Why People with Eating Disorders are Experts on Nutrition

A common misconception about people with eating disorders is that they don't understand basic nutrition.  This confusion leads not only to misunderstandings but to mistreatment and even condescension to people with these illnesses. 

The crux of an eating disorder is the inability to eat food through the day and to allow one's body to digest food regularly. Feeding oneself is an automatic activity for everyone else, as basic as taking a shower or going to sleep, but that mechanism is broken for someone with an eating disorder. 

When people who eat without difficulty try to understand what has gone awry in an eating disorder, it's very difficult to wrap their mind around the basic concept of the illness. Accordingly, they assume that the problem lies in concerns they themselves struggle with, such as the health benefit of food choices or portion sizes of meals.

It's more apparent to people in general that education about nutrition might solve the problem rather than realize the issue is something much more profound. 

The reality is that people who struggle with eating disorders actually know more than almost everyone else about nutrition. In fact, nutritionists who specialize in treating people with eating disorders know that education is not their primary role in treatment. Their goal is to help someone in recovery relearn how to eat meals and snacks throughout the day while avoiding the pitfalls of eating disorder behavior patterns. 

People with eating disorders, desperate to find a path out of their illness, often obsessively research nutrition. Many of them end up studying nutrition and become excellent clinicians because of their depth of knowledge. Their hope is that a vast amount of knowledge might counteract the eating disorder enough to help speed up recovery. 

Sadly, this information may be useful but does not contribute much to recovery from an eating disorder. 

The rules and behaviors of an eating disorder don't follow logic or reason. It will never be reasonable to starve oneself through the day, eat an enormous amount of food at once, regularly purge one's food or overdose on laxatives to lose weight. The driving force for these behaviors is the illogical but powerful thought pattern of the illness.

Combatting the thoughts of an eating disorder with reason and education will never work. 

I have written many times that compassion, kindness and understanding are the centerpieces of treatment for an eating disorder and for the support one needs from family and friends. This is a far cry from nutrition education, and for good reason. 

People with eating disorders suffer from a punitive, strong internal thought process that makes them feel horrible about themselves. The origin of these thoughts is different for each individual, but once the person is trapped in a cycle of starvation and illness, the thoughts intensify and dominate their lives. 

It's much more logical to combat a punishing thought process with kindness and compassion rather than with nutrition facts. After one understands the facts of these illnesses, the best way to help becomes much more clear.

Recovery is not a matter education about nutrition. It's a combination of learning new ways to manage food in one's life in an environment of kindness and compassion.

The Hard-Line in Eating Disorder Recovery

A common question from families, parents and loved ones about how to support someone in recovery from an eating disorder is about the type of support that is best to offer. After extended periods of illness, many people believe a hard-line approach will be helpful, one that emphasizes eating at all costs. They hope that standing their ground will enable the person to make the harder choices needed to get well. 

But often this kind of support represents frustration more than the compassion the person in recovery desperately needs. 

Given the choice between this type of support and the eating disorder, most people don't feel like they have a choice. The eating disorder is a way of life and has dominated every decision of every day for a long time. It provides comfort as much as it does misery. In the absence of other comfort, it feels like the only option. Just standing firm won't change an illness. It will just alienate the person who is unwell. 

Plus, families typically understand their loved one very well but don't understand the intricacies of the eating disorder thought process quite as well. The emotional bond of a close relationship remains important despite the illness but is not enough to lead to a magic cure. Instead, the person feels worse about the personal relationships but no more empowered to get well. 

The best support remains boundless love and compassion. This is not easy for even the most patient person to maintain through years of illness and recovery, but no one battling an eating disorder ever tires of that kind of support.

It inevitably creates a level of connection that sustains a person struggling to get well. Moreover, love and compassion send a clear message of believing the person can get well. That is invaluable. 

However, standing firm does have its place in the recovery process. The treatment team has a responsibility to assess the person at each step of the way. After a period of learning about recovery and learning how to face the eating disorder thoughts, most people get stuck. They can see the steps of recovery ahead of them but often back down out of fear of many things. 

It can be fear of getting well and the expectations that might come when the illness is no longer a crutch. It can be fear of losing the eating disorder, something that has defined identity for many years. Or it can be fear of gaining weight and looking healthy so that people stop worrying about their well being. Although these fears are the most common, there are many more. 

At this point, the treatment team has a responsibility to stand firm that it is necessary to take those steps forward in recovery. All these fears are present, but they cannot halt the steps towards getting well.

Years of illness have proven that life with an eating disorder is only a shell of a life. That is not enough. 

What the family needs to do is trust the treatment team, their loved one and the process of recovery. Taking recovery into their hands inevitably backfires, but family can provide love and support in ways no one else can. Love and compassion will be sustaining after recovery is finished and present the building blocks to life after recovery. That support plays a crucial role in treatment and allows the team to play its role as well.