A few years ago, I sat with a patient as she lamented how difficult it was for her to eat a normal lunch. After years of consuming only coffee for breakfast, a granola bar at lunch, and a dressing-free salad for dinner, this woman was finally seeking treatment for her eating disorder. “Why is this so hard? Why is it such a struggle?” she asked.
For those of us who don’t have eating disorders, eating disorder symptoms may seem perplexing. How can someone starve herself day after day? How can someone eat so much that she feels the overwhelming physical and psychological need to vomit?
The origins of eating disorders are complex. Experts believe that a combination of genetics and cultural factors contribute to the development of eating disorders, which are most common among women. Men are vulnerable, too, particularly those who are involved in hobbies or sports, such as rowing or wrestling, that emphasize the importance of maintaining a low body weight.
However, another factor appears to play at least as big a role in initiating and maintaining an eating disorder. Nearly every patient with whom I’ve worked reports significant difficulties managing negative emotions such as sadness, anxiety, and anger.
Like other addictive behaviors, disordered eating symptoms seem to help distract the person from or even alleviate these negative emotions, at least for a short time. For the person with anorexia who feels as though her life is out of control, restricting her food intake generates a feeling of enormous power and control. For the person with bulimia who is overwhelmed with anxiety, eating food rapidly helps her to “escape” painful feelings of panic, at least until she is stuffed or the food is gone.
Not surprisingly, a major focus of therapy for people who have eating disorders is helping them to develop healthier ways of coping with and releasing negative emotions that do not “hurt” their bodies. Learning to give up these self-harming behaviors and live in ways that are consistent with their most cherished values is not easy, but it is doable, with help.
All human beings struggle in some capacity. Sometimes, recognizing we are in the same boat as the rest of humanity can make it feel safe to explore options for removing our masks and being true to ourselves. So this year, in honor of Eating Disorders Awareness Week, reach out to someone you care about who might have a problem and encourage her or him to get help. After all, every one of us knows what it is to struggle. We are all works in progress.
National Eating Disorders Awareness Week is February 26 through March 4. The goal of this event is to “shine the spotlight on eating disorders and put life-saving resources in the hands of those in need.” People who need help are encouraged to get screenings and seek treatment for their eating problems. Learn more at www.neda.org or contact me.