The Social Isolation inside an Eating Disorder

Discussion among clinicians and patients about eating disorder treatment focuses necessarily on meal plans, health, treatment programs and behavioral change. What seems to be sidelined too regularly is the social and emotional isolation of these illnesses. In many ways, people with eating disorders end up feeling very alone and need help learning how to connect with people and build a life with relationships with people and not focused on their relationship with food.

Eating disorders may appear to be largely behavioral, but the crux of the illness is psychological. The pervasive, loud and dominant thought process of an eating disorder affects not just thoughts about food and weight but all decisions each day. Being able to choose foods that feel safe, exercise or limit time in the world to be sure no eating disorder rules are broken are the pillars of an eating disorder.

Notice what is ignored through these decisions. People with eating disorders don’t even consider friendships, relationships or true interpersonal connection. Even if they have friends and spend time with people, they universally talk about feeling alone and not having meaningful connections in their lives. Despite the yearning desire to connect, fear of breaking the eating disorder rules precludes ever prioritizing personal relationships.

The first connections that help people recover often begin in treatment. A strong bond with a clinician allows the person to remember why caring, close relationships matter. In the process of getting help for the eating disorder, patients also remember how to connect with another person and how those connections mean so much more than the eating disorder rules.

True recovery must include reconnecting in the world and forgoing the eating disorder in the process. Behavioral changes themselves may improve health and well-being, but they are not recovery on their own. People who get well relearn how to be fully in their lives and find value in other people and meaningful actions in the world, not the empty successes of food and weight.