Posts Tagged ‘Eating Disorders’

We in the eating disorder field are generally wary of restriction. Dieting is a key risk factor in the development of eating disorders, and eliminating it and other disordered behaviors is central to healing. One of the biggest gifts of recovery is the opposite of restriction: a life where food is just food, and all foods fit.

Even so, “all foods fit” does not necessarily mean that all foods fit for all people at all times. Like any pithy “all” statement, this generalization does not represent any unique considerations. For those with special dietary restrictions, all foods quite literally do not fit. For those with allergies and intolerances, some foods are forever off-limits, and those with conditions like type 1 diabetes or celiac disease need to closely monitor ingredients to avoid triggering their physical illness.

Similarly, gastrointestinal disorders such as inflammatory bowel disease (IBD) often require dietary restriction as part of their treatment. The relationship with food is especially complicated for people in this situation. IBD symptoms can overlap and interact with eating disorder ones, and there is no one nutritional plan proven to work for all of those suffering.

When eating disorder recovery is compared to substance use recovery, a sharp distinction is often drawn: You can’t quit or give up food, vowing to never touch it again. You can’t cold-turkey it with a pledge of sobriety.

That is to say, the human body doesn’t need alcohol or drugs in the way it needs food. Eating disorder or not, we all need food to survive. It’s one of the few can’t-live-without, most basic human needs. And those recovering from eating disorders need it, too, to heal from their mental illnesses. No matter your restricting, bingeing, or purging history, you do need to eat.

Eating is integral to the process of eating disorder recovery in ways that drinking or using are not part of substance recovery. To assume that recovery would be easier if this were not the case is, of course, an inaccurate oversimplification of the complexity of issues with alcohol and drugs, but the analogy does underscore a reality specific to eating disorder recovery: You face food every day, multiple times per day. You sit in the discomfort of eating a portion right for you, then the discomfort that often follows, then the discomfort that may come with knowing you will do it again. Soon.

Eating disorders are fierce, all-consuming illnesses. They develop gradually and insidiously, but once formed, impact more than a person’s relationship with food. They damage social relationships as well, affecting far more than the person experiencing the illness firsthand. Parents, siblings, friends, and partners are also subject to the toll of an eating disorder, their relationships with their loved one often strained in its presence. 

Given the secrecy and isolation common to these illnesses, eating disorders are particularly at odds with healthy intimate relationships. These relationships require vulnerability, honesty, and open communication, all qualities that are incompatible with an active eating disorder. The more consumed by disordered behaviors a person is, the more physically and emotionally distant from their partner they often are in turn. In situations where this distance or other relationship distress precipitated the development of the illness, the eating disorder only exacerbates it.

Is it possible to have two eating disorders at once? What if you restrict and binge and purge? Is that anorexia or bulimia? Both? Neither?

It’s a common question, one that makes sense to ask. Many people do experience a continuum of disordered behaviors within or over the course of their illness, at times restricting, bingeing, and purging. One behavior leads to another in what is often called the eating disorder “cycle.” Trapped in this cycle, people experience symptoms that overlap multiple eating disorder diagnoses. They may be left to wonder: Exactly what, then, is the appropriate diagnosis?

Eating disorders are disproportionately common in segments of the LGBTQ community. Disproving the myth that these illnesses impact only straight, cisgender people, research and personal accounts show that all sexual and gender identities are affected—and sexual and gender minorities perhaps even more so than non-LGBTQ people.

The LGBTQ acronym encompasses several distinct sexual and gender identities. It is an umbrella term that represents a group as diverse and varied as non-LGBTQ people, though often treated as a singular group. While we cannot generalize eating disorder experiences within the LGBTQ community—or outside of it—here we explore eating disorders in one segment: those who identify as lesbian, gay, and bisexual (LGB). These terms refer to sexual orientation, while “transgender” refers to gender identity. For more on eating disorders in those who identify as transgender, please read Eating Disorders in the Transgender Community.

Regular doctor visits are essential to a child’s and teenager’s overall health. These routine checkups are an opportunity to not only chart growth and development, but also to screen for a range of physical and mental health conditions, including eating disorders.

In fact, pediatricians and other primary care providers are often our first line of defense against eating disorders. Well-positioned to monitor ongoing health at well-child visits and other physicals, providers have a unique role in detecting and addressing any issues with food and body. Early identification of eating disorder symptoms can help prevent and interrupt the development of these serious disorders.