Yesterday marked the beginning of National Eating Disorder Awareness Week or, as you may have seen on social media, #NEDAweek. In true 2017/2018 style, the theme of this year's awareness week is "Let's Get Real" because just like other mental health issues, it's time to start breaking stigmas and misconceptions about eating disorders.
In support of #NEDAweek, the Let's Get Real campaign, and ending the sigma around all mental health issues, I'm going to spend the next six days dispelling some common eating disorder myths that I experience and observe on a regular basis. I'll add to this post with one new myth or misconception each day.
Myth #1: Eating disorders are about looks.
Despite increased attention to and availability of research surrounding eating disorders, there's still a widespread misconception that all eating disorders are caused by or hinge upon physical appearance. While there can be a connection between body image or body dissatisfaction and the development of an eating disorder, that's not always the case. Often times eating disorders manifest out of other mental health issues such as anxiety or depression, as a result of serious trauma, or as a coping mechanism.
The parts of your brain that deal with food are the same parts of your brain that deal with habits. Habits, as you might know if you've ever had a not-so-favoriable one, are notoriously hard to break. Once someone develops an eating disorder, and the longer that eating disorder goes unchecked, the stronger that "habit" becomes. Someone can suffer from lifelong eating struggles without necessarily feeling any body dissatisfaction. It's important to note that body dissatisfaction can also develop as a result of an eating disorder as well. If someone is engaged in eating disorder behaviors such as restriction, even if developed out of a desire for feelings of control, they might start to view their body negatively when it doesn't respond as it should (i.e. with weight loss).
In all my recovery work and honesty about the age and factors that encouraged the development of my eating disorder, body image has never been identified as a "direct" cause. As a preteen battling mental health questions and life transitions, my eating disorder began to formulate as a grasp for control. It was much more related to my need to feel like I could exercise power and choice in my day to fay life than any desire to be thin. My relationship with and the way I viewed my body absolutely deteriorated as a result of my eating disorder behaviors, especially in partnership with growing pressures to fit into certain societal norms of appearance.
So why does it matter? The idea that eating disorders, serious mental health issues that can cause lasting physical and psychological harm if left untreated, are an issue of vanity minimizes their severity and can act as a barrier to seeking help. The fear of being seen as "self-obsessed" or judged by doctors, friends, and loved ones can create intensified feelings of isolation and loneliness. In addition, this misconception perpetuates the idea that eating disorders always manifest in the form of extreme food restriction (i.e. anorexia) in thin, white women. ...We'll talk about this more later
Myth #2: The severity of an eating disorder can be judged by weight or appearance.
Most media depictions of eating disorders focus on anorexia in thin, white women. Anorexia is a serious mental illness but it doesn't always result in emaciation and it isn't the only treatment-worthy form of ED. More often than not, you can't identify someone with an eating disorder based on their weight or physical appearance. Many severe and life-threatening forms of eating disorders don't result in worrisome, if even noticeable, weight loss. Weight gain can even occur as a result of many eating disorders.
Just because someone doesn't "appear" depressed or bipolar doesn't mean they aren't suffering from a serious mental illness. You wouldn't want someone with depression waiting to get help until they're unable to physically function. Eating disorders should be treated the same way.
I definitely got asked the most about my "health" when I was at my thinnest. While my eating disorder was severe at that time, it's hard to say whether that was when it was most severe. There were many times when my weight was at what appeared to be an acceptable or even higher point that my eating disorder felt far more dentrimental to my mental health and ability to function on a day-to-day basis. Between the feelings of isolation, hopelessness and extreme anxiety and the physical injuries, irregular periods, and excessive fatigue, my appearance often made me look far better than I felt.
This misconception can both keep those in need of help from reaching out as well as encourage more detrimental behaviors. Eating disorder sufferers who do not feel they are "sick enough" because they aren't thin or don't fit into the eating disorder mold might be less likely do go to a doctor or professional. NEDA reports that bulimia and OSFED actually result in mortality rates almost equal with that of anorexia. The behaviors exhibited by folks suffering from bulimia and OSFED can put an extreme amount of stress on the body, specifically the heart, without causing extreme weight loss.
Myth #3: Eating Disorders ruin food ...forever.
I think this is one of the least discussed yet most prevalent misconceptions about eating disorders. A large number of folks who suffer(ed) from eating disorders and the general public assume eating disorders take away any chance of having a "normal" relationship with food. This myth ties into the misconceptions about the how eating disorders are formed. A lot of non-ED folks perceive eating disorders as a hatred of food and desire to be thin. This is rarely the case. Even if someone is viewing a food as "bad" or "evil," that association is likely rooted in a deeper emotional issue that's not actually about the food itself. People with eating disorders can and usually do enjoy food.
Once someone has suffered an eating disorder for any amount of time, there's also this idea that food-related activities will always be a stressful or scary event. Those struggling often experience this fear when entering recovery. Friends and families feel it too, sometimes never able to let go. There are powerful recovery tools for healing that relationship. As a friend or family member of someone healing their ED, it's important to know that your loved one wants the opportunity to feel "normal" around food. Don't act on the assumption that it's easier to leave them out of food-related events like going out to eat or cooking. Invite them in. Allow them to make the decision.
This is something I'm extremely passionate about and have been grappling with a lot in the later stages of my recovery. As much as we all hate the word "foodie," I'm a total foodie. I have a history of working in restaurants and craft beer, I love exploring new flavors and cuisines, and I genuinely love to eat. I love food. I had an eating disorder. I loved food when I had an eating disorder ...that love just got a little messy.
During my recovery, I was advised to ask my loved ones to assume that all foods were "on the table" for me but to also respect my boundaries if I decide not to eat something. I asked them to continue to invite me to eat, even if you think something is outside of my comfort zone or might just not be pleasing to my palate or even if I said no last time. Once asked, it is up to me to decide and to *politely* accept or refuse. Before implementing this policy, I'd often hear comments like "well you don't eat that stuff" or "I just assumed you wouldn't want any" and I'd frequently feel left out of experiences, like a burden, or reminded of my disordered eating past. We don't have to eat foods we don't like. If something tastes bad, doesn't fulfill us, or hurts our bodies than we don't need to eat it.
As I just mentioned, this assumption can create a lasting reminder of an eating disorder even once someone has entered recovery. It's like a scab on that person's relationship with food that just keeps getting ripped off or scratched. Further, being left out of experiences like going out to dinner or opportunities to cook and share meals with loved ones can increase or reintroduce feelings of isolation and hopelessness in an eating disorder suffer. When grasping at attempts to feel normal around food or in control of their recovery, the feeling of being trapped by an disordered eating past could lead someone to falling back into harmful behaviors.
Myth #4: Struggling with an eating disorder means you're weak
Part of this site's purpose is to break through stigma around mental illness, including eating disorders, so we've got to break through this whopper. Eating disorders are not a result of poor willpower or neediness. In fact, just the opposite. Eating disorders are mentally and physically draining, isolating, and complicated. It takes an incredible amount of strength just to make it through the day while struggling with and recovering from an eating disorder.
There's this idea that someone can simply "snap out of" or "power through" an eating disorder, but once an illness takes hold it can be a serious and potentially life-threatening mental illness. Anorexia has actually been said to have the highest mortality rate of any other mental illness. Recovery can often feel harder than living with an eating disorder. Owning the truth about an eating disorder and asking for help requires vulnerability and facing a lot of stigma. After that, the neurological and emotional work or retraining the brain and understanding what lies beneath the disorder starts. Sounds easy, right? It's not.
Struggling with an eating disorder is exhausting and painful but it does not make someone weak. You are strong and capable of recovery.
It doesn't take an emotional genius to see that I like to feel and be seen as strong and competent. Just watch me struggle to carry twelve grocery bags in from my car rather than taking two trips or asking my boyfriend to come help. This, undoubtedly, is why it took me so long to see a therapist. Even if I could admit that I had an eating disorder, I think part of me thought I could "save face" by handling it on my own. Once past that, I saw that while I was incredibly strong for being able to sustain that struggle on my own, I was even stronger for knowing my limits. Recovery has taken more effort and strength than I expected and has left me in touch with an even greater sense of resolve and tenacity.
This misconception can further hurt an already bruised sense of self as well as create another barrier to seeking help and recovery. Recovery is hard work and feeling (or being told that you are) weak or inadequate makes taking a step even harder and less likely. This myth also adds to the epidemic men with eating disorders going untreated because of the belief that this issue is reserved for weak-minded, overly emotional, thin women. In reality, a lot of folks who struggle with eating disorders are accomplished and intelligent individuals of all genders, race, size, sexual orientation, and age.
We have the ability to help all people suffering from eating disorders and mental illness on a larger scale just by talking about it. There's far too many people living below their potential because we allow stigma and stereotypes to stand in the way of truth. The truth is that we are human. Humans are wonderfully complex, emotional, flawed creatures and your struggle as a human deserves support. If you'd like more information, recovery resources, or to get involved, check out NEDA's website today.