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Eating Disorders: It’s not about the food!

Lisa Tretta Brugger, LMFT
September 14, 2009

In my work with women with eating disorders, I often hear concerned parents, partners, and spouses ask questions about the food. “Why can’t she just eat like a normal person?”, “If she just ate, everything would be fine!”, “What if she only ate healthy food instead of junk food?” Contrary to what we learn in the popular media, an eating disorder is not really about the food at all. While the behavior with food is indeed one of the primary symptoms providing clues that someone is struggling with an eating disorder, the behavior with food is not the reason for the eating disorder.

Often, there are multiple factors contributing to an eating disorder (i.e. stress, anxiety, trauma, and relationship issues). More importantly, the key ingredients underlying an eating disorder are the emotions and how we attempt to deal with or avoid them. Essentially, people with eating disorders “act out” their emotions through their behavior with food (i.e. restricting food, binging on food, purging food). While the origin and development of an eating disorder is unique to each person’s life story, there are common themes that tend to precede its development.

Disordered Thinking: Eating disorders often begin with “disordered thinking” before they evolve into disordered eating. Therefore, the way we think about topics such as food and weight are helpful clues to whether one has “disordered thinking.” Women with “disordered thinking” tend to get lost in messages about food and weight and develop unrealistic expectations about what they should eat and how much they should weigh. Food may begin to be labeled as “good “versus “bad.” Specific body shapes and sizes may begin to be designated as acceptable versus unacceptable. A negative view of one’s body often develops.

Unbalanced Relationships: Many women with eating disorders tend to act similarly in their relationships with people as they do in their relationship with food. Some women tend to stuff or restrict or hide their feelings from others. Later, these feelings may be “purged” in a big explosion of anger. Other women may express their feelings often, even inappropriately at times, needing to constantly “fill up” or “empty.” Most importantly, they tend to have interpersonal relationships where the giving and receiving is not equal - where they take up too little or too much space in the presence of other people and have difficulty finding a reciprocal balance.

Low Self-Esteem: Women with eating disorders often have a low sense of self-esteem and self-acceptance. While the reasons for low self-esteem and self-acceptance can vary, these women often feel like they are “not enough” or “too much” of something. Sometimes their efforts to be “enough” can take on perfectionist tendencies in other areas of their life, including food and weight. Often times, this sense of low self-esteem and self-acceptance can be seen in their negative body image, where they find that their bodies do not have “enough” or “too much” of something. Essentially, their body and their weight evolve into becoming a measure of their worth.

Developmental Transitions: Eating disorders tend to develop around times of developmental transition or major life events. Situations that involve change or create anxiety can be overwhelming (i.e. puberty, transitioning to high school, transitioning to college, marriage, and divorce). When developmental transitions occur to women who have difficulty managing their emotions, the added change can be stressful enough to disrupt one’s previous way of functioning. Being able to focus on something in which they control the degree of change, such as food intake, can provide a level of comfort in times of turmoil.

If you or someone you know appears to be struggling with an eating disorder, think about how one or all of these themes relate. Eating disorders do not evolve because a person has issues with food. They evolve when a person is struggling with unresolved issues. But please know that help is available. Please continue to educate yourself and/or your loved one(s) and seek out appropriate assistance.

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Lisa Tretta Brugger, LMFT is a Senior Staff Therapist in CFR's Paoli, Lionville and Concordville offices. She can be reached at 610-594-9808 ext. 2.

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