Eating disorders affect more than 30 million people in the United States; millions more have disordered eating or related issues. From emotional eating, to body image issues, to orthorexia (a fixation on “clean” eating), to diagnosed Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, or ARFID (Avoidant-Restrictive Food Intake Disorder), we are a nation with a very problematic relationship to food, self-love, appetite, emotional and physical nourishment and self-esteem.
Why is it such a problem? One thought is our society’s persistent bias toward thinness, and methods to achieve thinness, are so accepted. Scroll through any social media or pick up any publication and you will likely see “ideal” and often photoshopped bodies represented alongside diets, fasts, and other behaviors that promote disordered eating.
Why do we have such perfectionism aimed at our bodies? The answer is complicated, but I believe it has much to do with finding a place to enact control — to counteract shame when we feel a loss of control — both personally and on a societal level. Perfectionism and shame go together.
Women account for over two-thirds of eating disorders; men are affected in large numbers as well, and those numbers are growing. It starts early and moves through the life cycle — 42% of 1st through 4th grade girls want to be thinner. ARFID is thought to affect 3% to 5% of all children. Approximately 10% of all college age women have a diagnosable eating disorder. And 13% of women over the age of 50 engage in eating disordered behavior. Concurrently, nearly 30% of people with binge and purge behaviors also engage in cutting or other self-harm behaviors.
Eating disorders have the highest mortality rate of any mental health disorder, yet only 1 in 10 seek out treatment. Every 60 seconds, an individual dies as a direct result of an eating disorder.
There is help for eating disorders.
• Educate yourself. The National Eating Disorders Association, or NEDA, has a wealth of information, here.
• Screen Yourself. Here’s a screening tool to determine if you have an eating disorder. (T/W – many screening tools do require you to put in your height and weight to assist in assessing).
• Check yourself. Develop a critical eye toward what our culture is selling you. Remind yourself that media is in large part designed to sell products, and a following or readership with low self esteem is highly motivated to buy diet related products.
• Become Shame Aware. Much of disordered eating is rooted in shame and it’s twin, perfectionism. Watch this TED talk by Brené Brown which speaks to shame, perfectionism and vulnerability. Also, I highly recommend her books, especially The Gifts Of Imperfection, Daring Greatly, and Rising Strong. You can find a mental health specialist trained in her methodology (I’m one of them!) here.
• Read books on eating disorders. I recommend Geneen Roth’s books, especially Feeding The Hungry Heart, When Food Is Love, and Women Food and God. Another great book is Life Without Ed by Jenni Schaffer and Thom Rutledge. For families and friends, I recommend Surviving An Eating Disorder by Siegel, Brisman and Weinshel.
• 12-Step, Overeaters Anonymous. Contrary to the name, OA is not just for people concerned with overeating; it’s also for anorexia, bulimia, food addiction, or any type of eating problem. 12-step programs are a great tool and wonderful companion to therapy.
• Nutritional Counseling with a nutritionist or other medically trained person who is educated, aware, and sensitive to the psychological aspects of eating disorders and disordered eating. Not all helpers are! Ask for recommendations, ask for what you need, and trust your gut. That goes for mental health and wellness counselors as well:
• Counseling/Therapy with a therapist skilled in and sensitive to dynamics around body shame, body image, control, disordered eating, and eating disorders. Again, ask for recommendations for someone skilled, interview more than one therapist, and trust your gut. One powerful modality for working with an eating disorder is Internal Family Systems work. You can find an IFS-trained therapist here.
If you are currently struggling with disordered eating, please don’t delay in getting help. If you feel you are in a crisis, please reach out to one of these hotlines in this link (not just for bulimia, despite the words in the link). If you don’t want to talk, you can use the text crisis line, which is here and here: Text CONNECT to 741741.
