Treating eating disorders frequently leads to an existential conversation. There are many theories why recovery inevitably lands in discussions of the meaning of our lives. Nevertheless, the work of getting better apparently necessitates delving into why we are here.
In part, people with eating disorders are very coherent and clear in all other aspects of their lives outside of their own food and weight. The symptoms of every other psychiatric illness bleed into daily components of human life, but eating disorders are much more circumscribed. The result is that someone with an eating disorder can have a lucid, insightful conversation about their illness even when they are struggling to get better.
No matter how they start, eating disorders become the foundation of the meaning of life. Success is determined by the actions of that day: food eaten in the day, the number on the scale, avoiding food behaviors, the number of steps, to name a few. Or the eating disorders provide emotional needs not found elsewhere: comfort, companionship, guidance or praise.
Stepping away from an eating disorder and attempting to live without the feedback and direction the illness provides instantly leads to questions about what life means. The eating disorder provides clear answers about what makes life worthwhile. The immediate question is why else does life matter when the eating disorder begins to seem meaningless?
For most people, recovery cannot exist in a vacuum. People who try to change their behaviors, without any other part of life providing value, don’t see a reason to continue the hard work of recovery. They peek out at the world, perceive only emptiness and dive headfirst back into the disorder.
Successful recovery demands that other parts of life start to matter as well. As the eating disorder behaviors and thoughts recede, the person often finds they are drawn to focus on and think about these other facets of their existence. At first, that may mean broadly talking about what matters in life, but the transition is not fluid or easy and almost always torturous and challenging. Missing and grieving the distance of the eating disorder feels painful, and figuring out how else to live is complicated and confusing. It’s hard to start with no idea about how to live after having a guiding light one’s entire life.
These conversations need to give room for the uncertainty of our existence to remain a focal aspect of getting better. The existential nature of recovery is one we all find familiar. We all face the reality of our existence, and any therapist can identify with the fears of trying to find meaning in our lives.
Even more, the goal of thinness has a powerful place in generating meaning even outside of eating disorders. It would behoove us as a culture and country to rethink thinness as an accomplishment that gives meaning to our lives. A cultural phenomenon is now a capitalist boon to several powerful industries. We all need to recognize there has to be more to life than a number on the scale.
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