Catherine Silver LCSW

Therapy for Individuals, Couples & Families

My "_______" Has An Eating Disorder: 7 Things You Need to Know

If you've found yourself reading this, it is probably because someone you love has an eating disorder and you have a lot of questions.  While there is no one-size-fits-all approach, I find that it is important to start with the basics.  You first need to understand what an eating disorder is and, more importantly, what an eating disorder is NOT.  There are many myths about eating disorders and before trying to understand what is driving the engine, it’s important to clarify some of the common misconceptions.  Below are 7 things to keep in mind as you embark on this journey:


An eating disorder is about way more than food and body image.

At it’s core, an eating disorder is an unhealthy coping skill. The person is using food or body obsession as a way to distract from pain or discomfort.  It’s important to know that this is not something that is done consciously, especially in the early stages.  They themselves might not even understand what exactly they are trying to cope with.  This brings me to my next point…


It is not a choice.

Because this is an subconscious process, no one makes the active decision to have an eating disorder.  It’s a combination of biological, psychological and environmental factors that come together in a perfect storm.  Just like how some people are prone to substance abuse while others are not, some will be more prone to disordered eating.  An eating disorder is not an issue of vanity nor is it something that you can reason your loved one out of.  Chances are your loved one has a ton of shame around their food issues.  Deep down, they know that their eating disorder doesn’t make sense, that the thoughts are irrational or that the behaviors aren’t healthy.  The frustrating thing about an eating disorder (for everyone involved) is that despite knowing all of this, the person is still pulled towards the mindset and behaviors.


It is not the same as an addiction.

Many people will liken an eating disorder to an addiction (as I just did in my last point) but it’s important to understand that while there are many similarities, there are also huge differences.  One major distinction between the two is that someone who is recovering from an addiction can completely avoid their triggers.  An alcoholic never has to set foot in a bar again.  They don’t need to keep alcohol in their house nor do they have to associate with people who drink.  Obviously, that’s not possible for someone with an eating disorder.  Essentially recovering from an eating disorder is learning to use one’s “drug of choice” in moderation.  It’s about starting and stopping oneself multiple times a day.


You can be a “normal” weight and still have an eating disorder.

I cannot stress this enough.  The general public hears “eating disorder” and they automatically think of someone who is underweight.  While this is definitely the reality for some, the vast majority of people with eating disorders are within a healthy weight range.  This often leads to people minimizing the severity of the eating disorder and can also be a barrier to seeking professional help. 


They never come alone.

An eating disorder is never just an eating disorder. It is almost always accompanied by an underlying issue, whether it’s anxiety, perfectionism, trauma or low self-esteem to name a few.  The need for support doesn’t go away when the eating disorder behaviors abate.  As a matter of fact, your loved will likely need more support as they learn new skills and tools to manage whatever it was that their eating disorder was numbing out.


Recovery looks different for everyone.

A key part of someone’s treatment is looking at what “recovery” means to them.  Someone might get to a point where they have stopped their eating disorder behaviors, but they still find themselves obsessing over food or hating their body.  Or maybe they haven’t had any urges in a while and then all of a sudden, they slip.  Eating disorder recovery is not all or nothing and it is not a linear path.   As a supporter, it is important to understand that recovery is a complicated process that takes time and a lot of patience.


For many, professional help is necessary.

As a supporter, you are not your loved one's doctor, therapist or nutritionist and trying to take on that role can be problematic and ultimately dangerous.  Eating disorders are complex and they deserve treatment that is equally as sophisticated.  While the road to recovery is a long one, with the right help it is possible.

Why You Need an Eating Disorder Specialist

So. You’ve acknowlwedged that you have an unhealthy relationsip with food.  You’ve decided to get help.  You look online and there are hundreds of therapists in your area.  You call your insurance company and get a never ending list of therapists who claim to be ED specialists – you call some of them and worry that they don’t actually get it.  This is really important - you don't want just anyone.  Maybe you hate yourself when you look in the mirror.  Maybe it’s gotten so bad that you’ve have been hospitalized, or it’s gotten in the way of work, your relationships, or your social life.  Perhaps you have opted for surgery of some kind, but it still isn’t enough.  Or maybe you have been on a diet for as long as you can remember – categorizing your days as “good” or “bad” based on what you ate (or didn't eat), or what the number on the scale says.

You’ve come to the right place.

An eating disorder is a complex illness.  Unlike most, it is overwhelmingly emotional and undeniably physical.  It requires a treatment that is just as sophisticated and aggressive.  How many times have you been told by a therapist to practice “healthy distraction?” You feel sad – watch a funny movie; you feel lonely – go to a café; you have urges – do something with your hands; you feel anxious - do a guided meditation on that app you got.  That’s all fine and good until you sit down at 9pm, after a full day of distraction, and it all comes flooding back.  So then what?

It is important to remember that an eating disorder is a coping skill.  The obsession of food (whether it is restricting or over-indulging) and weight has served some type of emotional purpose for you.  Maybe the bingeing numbs you, or the purging gives you a “fresh start," the restricting makes you feel powerful and in control.  All in all, this just takes you away from whatever it is you are truly feeling.  What we don't want to do - and what many traditional therapies will recommend - is we don’t want to replace one distraction with another, popularly deemed “healthy,” distraction.  As Robert Frost said, “the only way out is through.”  If you are deciding to embark on your recovery journey, it is imperative that you accept that it will not be easy.  It will hurt.  You will feel worse before you feel better.  You will want to stop.  Every fiber of your being will tell you why your team is wrong, or why it makes perfect sense to go on that run, skip lunch tomorrow, or why you deserve to gorge yourself after such a hard day.

You must find someone who understands the intricacies of an eating disorder; someone who will call you out when you have a seemingly rational argument as to why using food, in whatever capacity, is warranted.  In a world of distraction – social media, music, kindles, etc. – you need to look at what is truly driving the engine.  You deserve it and, with the right help, you can do it.