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Eating Disorders Are Not That Simple

By Jennifer

Like many others, I believed eating disorders were “about control” before my daughter was diagnosed with anorexia nervosa. It didn’t take long, as a parent of a child with anorexia nervosa, to understand why this theory is problematic. 

First, it oversimplifies eating disorders. It also assumes that someone’s life is out of control when it may not be. Finally, it makes it sound as if someone can choose to have an eating disorder in order to gain control. 

I still hear about this control theory frequently, not only from therapists, but from people who have suffered from eating disorders themselves. If people elaborate on the feeling of control their eating disorders gave them, they will usually go on to say they realized they were wrong, and the eating disorder gave them NO control. The eating disorder controlled THEM, while taking over all their thoughts. 

These days, experts are likely to mention eating disorders as a coping mechanism, providing a sense of escape, a numbing feeling, or even a sense of euphoria. While this may be true for some, learning better ways to cope is just the beginning of the journey. Eating disorders are complex disorders with many factors and no two cases are the same. Saying the disorder is about coping is making a sweeping statement that may not be true in all cases. It also makes it sound as if someone can choose to have an eating disorder in order to cope. 

When my daughter was still in the early stages of recovery, she explained that she had been feeling significant anxiety for a long time but didn’t know what it was or how to verbalize it. She felt she began to use eating disorder behaviors as a “coping mechanism” to quiet the anxiety. This explanation helps her to express some of her feelings about her illness, but it only scratches the surface. It leaves out a lot of details, including the bio-psycho-social factors that also contributed to her eating disorder.

Therapists who generalize all eating disorders as a means of coping may waste precious time, working on an issue that doesn’t exist for some patients. Searching for root causes that may not be fully known is counterproductive. It causes us to look backward, instead of focusing on the illness in front of us and moving toward weight restoration and recovery.  

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8 Comments

  1. KAZ

    Your heading is the understatement of the year!!
    My d ED has “controlled” her and us as a family for the past 5 years
    Now after 5 years of up and downs, She refuses any help or suggestions

    I have absolutely done everything in my power over and above,I read all the books, taken all the advice on the forum, tried incentives/leverage, taken time off work, went to workshops, paid for care, paid for courses (that were never started or completed) cooked and cooked and cooked, as well as the shopping omg don’t even get me started on how much food I’ve brought, we’ve brought puppies and kittens, took her on vacation, I’ve massages her, sat with her during IP stays, took her to day programmes every day there and back 1 hour drive each way twice a day, dealt with the SH, the depression, dealt with my own tumor dx and treatment, along with caring for other members of family and their issues, the list goes on an on and on

    and I’m done
    My own health can’t take this anymore

    She doesn’t listen to me or her therapist and has now left home

    So I have to totally agree that ED’s are NOT that simple

    I wish!!!

    Maybe some cases are simpler than others idk
    I know this is very negative and I apologise for that
    I’m sick of hearing just feed her too, coz please tell me how to force feed a 22YO

    • joslyn biggins

      Please look into IFS, Internal Family Systems by Richard Schwartz. It has changed my life and has helped my daughter’s ED. Many useful Youtube videos (Derek Scott) and podcasts (The One Inside, Tammy Sollenberger). Do it for you first, then pass on the wisdom to your daughter. It’s like oxygen support on an airplane!

  2. Doreen

    Kaz I hear you. My d is 38 and living on her own and on disability. Brilliant young lady and her life is wasted b/c of ed. She doesn’t want help either. In having said that, she has had help over the 24 years of her being so sick and it did nothing for her only made her more bitter and less trusting. Everyone who suffers from an ed, CANNOT nor should not be tard with the same brush. My heart goes out to you.

  3. Nina

    Absolutely agree!

    The “control” label points to some sort of interpersonal dysfunction, whereas many an ED child had been a happy smart child, with loving and supportive parents.

    Many of us parents find it a shock when required to increase control over the child’s eating and movements. While it proves to be most effective, it is completely counter-intuitive for an age when – if uninterrupted by the ED – the child would have been gaining more independence.

    We had been conditioned to look for something to blame so we can nip it in the bud. This is not the case with ED. No time to explore the past while we are rescuing our child.

  4. Eva Musby

    Jennifer, brilliantly expressed. I am so grateful to you for saying, in so few words, how problematic it is to say an eating disorder is all about control.

    I would add to your list that if we think a person has an eating disorder because they need control, then we will be very reluctant to have parents take charge of meals etc, and then we lose an approach that has saved many youngsters.

    I remember a therapist of mine telling me that ‘control’ was not a ‘need’. That made me think. When we’re feeling well, we are very happy to be laid back and let others make many decisions for us. How nice to go on an organised activity holiday, for instance.

    It’s only when we’re feeling threatened, tense, anxious, that we start planning and controlling everything so as to prevent anything that might make us feel even worse.

    So the source of the problem is not a need for control, but the many poorly-understood biopsychosocial factors that made our children feel so terrible.

    At least that’s where my own thinking is at present, around this ‘control’ business.

  5. Gretchen

    Dear Kaz,

    I have felt the same way so many times. My daughter is 19, and we are in year five of this nightmare.

    I’m holding you in the light, other Mom. May the universe bring some peace to you and your family.

    With an aching heart for both us,
    Gretchen

  6. A nn

    Thank you for all the posts Both my s and d have this terrible disease I am so loss as to what to do now My family is at turmoil and any advice would be much appreciated My s re go uses any further help desperately much therapy ip and is now on hook on weed after his md got him the medical card My d is in therapy but not really helping I need advice as I falling apart

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