Eating Disorders: A Numbers Game
One common element found in many individuals who struggle with eating disorders is an obsession with numbers related to the eating disorder, calories in-calories out, pounds on the scale, minutes or miles run, portion sizes, quantities, even pulse and blood pressure, the numerical elements of the eating disorder are quite strong. The most common preoccupation with numbers is usually around the number on the scale. Those with eating disorders, and even the larger culture around us place an excessive value on the number on the scale. Really, that number means very little. Weight is not an indicator of health, beauty, nor self-worth. I hear from many people with eating disorders that the number on the scale dictated how their day would go, and how they would feel about themselves. If the number on the scale was lower, they would be happy. If the number on the scale was higher than their arbitrary desired number it would mean the beginning of a day of restricting, torturing oneself with exercise or other punitive measures. Then, when they reached the number they had in mind, the number suddenly moved. That number was no longer good enough, it lost its meaning and only became a motivator for further restrictive behavior, to try and reach a new low. As you can imagine, a significant problem with this pattern is that there is no endgame, other than death.
Calories become another set of numbers that someone with an eating disorder will often obsess about. They may spend time researching the caloric value of food items, on an endless quest to find the lowest calorie option to appease the eating disorder. Client will often have the caloric values of common foods memorized, and the mind becomes like a calculator they cannot turn off, churning over numbers in their head constantly, but never quite able to make the math work out. Caloric intake has the same phenomenon as weight, lower is better, and there is never a low enough number to satisfy the eating disorder. This obsession with calories quickly contributes to other problematic cognitive aspects of the eating disorder. It leads people to lump food into different categories, good foods and bad foods. Certain foods become off limits because they do not fit into the narrowly defined caloric criteria, and the rigidity with which they eat those foods becomes enhanced. An impossible double standard gets created in which if a person eats less than their predetermined caloric limit they feel proud, but if they go over this limit by one almond, it is a cardinal sin.
Similar processes exist with a person’s relationship with BMI’s, exercise, body measurements and clothing size. There are numerous ways a person with an eating disorder can obsess over, and place undue value in numbers.
Retiring from the numbers game is an important part of recovery, but how does one do that exactly? The truth of the matter is that it is very difficult to do so on one’s own. The mind is subject to a double whammy in that not only is the obsession with numbers being constantly reinforced, but simultaneously these behaviors are causing damaging cognitive effects, making it difficult for the person’s brain to function any differently. Trying to reason the with brain in this type of impaired state becomes increasingly difficult and the ability to think in nuanced and abstract ways is often the first ability to go. In treatment, a person receives the support and the philosophical shift necessary to change this obsession with numbers.
At Cielo House, our approach is designed to help clients throw in the towel with the numbers game. To begin with, we do not view nutrition in terms of calories, rather we teach clients about the necessary nutrients their bodies need and provide a structured, but flexible framework in which they learn how to accomplish those nutritional needs in a variety of ways. Additionally, we help clients to stop worrying about their numbers by preventing access to those numbers. Each time a person with an eating disorder checks their weight, or counts a calorie it strengthens the eating disorder, so when they are weighed by our staff without seeing their weight it challenges the eating disorder’s desire to have a number to obsess over. We don’t weigh or measure food, we don’t fuel the eating disorder’s obsessive tendencies. After a period of time without obsessing over numbers our clients see that the numbers lose their meaning. They start focusing on other areas of meaning in life. By being without numbers clients see that they are happy without having external, arbitrary forms of measurement, and it enables them to carry that mentality into their life outside of treatment. Numbers have a place in our society, but they ought not be the basis upon whichpeople measure their value. Once those in recovery learn to see themselves as more than numbers, their lives have countless possibilities.
Written by Matt Keck, MFT – Matt is the Founder and CEO of Cielo House Comprehensive Eating Disorder Treatment programs. Matt works with clients to end the obsession with numbers and find meaning in their lives through recovery.