Eating disorders are increasingly becoming a problem in our society. Either people eat too much leading to obesity or restrict their eating to dangerous levels in the case of anorexia. There are also many people who although at a normal weight are bing eating and vomiting on a frequent basis. Obesity, anorexia and bulimia are highly destructive and can be related to relationship problems, depression and high levels of stress.
The first step to recovery from eating disorders is to understand something about how they develop. This is a somewhat complicated area. There is certainly pressure in society for women and men to look a certain way and this is connected with images of wealth, success and and popularity. However in my experience as a specialist in this field there is more going on within the person that makes them vulnerable.
One issue that seems fundamental in any form of eating disorder is how the person manages stress and anxiety. This can be triggered very quickly by anything that threatens the person’s view of themselves which is often unrealistically perfectionistic.
When anxiety is triggered in someone with an eating disorder their brain labels this stress as completely unmanageable. Almost as if it was life threatening. And this labelling is indiscriminate and often out of proportion to the situation itself. The brain responds to this threat by immediately going down a well trodden path. This path is what could be described as the eating disorders response. The EDR mislabels the experience of anxiety as an issue to do with the body rather than the mind. Either the body is too fat, or too empty. Therefore the ‘obvious’ solution must be to get rid of the ‘fat’ by vomiting or starving or filling the void with binge eating. Both of these responses have the effect of dulling the original anxiety and making the brain forget what triggered it in the first place.
This pattern means that to recover from an eating disorder the first place to start would be the response to anxiety rather than trying to control responses to food, for example going on a diet. This is why diets don’t work for people with obesity issues because they can increase the stressful feeling of being deprived. This stress then becomes a trigger for increased eating.
The first thing to say is that recovery from an eating disorder is not usually smooth. There are often lots of ups and downs. Its very important to be kind to oneself in this process and learn to accept that a setback is not a catastrophe. Over the years of working with many clients I have developed some key principles that seem to be crucial for recovery.
The process I described above happens so quickly that most people have no awareness of their brains tendency to switch off anxiety by diverting into eating/ food preoccupation. So its important to slow everything down. This process means being more mindful and observing of what the stresses are. Looking back at what has triggered a ‘symptomatic’ episode of eating or food restriction. This takes some practice and it is helpful to give around 10 mins to this a couple of times a day. To as it were check in with yourself and scan through the body to see where the points of tension are. To notice any anxious thoughts. Cognitive therapy makes the helpful point that ‘we are not our thoughts’. Often a person may feel quite overwhelmed by negative and stressed thinking. However, simply observing and noticing these things without reaction can be incredibly helpful in reducing stress levels.
Usually when people struggling with eating disorders start to notice their own worried thinking and patterns of reaction to stress they can start to consider other options. This is a crucial part of recovery. People are used to being hijacked by their fears and compelled to eat or starve or vomit as the ‘only’ solution to the terrible feelings. Becoming more self-aware enables people to firstly engage with the actual trigger that set of the fear response. This may be as simple as someone saying something that they interpreted as critical or hurtful. It may be a line of negative thinking that got reactivated. Once these triggers come to light, the person can see the issue in greater perspective and consider alternative responses.
This may include finding new ways to communicate with others, including asking for help. A feature of eating disorders is often a high degree of self- sufficiency and a sense of shame at having to show ‘weakness’. So learning to accept and express vulnerability is very important.
Developing greater compassion for self and for ones own vulnerability is crucial if the perfectionistic drive seen in many with eating disorders is to be diffused.
At a practical level it can also be useful to find activities and interests that channel a persons energy into more creative expression. Many find writing, painting or making things is a useful outlet for trapped anxiety.
There is more that can be said about eating disorders and recovery but I hope this gives a helpful introduction into this complex area. If you struggle with any of the issues discussed here you can get in touch with me to arrange an initial consultation.