Eating disorders, more than just the food
Eating disorders are complex illnesses that combine both physical and mental aspects. The title doesn’t really explain how multifaceted they are, but it’s quite hard to capture this in a couple of words.
Whilst eating disorders feature a complicated relationship with food, they cause disruptions to the way an individual engages with one of the major things we need to stay alive. The types of behaviours that often present are wide and varied with the most predominant being dietary restriction. This behaviour often reflects the diet culture trends of the time which are regularly based on inaccuracies. Restriction is the behaviour that sparks the cycle and is often where we need to do the initial piece of work. Purging is also another common behaviour which occurs when an individual attempts to rid their body of as much energy as possible and can be done via many methods. Lastly, bingeing, which is an over consumption of food that often features a loss of control.
Whilst these are important aspects to understand, to focus only on an individual’s relationship with food in therapy is to miss out on so many other learnings and opportunities for change. Eating disorders also feature another commonality, a preoccupation with shape, weight or size. But I’m not just talking about the thought of losing a few pounds, I’m talking about significant and severe distress due to their appearance. So much so, that an individual will risk their own lives in order to make the perceived change that will keep their illness happy.
Now why would someone do this you may ask? This is not just about vanity and it’s not just about self obsession. It’s about a deep engrained pain that has developed due to temperament, genetics, experiences and societal conditioning. This leads someone to feel that the only way to cope with their existence is to put immeasurable pressure on themselves and change how they look, possibly putting their life at risk.
Eating disorders are not ‘one size fits all’. There are similar factors which we commonly see in people who are diagnosed with these awful illnesses, but I can honestly say that I have never seen the same eating disorder sit in front of me twice. It always has a different meaning or a different function for each person, whether it be interpersonal issues, issues around control, hatred of one’s body due to bullying or abuse, a mechanism of self punishment or a way to switch off intense emotions.
What we draw from this is the need to treat every client differently. There are some things that will help some people and not others, it’s the nature of psychology. But sometimes in treatment and in recovery it’s about walking a very fine balance, between focusing on nutrition and reversing starvation, whilst also addressing the other issues as they rise in the therapy setting.
As therapists we know it’s not all about the food, but it is also important to focus on the food. We believe in treating the whole person in their journey to wellness and recovery. We hold hope for all our clients that recovery is possible, and we always will.