Why Eating Disorder Recovery Must Focus on Being a Person, not an Illness

Often people with mental illness describe that they feel invisible. They experience being treated as an illness and almost as a deficient human rather than a real one.

Interestingly, newer lay terminology refers to “my anxiety” or “my depression” as a way to exert ownership over symptoms while separating and learning about one’s identity. The downside of the shift in language is to confuse ownership of symptoms as a core part of oneself, not a manifestation of mental illness or even just the human experience. People tend to conflate “my” psychiatric symptom with who they are.

Those with eating disorders experience even more powerful forces to lose their identity completely. In a world where food and weight already replace other forms of identity, there is little room to find oneself outside one’s body to start off.

In addition, eating disorders often substitute for identity as a form of both achievement and coping skills. It’s hard to replace such a powerful way to exist in the world despite the personal cost of having an eating disorder.

Last, treatment providers talk a lot about people with eating disorders as if they are the illness themselves. They indicate that any opinion or belief the providers disagrees with is an “eating disorder thought.” The effect of disregarding a person’s thoughts and feelings leaves no room for someone to be themselves or learn about themselves. This interaction only confirms the eating disorder as one’s identity.

I frequently note that the people who are the sickest and who have been struggling the longest despite adequate care have had no space to be themselves. The lack of room to freely and safely express one’s thoughts leads to an imperative to stay hidden and protected by the eating disorder. The symptoms provide a shield against their own feelings and others’ demands—a modicum of safety in a very threatening world.

Despite best efforts to monitor medical symptoms and lab results, to offer higher level of care or to show an overarching interest in weight restoration, standard eating disorder treatment often falls flat. Without any desire to listen to the person and what she has to say, there is very little chance of getting well.

People with eating disorders are still people. What they think and feel matters greatly. In order to go through the struggle to get well, they need to know that people around them see them and value them as individuals. There is no point in getting better to just be a shadow of a human being. The goal is to become truly oneself in the process.