When It Comes to Eating Disorders, Do We as a Society Know What We're Dealing With?

@RHRealityCheck

This week it is National Eating Disorder Awareness Week. Not that you’d know it. Three days in, Angelina Jolie’s leg at the Oscars on Sunday is still getting a lot more attention than the eating disorder usually associated with unnaturally thin and awkwardly poky limbs.

There’s a reason for that. Eating disorders make for an uncomfortable conversation topic. For one, they are incredibly insidious and prevalent. About 8 million individuals living in the United States have an eating disorder (7 million of them women and girls), and most never get the treatment they need. Essentially, this means everyone knows at least one person with a mental illness. Most people don’t like to think about that.

And then there’s the fact that eating disorders are deadly. Literally. Eating disorders are the mental illness with the highest mortality rate in the United States, and it is estimated that some 20 percent of those suffering from anorexia will die prematurely.

But mostly, many of us don’t like to talk about eating disorders because we’ve been very close to a sufferer.

In my case, me.

When I was 16, I arrived in the United States as a foreign exchange student from Denmark with a complicated, but manageable, case of bulimia, weighing approximately 110 pounds. I went home a year later with full-blown anorexia, weighing about 80 (which, considering my height, indicates a Body Mass Index of about 9.5, i.e. very underweight). It took fifteen years, 3 bouts of therapy, and a pregnancy to finally root out all obsessive thinking about food.

Now, when I think about food, it’s not obsessive. I may really want a cinnamon roll or crave salt. And I definitely get so hungry that thoughts of food take over until I eat. But I no longer think about the quantities I have eaten, or about whether or not I deserve food.

To say that this is “liberating” is beside the point. On the one hand, it feels like I am finally alive, that I can now concentrate on the real colors and textures of life. On the other, to be honest, it’s so basic that it’s mundane. When I don’t think about my past, I forget I ever obsessed over food. I eat when I am hungry and don’t when I am not. It seems uncomplicated, somehow. Yet, of course, I know it’s not.

There are any number of books and articles linking eating disorders to the depiction of boyishly (and unnaturally) thin women in fashion, movies, and television. In my experience, fashion has very little to do with it. Fashion will make perfectly well-proportioned and healthy women and girls want to lose five pounds, go on fad diets, and be miserable. Fashion dictates clothing that looks better on a stick-insect than on a person.

Fashion alone, however, does not make you live off half an apple a day. Fashion does not make you develop so much scar tissue in your throat that your gag reflex is inhibited and you need to use toothbrushes and pens to make yourself throw up. Fashion may be an impetus to lose weight. But it’s something else that makes you stop eating altogether.

And that something else is control. At least in my case.

I am not a reductionist, and years of working closely with victims of all kinds has taught me that while we all are experts on our own suffering, we can be woefully blind to the solutions that are necessary to deal with that of others.

Even so, I believe letting go of control is key to recovery for many. When my mother instituted a system of rewards for pounds gained with target body weight on certain dates, I’d carefully gain the required weight on the required date, then proceed to lose it all and more in the days after. In short, I never let go of control.

By contrast, when I returned to therapy briefly while dealing with a bout of bulimia during a particularly stressful time in my life, my therapist told me not to worry about it. “In the grand scheme of things,” he said, “you are just sticking a finger down your throat. Really, is that so bad? Just remember to brush your teeth.” My purging immediately got less frequent and then disappeared—it didn’t feel so imperative after I stopped worrying about it. In short, I gave myself license to let go.

The point is not that a cavalier attitude always generates the desired change. In this case, my therapist knew from previous interactions who I was and what my reaction was likely to be.

The point is that the perfection those suffering from eating disorders are longing for in themselves in most cases is neither physical nor real. It’s not that I wanted to be thin, or even that I liked my emaciated body. It’s that I was scared out of my wits of failing.

We will need to overcome our societal inability to see errors for what they are—an opportunity to learn—if we want to deal with eating disorders. So if you want to do something to counter eating disorders this week, sure, eat healthily and don’t assume that anyone who’s not a size 2 is unhealthy, stupid, or both.

But more than that: show through your actions that you appreciate effort and honest errors more than caution and control. It may seem three steps removed from eating disorders and food. Trust me, it is not.