The large majority of people with eating disorders seem fairly well and functional on the surface. Although the physical and psychological effects of the illness are rampant, most people can engage in conversation, hold down a job or go to school and maintain stable enough connections in the world.
The juxtaposition of someone who appears well but actually suffers from a serious disease is confusing for many people. It contributes to the difficulty many have with believing an eating disorder is a life threatening illness.
To those unaware of the nature of eating disorders, recovery could easily just mean starting to eat normally, as if the symptoms are a choice. That's the primary misunderstanding which explains why it's so hard for laypeople to comprehend the nature of these illnesses. If getting well were a choice, eating disorders wouldn't exist in the first place.
What lies underneath the seemingly normal facade is a thought process that drives the eating disorder. These thoughts make it a powerful and destructive illness. Distinguishing between clearly delusional eating disorder thoughts and healthy thoughts is extremely confusing for people in recovery. The process of recovery is largely about learning to identify and ignore the eating disorder thoughts. However, disregarding thoughts that have structured daily life for years takes time.
For the purpose of this blog, I will call these thoughts delusional. Clinically, a delusion is a fixed false belief. In the case of eating disorders, a common delusion is, for example, "I can't be thin enough" or "this crash diet will finally stop the binging" or "I'm really fine even though I feel weak and dizzy" or "I'll just use laxatives one more time."
The next few posts will explain in more detail what the delusional component of an eating disorder entails and the process of learning how to ignore them and move ahead in recovery.