Myths About Eating Disorders: Debunked

Knowledge is power, but when it comes to eating disorders, there is a lot of misinformation that is out there. Sadly, this lack of knowledge of accurate information about eating disorders can even extend to health care professionals. With conflicting messages about what is true, it can be hard to sort out what information is accurate.

Because I have lived now over half of my life with an eating disorder, I’ve learned a lot of stuff (mostly out of necessity), and I have become aware of some eating disorder myths and stereotypes that exist. In this post, I am going to go over a few of these myths and debunk them.

 

What are eating disorders?

Myth:

Anorexia means starving yourself and being emaciated. Bulimia is bingeing and purging. And… that’s all.

Reality:

Eating disorders are most commonly described as complicated biopsychosocial mental health conditions that impact all bodily symptoms, the brain, and can have devastating consequences such as death. The most commonly recognized eating disorders are: anorexia, bulimia, binge eating disorder, and EDNOS/ OSFED (eating disorder not otherwise specified/ other specified feeding or eating disorder). Eating disorders involve some type of dysfunctional behavior(s) around food, including restricting food or caloric intake, fasting for long periods of time, using compensatory behaviors after eating such as purging, laxatives, diuretics, or overexercising, and/ or bingeing, or eating a large amount of food (of course there is social construction around what is considered “large”) in a discrete period of time.

Many eating disorder behaviors overlap. People who have suffered from an ED for a considerable length of time frequently experience diagnostic cross-over. Thus, these symptoms are neither clear-cut, nor are they necessarily noticeable. Eating disorder behaviors are often done in secret. Also, people with bulimia or binge eating disorder may not be over- or under- weight. Similarly, those who struggle with anorexia may not be emaciated.

It is important that people educate themselves about the impact of eating disorder behaviors and rely less on stereotypes of how eating disorders are culturally portrayed… namely how someone with an eating disorder “should” look or behave.

 

Who gets eating disorders?

Myth:

Privileged white adolescents.

Reality:

Anyone! While eating disorders are most represented in the media as occurring in Caucasian women of upper or upper middle class SES in a Western country, people of all races, sexual orientations, genders, economic statuses, and ages can develop eating disorders. There is a serious lack of representation of other eating disorder voices, which is why I’m really happy that this Marginalized Voices Project exists. We need to get better media representation of what eating disorders are like and who they affect.

Males, older women (40+), as well as people who are gay and of other racial groups, who have EDs are getting increased attention because—well, they get eating disorders too. Sadly, treatment is not necessarily tailored to them, and it needs to be.

 

What are the causes of eating disorders?

Myth:

Eating disorders are caused by Western media, trauma, families, or other environmental factors.

Reality:

Eating disorders cannot be pinpointed as being caused by one given factor. If you’ve ever taken a statistics class, maybe you’ll remember that correlation does not imply causation. Just because eating disorders exist (or are identified) in predominantly Western-influenced cultures, that doesn’t mean that culture CAUSES eating disorders.

Similarly, any risk and precipitating factors—a traumatic situation, an unhealthy family system—cannot be said to CAUSE an eating disorder. Perhaps these factors may increase the likelihood of an eating disorder developing, or they could be precipitating factors, but they are not the cause or fault of culture, or a family, or trauma.

I would also heed caution in that there has been an increase of media coming from companies such as Dove challenging cultural perceptions of body image. This is all good. I am a fan of challenging the oppressive body-image status quo. However, there is a difference between eating disorders and disordered eating or general body image issues. A girl might have negative feelings about her body from reading fitness magazines, but that is completely different from that girl developing a serious eating disorder.

Also, there is a significant biological basis of eating disorders that is still being explored. One study by Bulik and colleagues in 2006 suggests that anorexia is among one of the more heritable psychiatric disorders (0.56 as reported in her study).

All that to say, in general, there are a lot of unknowns when it comes to a cause or causes of eating disorders. My stats 101 lecture for the day: Be very, very careful about language pertaining to causation. Eating disorder research is being conducted because so little is understood still. There is not enough available knowledge to determine that something is a cause (or even causes) of an eating disorder. Talk about risk factors, talk about precipitating factors, talk about comorbid conditions, that’s fine. But talking about a cause suggests that 1+ factors completely explain the manifestation of someone’s eating disorder, and that is not something that can be said at this time.

 

What are the treatments for eating disorders?

Myths:

Once you have an eating disorder, you never get over it.

or 

You just need to eat.

Reality:

Eating disorders can be treatment resistant. I am living proof of that. However, treatment can also be effective. Recovery is possible. People don’t have to struggle with eating disorders forever and ever until they die. Recovery is not easy, and it may take time… a lot of time. Like years. Maybe more. But it can happen.

While eating disorders can be difficult to treat, certain treatments have been shown to be effective: CBT, DBT, family-based therapy, perhaps even acceptance and commitment therapy. I have more thoughts pertaining to this, but right now I will just say that there are some good options out there. I have been privileged to have seen a lot of great therapists who specialize in eating disorders, and I have been a part of treatment programs that have used all of the above treatment modalities.

People with eating disorders are not lost causes. They are not resistant, difficult, or frustrating. They are hurt and scared. They are in desperate need of empathy and understanding.

Notice that none of the treatment I have mentioned involves locking people up and force-feeding them. I had an acquaintance who once said, “If I got an eating disorder, my parents wouldn’t have put up with it. They would have just locked me in my room until I ate.” Honestly, good luck with that. Because I’m pretty sure that’s not addressing the problem. As in, I’m totally sure. That’s not going to work.

For whatever reason, people can have this mis-perception that the problem is the food, and all we need to do is make these people freaking eat. I both agree and disagree with that– it both is and isn’t about the food. I do not think that people can delve into root causes of their eating disorder while engaging in eating disorder behaviors, but I also don’t think that magically eating will fix everything.

So: there are some treatments that exist for eating disorders that work. Maybe the treatments that exist could be improved, but eating disorders are not untreatable.

 

 

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Goodbye Ed: Why I Don’t Call My Eating Disorder “Ed” (Anymore)

In 2006, I entered treatment for the first time. I also read Jenni Schaefer’s book Life Without Ed. She externalizes and personifies her eating disorder as, “Ed,” on par to an abusive husband who she has since divorced.

At the time, externalizing my eating disorder was helpful because up until that point, I was convinced that my eating disorder was, actually, me. When I read it, Life Without Ed changed the way I understood my eating disorder. I learned that I could survive the loss of my eating disorder. That was a profound realization for me. When losing my eating disorder felt like part of me had died, and I didn’t know if I could pick up the pieces again, I had this: “Life without Ed is waiting for you/ Be strong keep the faith and you’ll see it coming true/… You can believe in life without Ed.”

I am not the only one who found comfort in Life Without Ed. During both of my stints in residential treatment, conversations were peppered with “Ed” lingo.

“Ed was really chatty today.”

“Ed was driving me crazy. I told him to go home.”

People in treatment would applaud and mmhmmmm. Head shake. Yeah Ed that jackass. He’s the worst. 

I used that language too. I found this from one of my 2010 journal entries: “Ed has been my horrible husband for the last few years, and when I feel so bitter and angry, I come running back to him, abusive as he is, because he’s familiar and comfortable.”

Phrases like, “It’s not you I’m mad at, it’s Ed,” or, “Tell Ed to shut up,” were comforting to me at the time. Besides, to be honest, if you don’t drink the “Ed” Kool Aid, residential treatment can be a menacing nightmare. It is a pseudo-expectation that if you are in treatment, you will call your eating disorder “Ed” at some point. Ed is common treatment vernacular, the metaphorical elephant in the room.

Since I left treatment for the last time, the seasons have come and gone and the roller coast of life has continued. As I morphed and grew, I said goodbye to Ed, but in a different way. I have stopped calling my eating disorder “Ed,” or by any other name, for that matter.

That has been my own personal choice, and I don’t have anything against people calling their eating disorder by a name. Similar to this eloquent blogger, I am just trying to open the conversation up.

I don’t think that “Ed”ing your way through recovery is the only way. 

There are some great reasons to externalize the eating disorder (ED) voice. But I am just going to say it: it is possible to go Ed-less. In this post, I am going to delineate some of the reasons that I have chosen life without the term Ed:

1. Because reducing my eating disorder to something outside of me does not take into effect that eating disorders are complicated diseases. What most worries me about the term “Ed” is that it has the potential for simplicity and reductionism. The whole of something cannot be reduced to the sum of its parts. An eating disorder is more than what the ED voice says. If it was only about telling Ed to shut the hell up, you might think that recovery would be easier. I recently donated my blood to support genetic eating disorder research. Why? Because, research wise, we know relatively little about eating disorders. Externalizing an ED may be helpful to sufferers but it is a shortcut, a heuristic. It may help someone for a period of time, and if it does, great, but “Ed” is a tool, not a solution. Pat answers to complex questions can be harmful if taken at face-value.

2. Because my eating disorder is a part of me. One of my favorite recovery books is Gaining by Aimee Liu (read it, seriously). In it, she interviews people who recovered from eating disorders decades ago, but she notices in them (and in herself) personality characteristics and other similarities to the ED that linger. I may not hear eating disorder thoughts for the rest of my life, nor will I give in to urges, but I believe that my eating disorder will always be a part of me in some capacity. In recovery, I have had to discover the scared, fearful voice inside and honor that voice. If my eating disorder thoughts are loud, I have to ask: Why? What is going on right now? Instead of screaming “ED I’M DIVORCING YOU” at the time of my lungs when an ED thought hits, I am now more likely to listen to what my internal voice is telling me and ask what I’m feeling and why.

3. Because the concept is a little strange. I get why people do it. Like I said, I myself called my eating disorder “Ed” for a while. But… can we for 2 seconds think that there might be down sides to using “Ed”? I mean, to state the obvious, my ED voice is not a person. It’s not like I’m living with this asshole named Ed against whom I can file a restraining order, you know? For me, the idea of an abusive guy (or girl, whatever) in my head is not appealing at this point in my life. I’ve dated enough asshole guys, so why would I make up a nonexistent one and be in a pretend bad relationship with him? I am doing fine on my own, thanks. Also, could the term be demeaning to people who have undergone abuse or domestic violence? Could it be re-traumatizing even?

4. Because, quite frankly, calling my eating disorder “Ed” can be a cop out. “Ed was talking so loud” is a common sentiment you hear in treatment. Or even, “Ed was getting really worked up when you said x yesterday.” Is saying something like that helpful? What about, “I was feeling really anxious today because I was thinking of x and did y, and I’m having issues coping with my anxiety. My feelings are overwhelming.” Okay then! Now we have something to work with. That is taking the issue to its source. Blaming, sometimes scapegoating, Ed is not helping people to recovery. Eating disorder thoughts don’t come out of a vacuum. I have to place them in their proper context and take responsibility for them.

5. Because, after a while, eating disorder recovery has less and less to do with the behaviors. At the end of the day, the reason I have stopped calling my eating disorder Ed is because the term is no longer relevant for me. I don’t have regular urges to engage in eating disorder behaviors. I am not over my eating disorder completely just yet, but my recovery process has shifted. My therapist specializes in eating disorders. But do you know what we do NOT talk about 95% of the time in therapy? My eating disorder behaviors! Or my eating disorder at all. These topics are not agenda items. In fact, if my therapist made me set up a chair and do an “Ed’s voice- my voice” role play, I’d stare at her and then probably get pissed. Those things might have worked for me at one time, but they no longer do.

 

I met Jenni Schaefer at an event earlier this year. She signed a bumper sticker for me that is pink and has a line through the word Ed. I have placed it on a binder for my school papers. I don’t hate Life Without Ed. I don’t read it anymore, but I don’t hate it. If it works for you, fabulous, keep using the term.

What I get concerned about is the fact that there is an expectation, or to get punny, an EDspectation, that if you have an eating disorder, his name must be Ed. Ed is preferable, Ana or Mia are secondarily accepted.

Externalizing is not the only way of recovering from an eating disorder.  Or, “Ed” may work for you for a reason of your life, and then it may become irrelevant. The “Ed” label no longer fits in my personal recovery journey. And that’s okay.

Like this blog post says, some people may find the term belittling. Some may feel invalidated by it. Some may find it simplistic. Others may find it to be a brilliant way of breaking from of an eating disorder’s tight grip. Great. But let’s at least talk about it.

Foregoing the term “Ed” does not constitute recovery heresy.

Just saying.