. But it’s possible to get through an eating disorder. You may be sitting there saying, “I had no idea that that’s what it was like…” or maybe you are thinking, “Wow, I am dangerously close to what you are describing there.” You are not alone. You are wonderful and you deserve the best.
People who suffer from eating disorders need a lot of support. They are literally challenging themselves to face their demons, and live in a world where they feel NO discernible sense of control or love for themselves. It is an uphill journey, but connection is what makes the impossible possible.
There are some excellent resources out there. National Eating Disorders is a robust source of information that can get you started in understanding, and maybe seeking help for yourself or someone you love. But if all else fails, just tell a friend. What IS a choice, is whether or not you do this alone.
Special thanks to Emily Stolworthy for the inspiration to write this piece. She is a strong example of what it means to take back control of your life.
Please check out and follow my blog at Balanced Counselor for more writing on topics like this.