Eating Disorder are About Not Being Heard

Eating disorder treatment is split between an academic and clinical focus. Research tends to look at assessment tools and perfecting diagnosis. The clinical treatment field is overwhelmed by the capitalist drive to turn a profit using health insurance payments. Individual outpatient treatment increasingly rests on virtual practices with clinicians limited in knowledge to treat people with eating disorders. The result is a wide ranging, disparate and unfocused way to help people looking for support and guidance.

Nowhere in this landscape is there a focus on the psychological and physical wellness of people seeking help.

People don’t get well using the criteria currently in vogue for assessment. So much of the focus is still on weight, daily judgment of food intake and regular threats of “higher level of care” when clinicians feel overwhelmed or frightened of a patient who doesn’t get better in a timely fashion.

People with eating disorders, for the most part, don’t feel heard or acknowledged in our society. They feel isolated and ostracized. They know they either need to fit into the box determined by external forces or be left on the sidelines.

The eating disorder, in one form or another, serves the purpose of getting the attention of those around them either by changes in their body or in their behavior. As much as treatment may be misguided and unwarranted, acknowledgement of the eating disorder expresses one’s displeasure and anger about the world in which they are trapped.

What is critical to note is that each individual does not choose this path. No one says they want to protest so they develop an eating disorder. Almost everyone falls into the eating patterns as a reaction to circumstances, experiences a beneficial physiological and/or psychological benefit and subsequently finds that they are trapped in the cycle.

Society is obsessed with thinness, so restricting food is encouraged in all communities, and these new eating patterns provide a form of expression that is otherwise ignored. Clinical research will show the genetic predisposition to eating disorders or the risk factors, but these data are not contradictory to the societal meaning eating disorders have in our world.

Attention to the individual person and their thoughts, feelings and desires can create a path for a meaningful life not lived solely through eating and weight. Similarly, opting for treatment which explicitly values the individual over food and weight will open a humane path for life to change and create a way for the person to learn to trust herself at the core.

Time and again, patients tell me that my belief in them and willingness to see them as an individual, no matter their eating patterns or weight, created the possibility for change. Ultimately, understanding people with eating disorders means understanding them fully. They are people suffering who only need someone willing to listen.