What is an eating disorder?
Okay, so you’ve probably heard of eating disorders. They show up every once in a while on the news about a celebrity or something. Maybe you’ve even known someone who had one. But honestly, the public understanding of eating disorders is quite limited.
Eating disorders encompass so much more than our world makes them out to. Understanding them (even if you’ve never had one) is important to understanding our society today and empathizing with the deep suffering of many around you.
I am an eating disorder dietitian, which means this is my world. In my time in the field, my eyes have been opened — wide — to a reality I had no idea existed. It is both highly interesting and terribly devastating, and there is hope and beauty in the midst of it. It is my heart to share here what I have learned. This post will be a broad overview, which will be followed by a series of posts about subtypes of eating disorders (anorexia nervosa, bulimia nervosa, avoidant/restrictive food intake disorder, and binge eating disorder. There are others, but these are the most prevalent).
Some quick facts about eating disorders:
- Eating disorders are a mental illness. This is a fact that most people either don’t know or don’t fully understand. An eating disorder is not a choice. It develops out of a “perfect storm” of genetic predispositions, biological factors, and social pressures. When someone has an eating disorder, their thoughts and emotions around food and their body can be significantly distorted, and this is not their fault.
- Of all the mental illnesses, eating disorders have the highest mortality rate. The physical impact of extreme behaviors surrounding food along with suicide rates of those suffering from eating disorders cause this to be true. In my work, I see firsthand the devastating effects of all eating disorders (not just anorexia — but we’ll get to that later).
- Eating disorders affect 24 million people in the U.S., both male and female, and of all ages. Surprise! Eating disorders aren’t just for the girls. They present differently in males, but are equally as dangerous. Also, 24 million people is around 7% of our population! That means that you probably know someone who is suffering from an eating disorder, even if they aren’t talking about it.
- Eating disorders can happen to anyone, in any body size. One of the most common misconceptions about eating disorders is that everyone who has one looks like they just came out of a concentration camp in the Holocaust. Actually, this is quite rare. All eating disorders can occur in people in larger bodies with equal severity. And in fact, the voices of those who do not understand this point can be extremely invalidating to patients with eating disorders and a huge barrier to them getting the care they need (looking at you, medical health providers).
- Motivation for recovering from an eating disorder is complicated. Unlike other illnesses such as cancer or heart disease, people with eating disorders don’t always want to get better. This baffled me when I first started working with this population, but as time went on I began to understand that an eating disorder is about way more than your body looking a certain way. Extreme food behaviors can actually be a coping tool for someone who feels their life is out of control in one way or another. It is scary to let go of this tool, especially if you’ve used it for a long time. Recovery means learning to deal with hard emotions (and often co-occurring mental health issues) in other ways, and this is hard.
- Recovery — even when someone wants it — can take a long time. I work at a facility where clients come for up to seven hours per day to eat meals with staff and attend groups with peers and meetings with their dietitian and therapist. There are higher levels of care where people live in an actual house 24/7 to have that constant support. People stay in various levels of treatment for weeks to months to years upon end. Changing deep-seated thought patterns and behaviors takes time, and it’s usually never as quick as people wish it to be.
This probably all sounds pretty defeating…
…and it can be. But I have three values when it comes to walking with people with eating disorders — faith, hope, and patience.
- First, faith. My faith is the cornerstone for the work that I do because I believe God cares deeply about each one of these people. I believe that the power of Jesus is strong enough to make them well, and that his light can shine even in such a great darkness.
- Second, hope. The process of recovery is usually long, and as someone giving care to these people, I must come each day with hope for them, no matter what happened yesterday. I believe that every day is a new day, and a new chance to take a step in the right direction.
- And lastly, patience. Recovery is never linear — it has many ups and many downs. Additionally, as much as my solution-minded brain wants me to just “fix everything,” that’s not my job. I am here to love my clients and walk with them side by side, and I must be okay with the “not yet.”
I’m reminded of the famous passage in Ecclesiastes 3:
“There is a time for everything,
and a season for every activity under the heavens:
a time to be born and a time to die,
a time to plant and a time to uproot, and a time to heal,
a time to tear down and a time to build,
a time to weep and a time to laugh,
a time to mourn and a time to dance,
a time to scatter stones and a time to gather them,
a time to embrace and a time to refrain from embracing,
a time to search and a time to give up,
a time to keep and a time to throw away,
a time to tear and a time to mend,
a time to be silent and a time to speak,
a time to love and a time to hate,
a time for war and a time for peace.”
My prayer is that we can all have faith, hope, and patience for those of us who are suffering from eating disorders, other mental illnesses, and really any type of suffering that doesn’t go away quickly. We have to learn how to walk with people in a way that says, “I see you, I feel your pain, I’m with you, and we’re going to make it to the other side of this together.”