Why are People with Eating Disorders Blamed for their Illness

Another component of eating disorders that differentiates them from other mental illnesses is blame. More than every other psychiatric problem, people with eating disorders are routinely blamed for their illness and their inability to get well.

Not just family and friends but even clinicians often tell the person to just eat a sandwich or drink a milkshake. The lack of compassion and limited inclination for people to even try to understand eating disorders are so powerful that it’s hard not to look for other reasons to explain hard-hearted responses.

Eating disorders are contradictory for most people. Eating is a basic component of living, not far behind breathing and sleeping. It’s anathema for people to conceive of a world in which they willfully don’t eat or purge food in some way. The instinct to tell someone just eat a sandwich comes in part from the incredulity that a person would do otherwise.

However, that reaction makes sense the first few times a person tries to understand an eating disorder. Why would family and friends continue to say the same thing months and years later? How can experienced clinicians repeat the same mantra to eating disorder patients?

Another part of the confusion is the dearth of successful treatment. Medications, by and large, are ineffective. Therapies are specialized and take a long time to have a significant impact. Moreover, not enough clinicians are experienced in treating people with eating disorders even though many people profess to have that expertise.

The decades of social pressure to be thin and diet has glamorized eating disorders. On the one hand, many people in general see an eating disorder as a prolonged successful diet. Few understand the psychological torture of the illness. On the other hand, the cultural zeitgeist professes that once someone has an eating disorder, they always will. It’s a life sentence. The concept of full recovery is one most people have never contemplated or even heard about.

All of these aspects of eating disorders leave the public with the sense that eating disorders are the person’s fault. The final blow in this scenario is that the blame ultimately disempowers the person, usually a woman, from feeling like she has any ability to get better. Since recovery involves a constant, daily fight against the disorder while attempting to tolerate the discomfort of changing an automatic behavior pattern, the blame undermines a chance at getting well.

It behooves family, friends and clinicians to scrap the assumption of blame. Eating disorders are true illnesses. The sufferers need and deserve support, comfort and compassion.

Connecting Eating Disorder Recovery with Women’s Emotions and Power

The first part of eating disorder treatment is typically focused on normalizing eating and implementing a meal plan. Regulation of food and nutrition allows the body and brain to receive adequate energy to heal and function normally again.

The second part of treatment is amorphous and more complex. The last several posts highlight, on a larger scale, how the suppression of girls’ and women’s emotions and anger is very much related to eating disorders. Thus, it’s not coincidental that recovery focuses on identification and expression of those suppressed feelings along with exploration of someone’s true identity once the eating disorder is no longer the only driving force in her life.

The true engine of an eating disorder is the obsessive, persistent thoughts about food and weight. At its worst, an eating disorder so dominates one’s mind that there is no room for all the thoughts, feelings and experiences that come from living life. Once the eating disorder thoughts begin to dissipate, the mind almost feels blank and people often find themselves longing for the old thoughts to occupy all the empty space.

It doesn’t take much encouragement or living to bring up new and different thoughts and feelings. They come automatically just by living in the world. However, the experience of true reactions to the world can be overwhelming after having been sheltered for years behind the wall of the eating disorder.

Fairly soon, the new feelings land on anger and often this anger relates to the ways in which the person has been suppressed, oppressed or kept down in some way. The reaction and feelings can be very overwhelming yet the path to recovery has to go through those very real and valid feelings.

In the context of the recent posts, this step in recovery represents the idea that eating disorders have become the newest psychiatric disorder that pathologizes girls’ and women’s emotions. The goal of recovery isn’t just to help people eat and live their lives again. The goal is to open the door to living fully and freely, including the ability to express all of one’s feelings in the world.

Anger as the Engine for an Eating Disorder

At the emotional root of many eating disorders is suppressed feelings, most commonly anger. For people taught at a young age that anger is not an acceptable emotion, food is an easily found, effective and socially acceptable way to manage emotion.

Indulging or overeating, secreting food or binging and restricting all help transform emotions into behaviors that either express feelings or numb them. As society continues to reinforce these behaviors as a viable alternative to acknowledging feelings, we collectively increase the likelihood of triggering eating disorders in those who are susceptible.

It’s also not a coincidence that most people who develop eating disorders are girls or women. As evidenced by the recent political events, anger in women is taboo in our culture. Women who express their anger are most often called names or vilified until they are able to control and channel their anger. The reality of human emotion is that no one can tamp down anger indefinitely without repercussions. 

Pushed into a corner where the reality is either express unacceptable anger or repress it, women often find themselves focusing on food behaviors or body shaming as a coping tool. The general pressure on women to eat and look a certain way only reinforces the behaviors as appropriate and meaningful. As I have written many times in this blog, the main risk factor for developing an eating disorder is food restriction or dieting, and using food behaviors to manage emotion is a first step to possibly developing an illness.

One hope I have behind the growing movement towards equality of women in the workplace and culture is the freedom for women to express their emotions, especially negative ones. Being trapped by their own feelings leaves women unable to embrace their full self. Subjugating their beliefs, thoughts and feelings for the meaningless obsessions with food and weight is a waste of time and energy. The goal is for girls and women is to be their true selves and not get lost in the inanity of an eating disorder.