Understanding Eating Disorders

Eating disorders have become increasingly prevalent in the cultural landscape. Loosely defined, it is an umbrella term involving a cluster of symptoms related to food intake which pose a threat to a person’s physical and mental well-being. Most notably, these are anorexia nervosa, bulimia nervosa and binge eating disorders. 

Food, Love and Connection

Beginning in infancy, relationships and feeding are intimately bound up together. Food is the primary means of communication between mother and child. Food and being fed constitute some of our earliest experiences of connecting with another person. The experience of eating is therefore closely associated with one’s experience of being cared for and loved.

American psychiatrist Hilda Bruch was the first to link challenging family dynamics with eating disorder symptoms. Food and food rituals are an easy substitute when fulfilling relationships are lacking in a person’s life. Bruch highlighted the need for a sufferer to control the body in order to compensate for a lack of control in life. 

Unhealthy Eating and the Media

Huge societal pressures are also at play. Images promoting unhealthy dieting proliferate on Instagram, including disturbing body imagery and diaries promoting weight loss. We are constantly bombarded by cultural messaging that ‘thin is good’ and ‘fat is bad’ – with fat people portrayed as lazy and lacking in willpower and thin people as powerful and active.  

 Sartre writes, ‘All food is a symbol’. Taking this a step further, one can say that an individual’s relationship to food represents his/her relationship to the world – hope, hopelessness, faith, doubt, love and hate laid out on a plate.

Any attempt to establish a universal formula for understanding eating disorders is of limited value. Each case is highly complex, both generally and within each person. The precise associations are always unique and specific to the individual experiencing them. 

Going Beyond the Physical: A False Sense of Security

What can be said is that an eating disorder suggests pervasive, long-standing emotional pain, not primarily about food. Something belonging to a person’s emotional life is being expressed physically through behaviour. In a sense, it tells us that there is some unfinished business which needs to be dealt with. Becoming consumed with body image, weight and calories becomes a distraction from feelings of emptiness or despair. At root, the eating disorder is a coping mechanism. 

Sufferers have described it as having a numbing effect as one disconnects from the world through hunger and ritual.  One individual spoke of having a relationship with the eating disorder so as not to engage with the world and in order not to care about the world. Instead, the world recedes into the periphery as questions around food and the body hold unquestioned primacy. 

For many, the eating disorder promises structure and safety, albeit a false sense of it, in an unsafe and overwhelming world. Herein lies the paradox - the false sense of control provided by the eating disorder is in reality out of control with a concomitant lack of awareness of true life choices and responsibility. 

Hope for the Future: Talking and Recovery

Despite the gravity of the symptoms, people can and do recover. The ability to use language rather than the body to express difficult feelings represents a major step towards positive life change. Therapy can provide a safe space where you can explore and understand the symbolisation of the eating disorder. We are all seeking safety in one another to ease the anxieties we face as human beings. And ultimately, thinking about the pain may be easier to bear than the condition itself.

Author: FTCC Psychotherapist and Counsellor, Sarah McDowall