When I look back on my time with eating disorders, I feel very bad for those who were around me. Sufferers from EDs tend to lock themselves inside little cupboards of denial. They are fine! They are healthy! If anything, other people have the problem. Penetrating these mental walls is very difficult — all the more so because these illnesses are so misunderstood.
Suffering often means suffering alone and it was this that first inspired the creation of awareness days and, as inflation inevitably happens with these things, weeks. So, although not everybody might be aware of it, this week is Eating Disorders Awareness Week, one of a diverse array of awareness weeks on the awareness week calendar.
There is clearly some value in such events. It is good for people to know that they are not alone and to have easy access to resources that might be of help. Still there are aspects of them — specifically those concerning mental health — which annoy me.
As writers like Jonny Gleadell have argued, modern discourse around “mental health” can pathologise quite normal behaviour. “Many issues have become medicalised,” Gleadell says, “No matter how far the symptoms are from meeting the threshold for diagnosis.” Professor Joël Billieux and colleagues suggest in an entertaining essay on overpathologisation that by the loose standards of some mental health scholars, we could diagnose them with “Research Addiction”. The market for shouty headlines about crises and epidemics ensures that this kind of sensationalism finds a home.
At its worst, this can provide a smokescreen for miserable, fixable material conditions. As students have been confined to their grief holes in British universities, for example, doing seminars online and thinking of the money they will have to spend for the privilege of having been there, we have heard a lot of talk about protecting their “mental health”. But this threatens to conflate a symptom with a disease. One trainee psychiatrist wrote, “I’m struggling to find the mental illness here. There’s no DSM code for being locked in a cupboard. CBT worksheets aren’t going to let students hug their parents again.”
Another problem is how simplistic the messaging can be. There is no doubt that British institutions need a renewed focus on eating disorders as experts warn of a “tsunami” of urgent referrals, and there is no doubt that the loved ones of people who might succumb to anorexia, bulimia et cetera should be aware of warning signs. But the valuable goal of communicating this demands some awareness of their complexities. “Awareness” is not an instant revelatory experience. It takes time and thought.
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Absolutely!
I think a lot of it actually is. Maybe the ‘changeling’ was so full of self loathing with a total lack of self worth that swapping gender is an easier and less painful (read fatal) form of suicide?
Also an interesting comparison to note the upsurge in reported gender dysphoria recently with a similar upsurge in eating disorders in the 80s. Both very strongly found within teenage girls. Social contagion?
Very helpful and insightful article into a terrible condition. As you say people who feel they have little control over their lives can at least control their eating, which in itself gives them a mental boost, but then can lead down a vicious spiral.
The article isn’t only about anorexia. Strikes me that bulimia and binge eating are characterised by a complete loss of control wrt eating.
Excellent article and all (by my experience with others who suffer anorexia) nailed on the head. Serious question though what about those who pile tremendous weight on using the excuse of ‘comfort eating’. Is this the flip side of the same coin maybe?
no, its something quite different apart from the common denominator of underlying psychological issues, just very different ones.
Disordered and compulsive eating is a process (or behavioral) addiction – whether it’s binging/ purging bulimia, or anorexia or overeating to the point of obesity. And yes, I agree w/the author that no addiction can be reduced to some simple or single causality; it’s by nature a complex disease that affects mind, body and spirit.
The cultural emphasis on escape mechanisms as a good (like ‘perfected body’, glamorization of alcohol and drug abuse, elevation to a social good of winning at all costs, looking good on the outside, etc.) aren’t causations of addiction, but symptomatic social reflections of addiction.
These cultural signs and symptoms of addiction can become conflated w/addiction itself, causing serious confusion for not only the addict, but for those who inadvertently enable the addict by confusing symptoms of addiction – such as winning at all costs – as signs of good health and not of sickness.
Which is one of the reasons that people who successfully deal w/healing from addiction find spiritual transcendence – which enables the practice of values that contraindicate the deadly selfishness of addictive behavior – invaluable.
“real” anorexia is not “caused” by social media, celebrity fascination, etc, it is a very individual problem, far more common in early adolescent girls, and can persist long into adult life.
in young girls, the underlying psychological issues have a lot to do with fears around growing up and the implications that has for a young girl. True anorexia usually is not just significant weight loss, but is accompanied in young girls often by periods stopping, loss of the body hair characteristic of a developing young woman.
overeating usually is related to stifling inner feelings of anger, rage, that are soothed by food, especially sweet food,
it is not genetics that is the influence – but it is family behaviour that children pick up at a very early age that is a significant factor.
even “world renowned” psychiatrists make this mistake, confusing things that are genetically inherited – with behaviours that are passed on within a family, and so poorly trained psychiatrists and mental health workers taking a “family history” and a person says “yes, my mum, dad, uncle, aunt, etc, had this problem” jump to the incorrect conclusion that it is a genetic trait – rather than a behaviour picked up in early childhood.
obese parents have obese children – not because of genes or fat cells, but because their behaviour pattern is to overeat to stifle uncomfortable emotional feelings – and don’t even know that is what they are doing.
As I say to people, the “best” or worst “experiments” proving the truth of this have been the concentration camps, there are no fat people in concentration camps, doesn’t matter how many fat cells you have, or whether your parents were obese, on a starvation diet you will lose weight,