People engaged in recovery from an eating disorder comment on how personal and how philosophical the process is. They marvel at their internal growth and maturation and at how their view of themselves and the world has transformed.
In the same breath, they often ask why eating disorder recovery needs to be this way. If eating disorders are largely destructive behavioral patterns, why can't behavioral treatment lead to health and wellness?
The answer lies in the fact that ingrained food behaviors tap into our basic human drive for survival. Accordingly, deeply rooted food behaviors function within the oldest and least conscious parts of our brains, parts we share with much more primitive living beings. And so once food behaviors are fixed, changing them becomes overwhelmingly difficult. The patterns exist in the least accessible parts of our psyche.
As I wrote in the last post, once the survival instinct transitions to diet and weight management, it starts to feel as if maintaining a certain weight is as urgent as our survival. Once that instinct is triggered, changing the association is very challenging.
The key to creating a meaningful life, one not dominates by the endless search for the perfect diet, exercise plan and weight, lies in the most successful eating disorder treatments. Although the severity of the medical and psychological risk is much greater for people who suffer from these illnesses, the methods used to change profoundly ingrained food behaviors are relevant for both.
The medical or purely practical approach to treating people with eating disorders is hardly ever successful. Short-term improvement in health belies the course of the eating disorder. Inevitably, the eating disorder thought process hardens when someone is forced to make behavior changes. It may appease clinicians to blame the person for her illness in this situation, but the clear problem remains in the treatment decisions.
Treatment directed towards a fuller recovery combines refeeding and improved health with a consistent message of creating a meaningful life. Using our conscious brains to introduce and reinforce the need for useful activities, important relationships and intrinsic personal value creates a foundation to combat the eating disorder thoughts.
The psychological process of recovery involves replacing the old eating disorder thoughts about food and weight with a new philosophy focused on meaning and relationships. As the new philosophy strengthens, the old eating behaviors lose steam and normal food patterns dominate.
Applied to the general world focused on weight and appearance, the message that dieting doesn't work is too practical. There is no personally meaningful voice or system to replace the incredibly powerful diet, food and exercise industries. It's not a surprise that even those fed up with living their life for weight loss turn to Bariatric surgery for relief rather than a compassionate and kind approach the identity and life.
The messages competing with the seemingly perfect life of diet and exercise need to find their way into our daily awareness to be effective.