While all eating disorders are different in terms of primary symptoms, anorexia nervosa, bulimia nervosa, and binge eating disorder all center around a dysfunctional relationship with food, weight, and appearance. But compulsive behaviors and obsessive thinking around food, weight, and appearance are only the tip of the iceberg of an eating disorder.
Below the surface, we see that those behaviors could be a result of mental health issues, trauma, grief and loss, identity and societal pressure, gender and sexuality, or attachment wounds…. and not uncommonly, all of the above. A person with an eating disorder isn’t being vain or picky or selfish or sneaky or whatever by focusing on food, weight, and appearance, they’re just trying the best they can in the way they know how to cope and keep it together.
Using an Eating Disorder to Cope
People use eating disorder behaviors because (unfortunately) they work. Food and exercise impact our body chemicals and physiology. They can help ground and soothe anxiety and trauma by helping distract by focusing on food instead of pain or mindlessly eating or exhausting your body through exercise or being too hungry to feel emotions fully. They are also a way to have control. Maybe you can’t control your mind or your family, but you can always control your food and appearance. Everyone has their own specific ways and reasons why their eating disorder works…until it doesn’t.
Healing More Than Just an Eating Disorder
Healing an eating disorder is complex in that there are usually hidden aspects of the person's life that lead to using food as a form of control. It does take healing the relationship with food but, more often than not, that comes through healing the relationship with self and others that either were broken before the eating disorder or got broken as the eating disorder took over.
Just focusing on food and weight in treatment would be a bandaid on a broken bone (at best). Healing looks like attending to all those underlying issues and not just focusing on the eating disorder. The eating disorder was there to do a job (manage a complex, painful, and challenging life) and our mission in therapy is to heal old wounds and add new tools and skills so that the eating disorder is no longer needed.
Because eating disorders can be quite damaging and even lethal, they often aren’t just treated by a therapist. Depending on the severity of symptoms and health issues, treatment often also involves a medical doctor, registered dietician, or psychiatrist. If they’re caught early or in less severe cases, these may not be as necessary as often, but like all eating disorder treatment, those decisions come on an individualized basis.
Eating disorder treatment is slow, complex, and challenging but also rewarding, transformative, and, most importantly, possible.