In order to recover from an eating disorder, it is important to understand what it is you are recovering from. Eating disorders still remain relatively misunderstood in our culture. They have been misconstrued as women’s issues, they have been misattributed to a hyperfocus on appearance or vanity, or have been mislabeled as means of inappropriately seeking attention. Many people find it difficult to understand how someone could have difficulties with such a fundamental part of existence such as eating. Their misguided attempts at helping those with Eating Disorders revolve around the idea that all one needs to do is eat and everything will be fine. We all wish it were that simple, but unfortunately it is not. In fact, and this conceptis extremely important to grasp, Eating Disorders are NOT about eating. It’s so important that I will say it again, Eating Disorders are NOT about eating.
An Eating Disorder is a complicated biopsychsocial illness that affects far more people than we are even aware of. It is an illness of the body, an illness of the mind, and even an illness of society.
So how does someone contract an eating disorder? A useful way to think of this is by using what is called the diathesis-stress model. Diathesis refers to the genetic predisposition that one possesses toward something. Everyone possesses some degree of diathesis towards an Eating Disorder. Some may have a greater propensity than others, for example if there is a family history of eating disorders, or if one possesses personality characteristics involving rigid thinking, perfectionism and over-control. Stress refers to external events that cause psychological stress or distress, which then can lead a person to try and find means of coping with that distress. The diathesis-stress model involves both the innate propensity towards the Eating Disorder along with environmental stressors that set it off.
How do we calculate someone’s predisposition towards an Eating Disorder? The best we can do is piece together factors that we know are associated with Eating Disorders and roughly estimate. One strong factor is a family history of Eating Disorders. This may be complicated to determine, because of a generational gap around the acceptance of Eating Disorders. Many individuals who are at the prime age for the development of Eating Disorders, adolescents and young adults, have parents who may not have been aware of an Eating Disorder in themselves or in previous generations. Other factors include inborn personality characteristics such as cognitive rigidity, anxiety, perfectionism, and over control. These characteristics may begin to be surface in childhood, but don’t fully manifest themselves until young adulthood, so it is also tricky to determine whether a young person possesses these characteristics. I believe a better practice is to assume that just about anybody has some degree of predisposition towards an Eating Disorder, so that we can then focus on mitigating some of the external risk factors.
What are those external risk factors and how do we reduce them? Some of the major stress factors are abuse, neglect, or other psychologically traumatic experiences. Unfortunately, the prevention of these is not within the control of the person who is afflicted by them. Other risk factors are excessive pressure placed upon someone regarding their appearance, particularly pressure to be thin. Also, the act of dieting itself has been identified as a risk factor for the development of an Eating Disorder. Often, these seemingly harmless attempts at managing weight, can quickly become out-of-control in those with a strong diathesis towards an Eating Disorder. Other stressors stem from strong and overpowering emotions accompanied with a lack of coping skills to deal with these emotions. Coping skills are rarely taught in schools, and as young people developing their emotional landscape, they often are not adequately equipped to manage their strong emotions, and may turn to something like an Eating Disorder to numb themselves from those painful feelings.Since life comes with its share of unpreventable stressors, perhaps what is more important than preventing stress is learning how to appropriately cope with it.
What role does eating actually play in eating disorders? Eating is the domain through which all of the psychological turmoil associatedwith an Eating Disorder is played out. Think about how integral eating is to just about every aspect of our lives. Whether it is eating out with friends or with family, so many social occasions revolve around eating, and if there is a disruption in our relationship with eating there will also be significant disruption in these other areas. Many individuals who suffer from an Eating Disorder will avoid social interaction and potentially positive relationships because of the fear that it will involve eating. Not only that, but when we are nutritionally impaired in some way, we have less energy and poor cognitive functioning,both of which are extremely important to do the hard work of recovery. Being well-nourished physically is an important part of recovery from an Eating Disorder.
So you maybe asking yourself, if not about food, what are eating disorders really about? Simply put, Eating Disorders are about feelings. It’s not about what you’re eating, it’s about what’s eating you. Sometimes it is the discomfort with strong, painful emotions that leads someone to engage in eating disorder behaviors to numb their feelings. Other times it can be deep existential feelings, such as a fear of not being able to succeed in life, feelings of inferiority inadequacy or burdensomeness to others. The Eating Disorder offers a convenient means by which to anesthetize oneself from those strong feelings, but the price is far too high. Our emotions are a packaged deal, and when we numb out from the negative emotions, we also prevent ourselves from being able to feel positive emotions. This makes recovery all that much more challenging, for if you have lost the ability to experience joy, happiness or other positive feelings it can be hard to have faith in those feelings to use them as motivation. It is not until we make peace with our feelings, embrace them and learn how to appropriately cope with them that we are able to relinquish the numbing function of the eating disorder, and free ourselves from it.
If you have an eating disorder, it is important to understand that the development of the Eating Disorder was not your fault. You can’t truly know how strong your innate predisposition to the eating disorder was, nor could you control the stressors that contributed to its development. But take heart in knowing that you can recover, you are in the driver’s seat and can take control of your life. If you work on accepting your feelings, nourishing your body, and living in accordance to your values, recovery is possible, it’s possible for everyone. It’s possible for you.
Written by Cielo House Founder, Matt Keck, MFT. This is the second installment in the #OutsmartED series.