To The Bone: Proceed With Caution

My fascination with eating disorder movies developed suddenly one day years ago, when I had a free afternoon and access to YouTube. For example, Growing Pains actress and anorexia survivor Tracey Gold played someone named Nancy in a Lifetime movie that is one of the most cinematically horrendous things I’ve seen.

Did these stories perpetuate my already severe eating disorder symptoms by including numbers, behavior details, and images of thinness? Yes, probably. However, I watched movie after movie, memoir followed by documentary, for another separate reason: I wanted to feel understood.

In the isolated pain of anorexia, I had shut out all my friends. I had stopped going to treatment appointments. Cold and alone in a prison that became unmanageable, I wanted someone to take my hand. I wanted someone to tell me, “I get it.” I wanted to connect with stories that made me feel safe and validated.

So, I turned to YouTube.

These films did not “heal” me. They did not constitute treatment. However, years later, these narratives stick with me. Nowadays, I am not seeking “tips” or numbers; I seek understanding.

I want eating disorders to be understood.

So many films have broached the difficult subjects of schizophrenia, addiction, and bipolar disorder, to name a few. But eating disorders? People are primarily directed to Lifetime movies and documentaries so corny, outdated, and ridiculous they can barely be taken seriously.

Cue my excitement when I learned about To The Bone months ago. Perhaps this would be a good movie about eating disorders. My high hopes were based on the fact that lead actress Lily Collins and director Marti Noxon struggled with eating disorders in the past. In addition, Project HEAL, a recovery organization I respect very much, provided consultation during filming and has endorsed the movie.

The conversation began to shift when the trailer premiered last week. Controversy spread across the opinion spectrum. Many eating disorder sufferers are infuriated (understandably) that the already small lead actress lost weight for the movie, as well as the trailer’s triggering images of empty plates and protruding collarbones. Project HEAL founder Liana Rosenman released this statement:

It’s a challenge to make a truthful movie about eating disorders that sheds light on their severity and complexity — capturing the patient and family experience of this real mental disorder — without glamorizing the disease ‘To the Bone’ tows this line beautifully. While the movie has the possibility to be triggering to some, I strongly believe that it will make a huge difference of raising public awareness of this silenced disorder.

In this post, I will be giving a layered critique of To The Bone by highlighting some key issues at play.

While I have not watched the movie, both the trailer and my understanding of the social and psychological factors of eating disorders will equip me to preemptively raise some questions and critique aspects of the upcoming film.

The Power of Eating Disorder Narrative (For Good and Bad)

Let me preface what I am about to say by noting that I will be watching To The Bone when it premiers.

I believe in the power of narrative.

When harnessed for good, the power of story can bring peace, hope, and understanding to the weary. Eating disorders are complex, misunderstood illnesses that have not captured adequately in film. Dozens of movies embrace plot lines surrounding alcohol and drug addiction, but eating disorder themes are often swept under the rug.

Historically, movies that cover eating disorders are truly awful.

I cannot say that more emphatically.

The level of cinematic creativity and diversity can be represented by me describing one scene that is inevitably in all these movies: Brooding teenage girl staring at the mirror with a bra on feeling like she is fat.

Is that the best we can do?

Elementary school-aged children have body image issues, dorm bathrooms have clogged drains from vomit, and the American diet industry is worth billions, but let’s look at a white, upper-class girl looking in the mirror with disdain?

American film is better than that. Eating disorder research is farther along than that.

It’s treacherous territory making a movie about an eating disorder. To accurately depict the hell and pain of these clusters of symptoms, while promoting recovery versus the pro ana/ mia communities, is like tiptoeing on a cliff.

“Honest” depictions of eating disorders such as Wasted and Thin have done much harm in inadvertently exacerbating a pro-eating disorder mindset. Included in these films are details that have served as “how to” tips for those who are very much embedded in an eating disorder mindset.

What can be most triggering for eating disorder sufferers in film is mention of numbers, images of grotesquely thin people, and vivid descriptions of ED behaviors.

This brings us to To The Bone.

To The Bone is advertised to be a movie that doesn’t “hold back,” in terms of showing a woman out of control in her life, with a sunken face and empty plate. Lily Collins is emaciated in the movie, a role for which she lost weight from her already small frame, despite having an eating disorder history.

I have no doubt that the movie will promote full recovery for Collins’ character, nor do I doubt the film’s intentions. I also believe it will be a great conversation-starter for the general public surrounding the secrecy of eating disorders.

However, the trailer is disturbing. 

Upbeat music and triggering imagery are paired with colorful sayings like, “I am in control,” and, “I am strong.” There is a scene of a friend joking that Collins has “calorie Asperger’s.” Snap shots of group therapy and psychiatrist Keanu Reeves indicate that the movie will have a “happy ending.” The treatment center is led by a cool, hot, “unconventional” doctor (Keanu Reeves) who takes the residents to a waterfall, I guess. Sunken faced Collins asked a fellow sufferer, “How do you just eat?” The boy replies, “I’m not going to lie. I’m really f%&#ing hungry.” Cue the upbeat music and bold colors.

Let’s start with the obvious emotional disconnect between the cheerleader music that could as easily introduce Bring It On, paired with disturbing words, phrases, and images. It’s obvious the movie is trying to promote an upbeat, “pro recovery” vibe in the weirdest way.

I’m also fixated on the hot doctor thing. There is nothing realistic about a doctor somehow going on treatment outings with clients. Sorry, been to treatment, and they have mental health techs do that kind of stuff. Usually people are lucky if they see psychiatrists once every 90 days. They’re billed at way too high of a rate to take treatment residents to waterfalls. In real life, that treatment center would cost at least $100,000 per month.

I get that the upbeat attitude of the trailer intends to foreshadow a happy ending, but it doesn’t fit. There is nothing sexy or upbeat about an emaciated girl with a protruding spine in a doctor’s office, or having “calorie Asperger’s,” whatever that means. How do any of these movie clips warrant the musical equivalent of high fives and bubble gum?

This trailer had me shaking my head as a once-enthusiast of this movie. I will still be watching To The Bone, but my concerns about this narrative are seismic, especially after the trailer. If this movie opens up the conversation about eating disorders and helps sufferers feel understood, I will celebrate. At the same time, this trailer depicts the sad reality of the lack of eating disorder education to the larger public and highlights persisting stereotypes.

Oh Look, Another Young, Upper Class White Girl With Anorexia

It’s a tale that is unfortunately the plot line of almost every eating disorder movie. A white, cisgender, upper-class, long-haired, intelligent, already-thin girl who needs control develops an eating disorder. She has issues with her family, probably. At the end, she gets better or dies.

To The Bone uses these same demographics with the main character.

Groundbreaking.

The reality is that eating disorders affect those in any ethnic group, socioeconomic status, religion, sexual orientation, age, and geographic location. Moreover, the rates of eating disorders are rising in other key demographic areas: males (especially gay males), younger children, and middle aged women.

Director Marti Noxon defended this story choice, “It’s important to remember EDs is unique and To The Bone is just one of the millions of ED stories that could be told in the US at this very moment.”

Noxon is correct in that millions of ED stories could be told, but this is the one being told in the film. This cinematic choice has broad implications. Many who watch this movie might not be familiar with eating disorders, so the choice to feature a thin, white, young female will shape the way others view what an eating disorder looks like.

The problem with a white, emaciated woman of privilege being the heroine of this movie is two-fold:

  1. It does not represent the reality of eating disorders, nor does it accurately portray the significant crossover between disorders across a lifetime (e.g. shift from bulimia to anorexia to binge eating back to anorexia). I’m not going to lie, Lily Collin’s emaciated frame and overdone sunken-eye makeup makes me roll my eyes. Many people with eating disorders are not underweight. It certainly doesn’t represent the physical “norm” of someone with an eating disorder.
  2. These demographic choices of the main character highlight existing stigma. Sadly, Lily Collins’ emaciated frame will draw in viewers. I wonder what would happen if Lily Collins had gained 50 pounds for the role rather than losing weight, or if the heroine of the film was another beautiful, but overweight, actress, such as Melissa McCarthy or Queen Latifah. What about James Corden? I don’t think a film like this would be popular. Starving is the most culturally sanctioned eating disorder behavior. Do I think a story needs to be told of someone who binges and is obese as a result, for instance? Absolutely!! But it won’t be, for a long time, anyway. I’m not surprised that the dominant narrative of this movie plays into societal fascination with anorexia and the cultural thinness ideal.  I have been disgusted by interviews discussing Collins’ weight loss. “How Did an Already Thin Girl with an Anorexia History Lose More Weight to Play Someone with Anorexia?” might be a popular headline, but it’s nonsensical for those in recovery.

The problem with this one story fitting the predominant cultural narrative is that it makes us more likely to miss someone who doesn’t fit the physical “type” of Lily Collins but is displaying eating disorder behaviors. We are more likely to overlook an older female who is always in the gym or a young male who sneaks off to his car and comes back hours later smelling of food and vomit.

Moreover, those who don’t fit the mold To The Bone sets forth might feel even more shame. These are things I’ve heard or said dozens of times:

“Someone like me shouldn’t have an eating disorder.”

“I don’t look like I have an eating disorder.”

“My insurance company denied me treatment because my symptoms weren’t severe enough. I think if I lose weight they’d pay for it.”

“What if my church/ friend group/ school/ ethnic community found out I have an eating disorder? I’ll disappoint everyone.”

I am not knocking stories of women in privilege. In fact, my story is in some respects that story– white, small girl in a seemingly normal, upper-middle class environment with straight A’s develops anorexia. I had access to health care, even when my insurance refused to authorize treatment. This is not to say that I fit the standard mold entirely. There is no “normal” eating disorder story. People are dimensional, complex beings. Those of any religion, race, cultural group, age, and sexual orientation can develop an eating disorder.

My concern is that To The Bone will fall into a category of story of a woman in privilege, stifling and silencing other narratives. To the third grader chewing gum instead of eating popcorn with her friends as an attempt to reduce “baby fat,” to the male model who drinks and smokes to avoid daytime meals, and to the middle-aged housewife who finds herself needing inpatient treatment, I say this: Your story is valid. Just because To The Bone features an unrealistic, seriously emaciated young actress doesn’t mean your pain is less valid.

Eating disorders are eating disorders. They don’t discriminate.

The Mundane Reality of Eating Disorder Recovery

Keanu Reeves apparently plays an “unconventional psychiatrist” in the movie and seems both hot and cool. I worry that these unconventional methods will serve as the vehicle of healing in the movie. As if meeting a cool doctor and coming to a profound understanding of the “why” of symptoms leads to recovery.

For years, I expected when I found out the “why,” perhaps through lots and lots of digging during therapy, I would stop my eating disorder. Maybe would no longer be necessary. I was trying to find the elusive “it,” which often doesn’t come. 

I never found out why I have an eating disorder.

Does it matter, at the end of the day? To really, truly know why I developed an eating disorder, I would have to dissect my brain with the science of 200 years from now and look at every single circumstance in my first 13 years of life. I would have to look at my family history, get data from my mom’s pregnancy and my prenatal care, etc. It is impossible to know exactly why. 

I did not find recovery from talking about my family background for years or going to restaurants with my therapist in treatment. Yes, I have done these things, and to an extent, they helped, but they never got me “there,” to the elusive “it.” 

The reality of eating disorder recovery is a secret, but I’m going to tell you it anyway:

It is boring.

There, I said it. Eating disorder recovery is choosing to sneak a mid-day snack between meetings because my stomach is grumbling. It is paying the damn $100 every few weeks to check in with my dietitian. It is filling my medication on time. It is grocery shopping on Sunday night because I am tired.

It is ongoing, and it is not fun. Well, sometimes recovery is fun. Eating ice cream on a warm night is a fun part of recovery. Most parts are not fun. I hate having to wake up, knowing that the extent to which I restrict will guide my body’s well-worn path of switching to starvation mode. I hate forcing myself to eat lunch when my stomach is in turn due to anxiety, knowing that I have to eat anyway.

Boring is not Hollywood. Boring will not gain ratings. And so, I assume To The Bone will be filled with exaggerated moments of truth and insight, as well as dramatic sensational images and numbers. Showing a protruding spine is extreme, so it’s better for ratings. Getting weighed when you’re bloated and haven’t taken a shit in 2 weeks is gross and not sexy, so it will not be included.

Most of us don’t have the luxury of having a hot, cool psychiatrist taking us to waterfalls in treatment.

Real eating disorder recovery is boring and regular. It isn’t sexy or worthy of a red-carpet Netflix debut, but it is so worth it. 

Proceed with Caution

As I said before, I will be watching To The Bone on July 14th. I hope my concerns will be unfounded and that others will benefit greatly from this film. I hope I’m not going to be on the couch eating sour candy rolling my eyes because of unrealistic “aha” moments, too many protruding spines, and calorie-counting.

I know the film will open up conversation about what eating disorders are like.

I just hope it opens up good, informed conversation, conversation that heals rather than shames and stigmatizes.

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The 25th Anniversary of The Little Mermaid and The Demise of Mark Driscoll

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I know, how could I possibly pair seemingly unrealistic topics of my childhood favorite Disney movie and Mark Driscoll? Continue reading. It shall all make sense in due time.

My blogging rants have previously spanned to the topics of Mark Driscoll and Disney (e.g., here, here, and here).

In the last few months, a lot has gone on in the world of Mark Driscoll (MD) and Mars Hill, Driscoll’s Seattle-base mega-church. While the purpose of this blog post is not to summarize what all has transpired, I will catch you up to speed here:

The quick summary: Shit went down. MD resigned and Mars Hill has disbanded.

The longer summary: The trouble started when MD got into some trouble regarding posts he made 14 years ago under the pseudonym of William Wallace II to attack “emerging-church-type feminists and liberals.” Why this happened to resurface after 14 years I have no idea, as Driscoll’s last year has hardly been clean, including controversies with possible plagiarism and allegations of paying off NYT best-sellers list. Somehow, the conglomeration of controversy spiraled in the last few months and resulted in the following: Acts 29, the church-planting organization Driscoll himself started, kicked out Mars Hill from its organization (major burn to MD) –> MD resigned from Mars Hill, saying he didn’t want to take away from the church mission, yada yada –> Mars Hill chose to disband.

This is HUGE in evangelicalism.

HUGE.

MD has been (with some exceptions) America’s evangelical, manly-man, neo-Reformed, social-media-savvy sweetheart. He captured the lives and hearts of thousands of Mars Hill goers. I myself, as I admitted in previous MD posts, used to listen to his podcasts. He is a captive speaker, quick with words, quick-witted, and relevant. Churches were planted. Good things happened. I do not want to negate the good things.

Do I believe that MD loves Jesus? I think that he does.

Do I think that MD bettered the city of Seattle and beyond? I think he did.

Now onto why I’m really writing about this story.

I am going to try really hard not to kick MD when he’s down. MD has long been controversial, and specifically what gets me going, are his homophobic and sexist comments that have been plentiful and sadly influential. Anyone who mocks effeminate worship leaders on Twitter is going to get a mouthful from me.

I saw the way this impacted others. Attending a Mars Hill campus in person in 2011, I was horrified to find every other woman pregnant and blonde and gorgeous. Every guy was ripped and strangely Driscoll-like in physical appearance. Everyone was white.

My own church when I lived in California preached out of MD’s book Real Marriage, a book filled with questionable antidotes such as one regarding a woman’s haircut pleasing her husband. This was the book also associated with a  plagiarism/ NYT best-sellers list scandal.

When MD resigned, Mars Hill leadership wrote the following: “Pastor Mark has never been charged with any immorality, illegality or heresy. Most of the charges involved attitudes and behaviors reflected by a domineering style of leadership.”

Uh…….?

How exactly are we defining immorality?

What is to be said for so many previous MD followers in therapy from attending Mars Hill and being subjected to degrading “church discipline” for being, for instance, a stay at home dad!!!! (GASP)?

What is to be said for the numerous controversial, hurtful comments that MD has said via Twitter or in personal conversations?

Those are moral because… MD believes that Jesus is God? And his doctrine is in line with certain standards?

Rachel Held Evans, in a typically eloquent post on Facebook yesterday, wrote the following:

It surprises me sometimes how people who are cruel and unkind get a pass on rude behavior from Christians because “at least their theology is sound.” But your theology is only as sound as the fruit of the Spirit it produces. Love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, and self control – both Jesus and the apostle Paul taught that THESE are the things to look for when assessing whether someone is preaching the true gospel or a false one. I am so much more inclined to listen and learn from a teacher who exhibits these traits than those who may be highly credentialed whose fruit is bitter.

I think we as the church need to take a long, hard look at what fruit we are producing and the ramifications it has on others. There is this archaic idea that heresy means what you believe or cheating on your wife. I think this blog gets it. At the end of it, the writer, Kristen Howerton, says:

“It’s time we examine the negative ramifications to long-standing microaggressions, misogyny, and verbal abuse as seriously as we would embezzling or sexual misconduct from a church leader.”

Exactly.

More later but first…

NOW ONTO THE LITTLE MERMAID. 

The 25th anniversary of everyone’s favorite classic was this week. Growing up, I was obsessed with Ariel, as was every late 80s-90s girl. I had my Ariel Halloween costume and Ariel dolls and barbies and Ariel EVERYTHING.

I LOVED THE LITTLE MERMAID. Who didn’t? Cute, clever, catchy, adorable. A success for Disney, a success for mankind.

It wasn’t until I saw this Second City clip several years ago that I got to thinking:

What messages was this movie really teaching me?

Maybe not the 1st… or 100th… or 1000th… time that I saw that movie at age 4 would I think differently, but I wonder… what kinds of things did I implicitly learn?

I wonder… what we would find if we did a study on young girls before and after watching The Little Mermaid? Specifically, I wonder whether we would find that little girls are less likely to want to be a woman president or the effect a movie such as that would have on their ambitions and views of womanhood.

And as someone who has had an eating disorder for 13 years and is sensitive to weight-based discrimination, this movie is SO FRUSTRATING! Ariel is practically a mass-disseminated cartoon pro-ana figure, so much so that this PERFECT “Realistic Movie Trailer” renames the movie, The Little Waistline. And how fitting that the villain is a fat old woman. Perpetuating decades of stigma against older women and showing young girls that FAT IS BAD.

I read the host of perky articles that come out on the day that The Little Mermaid turned 25, and I tried to relive my childhood love of this movie. It didn’t work.

I know too much. I’ve been through too many years of therapy. I’ve battled too many companies selling pro-ana shirts, and we still haven’t had a woman president, and eating disorders are existing in unprecedented numbers. I have battled my entire life the voice that tells me to sell myself for society.

That started in childhood. THESE are the messages young girls get!!!!!

It’s not The Little Mermaid‘s fault, but does this movie perpetuate these messages, in my opinion? A resounding YES!

BRINGING IT TOGETHER

I told you I would bring it together. Now what could a middle-aged pastor from Seattle have to do with a movie about a mermaid?

Turns out, a lot (in my opinion).

Media, my friends, is an important thing. We are not untouched by what we fill our minds with; we are not untouched by what we watch or see or listen to or by the venues and organizations we attend.

Media is powerful, sometimes so subtle, you don’t realize how it’s slowly seeping into your consciousness, changing the way you see the world.

Both to Mark Driscoll and The Little Mermaid perpetuate some ugly stereotypes about the objectification of those who are different, whether it is those of different genders, sexual orientations, physical appearance, or anyone who you label as “the other.”

Sadly for evangelicals, Disney is stepping it up. Movies like Frozen and Brave are FAR (X 1000) better than movies like The Little Mermaid. I think Disney is learning their lesson. I am hopeful for today’s young girls, that they will be empowered to do WHATEVER it is they want to do, including achieving equal pay and other problematic society ills. I am hopeful that the movie Miss Representation and The Representation Project exist. I am hopeful because activist movie clips like THIS are going viral.

For evangelicals, I am not so sure. The oppression and discrimination of women and LGBTQ people is still prevalent is so many churches. And while The Little Mermaid turns 25 this year, MD JUST resigned. Apparently mocking stay-at-home dads and effeminate male worship leaders is still kosher in evangelicalism. So I guess the evangelical church is at least 25 years behind the rest of culture. Probably more than that.

I am not trying to be a hater, or promote a boycott of Disney/ Mark Driscoll. Like I admitted, I listened to Mark Driscoll. I loved (LOVED!!!!!!!!!) The Little Mermaid. If you like MD or old-school Disney movies, you know what, have fun. I will probably show my future daughter The Little Mermaid.

However, I think it’s well within my rights as a human to be critical of culture. I am in the field of mental health as a career, and I am an activist regarding body image, eating disorders, and gender-related concerns. And some of these things don’t sit well with me.

I am all too familiar with the scars that life leaves, and I am a fan of changing things so that people in the future can have a few less scars in life. So I’m going to leave you with the following thoughts:

For Disney lovers who show their little girls The Little Mermaid: If you must show your little girl this iconic movie, please have a discussion about it with her. She is SO much more than her body and selling and starving herself to please some hot dude (per the realistic movie trailer “white Aladdin”).

For evangelicals: Think before you preach, attend church, talk to others, and use the Bible to condemn. We need a movement based on love and acceptance, a movement that honors differences, and minimizes support groups needed for people in church. I mean GUYS how crazy is it that people should need to be in therapy or band together because of an oppressive church experience that leaves them feeling like scum. How much do you think Jesus is weeping because of that? MD’s popularity shows me how much we evangelicals are under the sea-– and many people don’t even know it.

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.