How to Fight the Positive Feelings about an Eating Disorder

Unlike most psychiatric disorders, eating disorders become a comfort and source of pride to many people. Patients feel sick and miserable when trapped in their eating disorder yet often feel a sense of accomplishment from the idea of mastery of food and weight or pleasure in how they eat. Moreover, they often get a sense of relief and comfort from their symptoms that can be hard to replace.

A strong emotional attachment to an illness is unusual. It’s to be expected that almost always people want to get better from their illness. The ambivalence and identification with eating disorders makes them unique among mental illnesses.

Successful treatment cannot solely focus on managing symptoms and finding new ways to cope with stresses in life. Creating new eating patterns and countering the thoughts of an eating disorder also remain central. However, even these goals may only lead to temporary recovery. Something else needs to create enough motivation to fight against an illness so wrapped up in one’s pleasure and identity.

The last piece of recovery is finding an anchor in the real world. Specifically, someone with an eating disorder needs to identify at least as strongly and maybe more strongly with a desire or goal in their life outside the illness. This goal needs to be impossible to achieve while the eating disorder is dominant.

The conflict between this goal and the eating disorder forces the person to choose between life and the illness. Instead of arguing with a therapist about getting better, the conflict is now internal.

The external goal can be having a family, maintaining an intimate relationship, being physically well enough to achieve a goal or raising children. The goal must be of supreme importance to the person and driven solely by their own needs.

No therapist can help a person find these goals; however, a therapist can identify and reinforce that this goal really is important. The eating disorder thoughts can be so demoralizing and render the patient helpless, but support to remember the goals are achievable will make this conflict feel very real.

The other aspects of recovery are still just as important. However, internalizing the conflict by having real goals in life that cannot exist with the eating disorder opens the door to fill recovery.