We live in a society that places significant focus on appearance, and a culture that is strongly obsessed with dieting and thinness. Media is filled with messages that portray an unrealistic thin ideal and imply that beauty is based on external sizes, shape, and weight rather than on internal traits, values, and abilities. Additionally, poor body image enhances vulnerability and often leads to the development of an eating disorder. In the first part of this series, myths and misconceptions around eating disorders will be addressed. Helpful and unhelpful comments will also be discussed.
CHALLENGING COMMON MYTHS
- People with a normal weight cannot have an eating disorder. The fact is that appearance alone doesn’t accurately identify or indicate who may be struggling with an eating disorder. Some illnesses are not externally visible to others. It is more about how thoughts regarding body image and weight impact a person’s self-worth and self-evaluation. Similarly, individuals in the “normal” weight range my have more difficulty recovering from an eating disorder because they don’t necessarily feel “sick enough,” or receive the attention and support from others during treatment. Behaviors change first, followed by irrational thinking patterns.
- It is only about the food. The fact is that eating disorders are complex, mental disorders and are NOT only about the food. While eating well-balanced meals and gaining weight may be part of treatment, it is not the only key component. It is not about willpower nor is it about trying harder to avoid binge eating. Issues regarding food relate to other unfulfilled emotional needs, such as lack of control, anger expression, and numbing out from difficult feelings and thoughts. Underlying issues relate to depression, self-esteem, anxiety, low assertiveness, stress, physical pain, poor body image, etc.
- Only young Caucasian girls are impacted by eating disorders. The fact is that both men and women are diagnosed with eating disorders every year. Likewise, individuals of all age brackets, SES classes, and ethnic backgrounds can struggle with symptoms related to body image and food concerns.
- People with eating disorders have the goal of hurting others. The fact is that individuals with eating disorders usually feel shame and guilt for their behaviors, and do not have the intention of acting out or lashing out in revenge. While it can be easy for families and loved ones to blame themselves, eating disorders run deeper than this and it is rare for these behaviors to be deliberately hurtful or spiteful. Eating disorders are also more about coping with stress, even if maladaptive, than a vanity issue.
- Normal blood work results indicate being healthy. The fact is that some doctors may not have the specialized training to be aware of key warning signs and traits, or have the knowledge on which tests to use. Similarly, the human body is resilient and adaptive. Therefore, blood tests can essentially be normal even during times of severe malnutrition. Blood tests may be misleading, but bone tests do not lie and do not minimize the potential devastating effects of an eating disorder.
- Eating Disorders are Hopeless. The fact is that 60-70% of individuals can make a full recovery if undergoing appropriate treatment. Recovery is a process and happens slowly, likely over several years, but a return to full health without distorted thinking patterns is possible. Do not give up on these individuals.
HELPFUL VS. UNHELPFUL
- Be realistic regarding change, not expecting it to happen overnight. Be kind when having conversations, and do not get frustrated with lapses. Remain positive and don’t dwell on weight or appearance. Be gentle, resist falling into the guilty trap, and remember that recovery is not a choice you can make, but rather is the responsibility of the person who is struggling.
- Do not threaten, bribe, or yell at someone who is struggling with an eating disorder, and avoid power struggles. It is important not to ignore the problem, while also not taking control of the situation. Eliminate shame talk and do not challenge someone who believes he/she “is fat.” This is not your role or job. Minimize conversations around weight gain and weight loss, as this could make someone believe a goal is being attained or make someone feel like a failure. Finally, don’t give advice unless it is specifically asked.