The Plight of an Eating Disorder Born before the Emergence of Treatment

People with chronic eating disorders who are age mid-40’s or older have had a very different course of their illness. Without access to treatment or even knowledgeable professionals when they were younger, they had to navigate their personal struggle on their own and find any way they could to survive.

The term eating disorder was only coined in 1973, and the first fledgling treatment modalities first appeared in the early 1980’s. However, more widespread diagnosis and treatment did not emerge until the late 80’s or early

90’s and even then only in certain urban pockets of the country.

Before then, the medical literature reports only a handful of perplexing cases largely attributed to profound neurotic complexes. The concept of a genetic or biological illness called an eating disorder was unimaginable. So the people with eating disorder flew under the radar: undiagnosed and untreated. 

People who developed eating disorders prior to the advent of eating disorder treatment found ways to cope and survive. Rather than learn about their illness start recovery, people rightly assumed this illness was their lot in life. In order to move forward, they coped the best they could and endured.

Now, later in life, some of those people have taken advantage of treatment programs but with little success. Residential treatment is aimed at young, newly diagnosed women and struggles to accommodate people with different backgrounds and courses of their illness. 

Even in outpatient treatment, these women need a different approach. Once an eating disorder has been fully incorporated into one’s identity and psyche, it isn’t easy to extricate it at all. Instead, treatment needs to adapt to the psychological reality of these women.

They have survived the all-consuming existence of an eating disorder without any prospect of help. Now, with the possibility of knowledgeable support, a clinician needs to table the idea of recovery and instead embrace the prospect of exposing the secret world of this illness in therapy. Just the step towards releasing the secrecy and sharing the details of this private world can be immensely helpful.

The goal in these instances is not the supposed panacea of recovery. Instead, treatment aims at debunking the myth that an eating disorder is a lifelong burden. Therapy can open the door to see an eating disorder as an illness that can improve with real support and help.