Delusions of an Eating Disorder

Some recent posts have focused on the medical issues inherent in eating disorders. Classifying these illnesses as psychiatric belies the reality that disruptions in eating patterns trigger significant medical comorbidities, some obvious like vitamin deficiencies or osteoporosis, others less so like renal dysfunction or endocrine abnormalities. 

The classification system for eating disorders elucidates the more obvious psychological symptoms of these illnesses: feeling fat, the overwhelming need to restrict intake and the urge to lose weight no matter what cost. The sad reality of our current societal norms is that many people who don't have eating disorders espouse these beliefs, at least on the surface. 

The plethora of unrealistic, if not harmful, diets, cleanses, and reality weight loss shows points to the fact that eating disorders are only a step past what's considered perfectly reasonable in this day and age. It appears that the unlucky few who are genetically programmed to respond differently to an extended period of food restriction or overexercise cross the line into a disorder from the more typical disordered eating. The acceptance of disordered eating puts the susceptible ones at risk, but the drive for thinness makes those who get sick necessary casualties to satisfy our collective obsession. 

Despite the communal experience of food and weight, there are some psychological thought processes of eating disorders that step past what is considered reasonable and can even be seen as delusional, a fixed belief that is clearly false but unwavering. These thoughts often reside in the eating disorder of someone who is otherwise very practical, clear-headed and logical about life, someone even whom others seek out for guidance and advice. However, buried deeply under the rational facade is a host of thoughts about food and weight that is nonsensical and clearly untrue but guide that person's daily life. 

In these symptoms, the psychiatric nature of an eating disorder is abundantly clear. 

Common symptoms tend to involve the same basic premise that food is somehow detrimental for one's health and well-being. This thought process extends past a fear of foods, an idea that many diets and ill-advised nutrition research advocate, towards the attribution of an almost evil purpose to food. As that belief becomes more fixed, the natural response to avoid food and to feel that eating will jeopardize one's well-being is a natural, logical step. 

Once food is seen as the enemy and harmful, convincing someone that this thought is patently false becomes very challenging. It is so antithetical to people without eating disorders to view food in this way that someone with this kind of eating disorder seems very foreign and lives life very differently from other people and in fact differently from people with eating disorders who don't have these delusional thoughts. 

The process of realizing these thoughts are false takes time but is very possible in successful treatment. It's clear that other people don't view food in this way and that approaching food, something commensurate with healthy life, as harmful makes one's daily existence very difficult. There is a learning process to change deeply rooted behaviors associated with the delusion, but sustained challenges to old thought patterns can be very effective. 

These delusional thoughts are part of an illness. Even though they are not logical and clearly untrue, they render an otherwise thoughtful, kind and caring person seemingly very unwell. However, these illogical thoughts are circumscribed solely to the experience with food and don't take away that person's value as a human being. Even the most confusing parts of an eating disorder cannot take away the humanity and empathy of the person underneath.

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