By Judy Krasna, F.E.A.S.T. Executive Director
Last week, one of our social media posts was a “mythbuster” graphic about the need to find underlying “causes” of eating disorders. The myth was that you can’t recover from an eating disorder until you find the underlying cause. The mythbuster was that for some people there is an underlying cause or trauma and for others there isn’t; and from what we have seen, what leads to healing the brain and to recovery is the normalization of eating and sufficient weight gain.
That was a lot of content squeezed into a social media graphic; in retrospect it was way too big of a topic to have been presented in that format. Totally my bad. And more importantly, I realize that the word “cause” is problematic and I shouldn’t have used it. We don’t know what causes eating disorders.
One of the biggest myths that I encountered personally on my journey, one that inflicted catastrophic damage, was this myth of needing to find a reason why someone developed an eating disorder. I know that other parents have dealt with this as well, and I wanted to address it in one of our mythbuster posts. I realize though that my execution was flawed, and I apologize for that.
I would like to share some of my experiences as a cautionary tale.
My daughter had a treatment team at the beginning of her illness who believed that there is an underlying cause of all eating disorders, most often trauma. They believed that until this underlying cause was uncovered and addressed, recovery was not possible. And so, they dug and dug trying to find what caused my daughter’s eating disorder. They didn’t believe that it was genetic or biological or brain-based, or that she had a predisposition to developing this eating disorder, or that restriction and the resulting weight loss led to negative energy balance. They believed that it was the result of something that happened to my daughter; and until they discovered what that thing was, my daughter couldn’t recover.
My daughter kept insisting that there was no underlying cause or trauma. Her treatment team tried to convince her otherwise, session after session, to the point where my daughter asked her sister, “I wasn’t abused, was I? I don’t remember any abuse, but they keep telling me something must have happened.” The irony is that the trauma came from my daughter’s treatment team after she had developed an eating disorder.
My husband and I were extremely distraught about the possibility that our daughter experienced some type of trauma and we didn’t know and didn’t act to help her. Her treatment team put this awful idea about trauma in our head, during a time when we were already in a state of extreme crisis.
And because the focus was on discovering the “root cause”, under the mistaken assumption that there always must be an underlying issue, my daughter’s treatment team was not actually treating her eating disorder. They were losing time and losing ground during a critical point in her illness when treatment should have been aggressive. Because they assumed that there was some type of trauma or abuse somewhere, they were suspicious of us as a family. It affected not only the way that my daughter was treated, but the way that we were treated as well, and it was used as a wedge between us and our daughter.
Due to this experience, I feel strongly that treating all eating disorders with the assumption that there must be an underlying issue is damaging. I thought this was important to highlight as a myth, because I am definitely not the only parent out there who has faced this type of detrimental treatment.
I know that there are people affected by eating disorders who suffered trauma, or who have other underlying issues, and that these factors can contribute to the development of an eating disorder. It’s problematic to call them causes, and I know better, so that never should have happened. I have heard them referred to as triggers, and that resonates with me, but I know that not everyone would phrase it that way.
Any trauma or underlying issues need to be addressed in treatment. If indeed they contribute to the development and the sustenance of an eating disorder, and they are not treated, then recovery may not be possible or sustainable.
This leads me to the second part of the mythbuster, which I think is a natural follow-up to the first part. If the myth is that you can’t recover from an eating disorder until you find the underlying cause, then the truth is that what leads to the healing of the brain and to recovery is normalized eating and sufficient weight gain. Once the brain is renourished, any trauma or underlying issues must be treated so that a person can achieve a full and lasting recovery. But trying to treat those things before weight restoration is accomplished and while a person’s brain is heavily under the influence of the eating disorder is too often futile and frustrating, and leads nowhere productive.
I wish that my daughter had received different treatment that focused on restored nutrition as a priority and that did not assume that there must be a reason why she developed an eating disorder. While her treatment team was chasing after that reason, because they were convinced that there must be one, my daughter’s eating disorder was given more and more latitude to run wild and grow. Instead of leading my daughter toward recovery, her providers led her away from it. I don’t want that to ever happen to another family.
Myths are a barrier to treatment and to healing. Let’s use our voices to break them whenever and however we can.
If you have encountered myths about eating disorders that you would like us to address in our next “mythbuster” series, please let me know at email@example.com.