Earlier this week, I went on vacation for a few days. Many other vacationers were very friendly, engaging, and talkative, so I got to hear some beautiful love stories, travel experiences, and all sorts of interesting things.
During one of these conversations, one woman asked what I do for work. “I’m a psychotherapist,” I said, “I primarily work with eating disorders.”
“I wish I had one of those!” she exclaimed with a snide laugh.
Like many, I feel like I always have the perfect response … just ten minutes too late. But what is the perfect response to this?
I think I said something like, “Ehh, it’s not what you think,” but she started talking over me, saying something about how her daughters are always saying they think they’re fat.
I couldn’t shake it for awhile. My husband and I stood there talking to her for a few minutes about her most recent vacation, her kids, etc, but I was already shut down. I stayed (unusually) quiet.
Once the time was right, we ended the conversation and walked away. I took a moment to vent about her comment. How could she think that?! Doesn’t she realize that’s an awful thing to say? What a terrible thing for a mother to believe!
Then I realized she is not the problem.
I’ve been reading Brené Brown’s book “I Thought It Was Just Me (But It Isn’t),” which is all about shame. One of the most important things she says is that there is no evidence that shaming someone (telling someone they are bad) leads to change. There is, however, evidence that guilt (acknowledging that someone did something bad/wrong) can lead to change. Announcing to this woman that what she said is abhorrent and she should really think before she talks won’t change anything – in fact, it likely would have made her more defensive and shut off to what I had to say.
In fact, perhaps this woman is lucky in that she has not been directly affected by an eating disorder – either by having one herself or by watching a loved one suffer through the downward spiral of the illness. The problem here is that there is a societal misconception about eating disorders, and not enough education about the topic. Looking back, I wish I had given her more information, and said something like, “Yeah, the media sometimes makes it seem like eating disorders are just a quick way to lose weight, but really they can lead to deep anxiety and depression, and actually kill 10% of the people who have them. I have definitely learned a lot from working with people suffering from the disease – things I’d never realized before.” That way, I could have educated her, while also avoiding shaming her for what she’d said.
If you have ever thought “a little anorexia” could do you good, or heard someone joking that they have an eating disorder because they just “love french fries so much they could eat them all day!”, here are some reasons why an eating disorder is not something to be desired:
- Eating disorders have the highest mortality rate of any mental illness. This means more people die from eating disorders than from any other mental illness, often due to cardiac arrest, failure of other vital organs, or suicide.
- People with eating disorders often experience significant hair loss, dry skin, growth of lanugo (a fine layer of hair covering the face and body), weakness and fatigue, premature osteoperosis or osteopenia, stress fractures, tooth decay, low heart rate and blood pressure leading to heart failure, dehydration leading to kidney failure, swelling of the face and limbs, tears or even rupture of the stomach and esophagus, and many more uncomfortable and extremely dangerous medical side effects.
- Those struggling with eating disorders often experience substance abuse at a rate about 4x higher than those without eating disorders, as well as comorbid depression, anxiety, and suicidal thoughts and/or behaviors.
- Although I do not have a formal statistic to back this up, in my work over the past several years with people in recovery from their eating disorders, many have stated that their body image (perception of their own appearance) was worse when they were at their lowest weight. In other words, many actually felt worse about themselves when they were at their “thinnest” than when they were weight-restored (i.e. at their natural, healthy weight). This is often because the stronger the eating disorder becomes, the more it can hijack one’s brain into believing they aren’t good enough – or in this case, thin enough.
When someone says they “want an eating disorder,” they likely mean they want to lose weight. It is important to remember that those are two different things. That being said, 35% of “normal dieters” progress to pathological dieting, and, of those, 20-25% progress to partial or full-syndrome eating disorders. On top of this, 95% of all dieters will regain their lost weight in 1-5 years – so really, what is the point!? Instead of focusing on changing your body to feel better about your appearance, remember that there is a less common, yet much more effective option to improving your body image, which is to change your mindset. Find body positive role models in your friend group or community, talk to a therapist about your self-worth, do what makes your body feel best rather than what will burn the most calories, and eat foods that give you both nourishment and satisfaction.
It is also important to remember that not everyone with an eating disorder loses weight – some maintain or gain as a result of their behaviors. You cannot tell from looking at someone if they have an eating disorder. Instead of glorifying or dismissing the severity of eating disorders, remember that they are serious, life-threatening diseases that hold people’s minds captive, forcing them to obsess about food, weight, shape, appearance, calories, compensatory behaviors, and rigid rules all day. Rather than wishing we had eating disorders or could just lose a little weight, let’s focus on wishing away eating disorders – or better yet, fighting society’s obsession with weight loss and dieting so eating disorders can become a thing of the past.
Note: Although one of the diagnostic criteria for an eating disorder is fear of weight gain or of becoming fat, eating disorders are not only about weight and appearance.