It's Not About the Food?!

Eating disorders have nothing and everything to do with food.  When I was first diagnosed with Anorexia Nervosa, I had every therapist, dietitian, and psychiatrist telling me the same thing:  “It’s not about the food.”  I remember fighting with them constantly.  Of course it was about the food.  Food was all I thought about.  And yet, (spoiler alert) they were right.  It’s not really about the food.  Eating disorders are complex, biopsychosocial illnesses that affect the individual physically, mentally, and emotionally.  They do not discriminate between age, gender, race, ethnicity, sexual orientation, socioeconomic status, or body shape/size.  Contrary to popular belief, you cannot tell someone has an eating disorder by just looking at them. 

 Eating disorders can manifest in many different ways. 

• Anorexia Nervosa (AN) is characterized by an obsessive fear of weight gain, a refusal to maintain a healthy body weight, and a distorted body image.  AN can present in one of two subtypes:  restricting subtype or the bingeing/purging subtype.
• Bulimia Nervosa (BN) is characterized by repeated episodes of binge eating (consuming a large amount of food in a short period of time) and purging (eliminating or counteracting calorie consumption).
• Binge Eating Disorder (BED) is characterized by recurrent episodes of binge eating, where the individual feels the sense of a lack of control over the food.  These episodes are not typically associated with any compensatory behaviors, such as purging.
• Other Specified Feeding or Eating Disorders (OSFED) are characterized by severe disturbances in eating behaviors that don’t meet the full criteria for AN, BN, or BED.
• Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by a persistent failure to meet appropriate nutritional and/or energy needs, and can be exhibited by a lack of interest in eating, an avoidance of foods based on different sensory characteristics, and/or a fear about an aversive effect of eating.  Individuals with ARFID do not typically show a disturbance in how they perceive their body weight/shape/size.
• Pica is an eating disorder characterized by the persistent consumption of non-food items that contain no nutritional value, such as chalk or dirt.

 Those behaviors, however, are just the “tip of the iceberg.”  On the surface, you see the symptoms:  restricting, purging, bingeing, compulsive overexercising, and everything in between.  But below the surface is where you’ll find the underlying issues:  anxiety, depression, perfectionism, OCD, trauma, etc. 

 Ah-ha!  So, that’s what all those clinicians were trying to tell me in the beginning of my recovery journey.  Eating disorders are about so much more than food.  When I was finally willing to listen to my clinicians and “look below the surface,” I understood what they were always trying to tell me.  I wasn’t not eating because I didn’t like food or just wasn’t hungry (although I did try to convince them of that).  I was acting on my eating disorder because I didn’t want to deal with all those underlying issues.  I didn’t want to feel my anxiety and depression.  I didn’t want to deal with my trauma.  And when I was engulfed in my eating disorder and only thinking about food, I didn’t have to.

 Recovery has been the hardest thing I think I will ever do.  Facing all those underlying issues head-on has been painful, messy, and definitely nowhere close to perfect.  For me, recovery has been one step forward and two steps backward.  I have learned that I didn’t choose to develop an eating disorder - no one does.  But, I can choose recovery, and I do choose it every single day.

 For resources or more information, please contact The Alliance for Eating Disorders at 866.662.1235 or visit www.allianceforeatingdisorders.com.