The problem with food
By: James Foley
The problem with food
The area of eating disorders is a complex issue of disordered thinking and related behaviour. In my experience I have seen how families are torn apart by it. They see their family member seemingly self destructing before their very eyes. The family feel helpless. Indeed it seems the more they offer help the more deterioration is observed.
Eating disorders know no boundaries. Male or female, older or younger, well off or not. Over a process of perhaps years the person’s control of eating and perception of body image has turned into these two issues controlling them. How he or she feels about what they see in the mirror is everything to them.
The tangle of associations causing eating disorders is as complicated as those associations that result from the disorder.
It is impossible to fully cover the issue in this blog. My main purpose is explain eating disorders simply. Also to give some pointers as to how to work with and hopefully through it over time. I give some consideration as to how how families can help and be helped.
I will indicate to you how Prevail could help a client with an eating disorder.
What are eating disorders anyway?
The American Psychiatric Association gives this definition:
“Eating disorders are behavioural conditions characterized by severe and persistent disturbance in eating behaviours and associated distressing thoughts and emotions”
In this definition are mentioned behaviour, thoughts and emotions.
Some behaviours associated with eating disorders
Frequently self checking in the mirror.
Disappearing after meals, often to the bathroom.
Very controlled eating patterns
Eating in private
Wearing bulky clothes to hide the body
Some thoughts associated with eating disorders
All or nothing thinking
Constantly thinking about food and perception of body image
Controlling the perception of body image aids in the control of other life issues, primarily subconsciously
False beliefs about the merits or demerits of particular types of foods and exercise
False beliefs of what a healthy body is
Some emotions associated with eating disorders
Intense fear of gaining weight
Irritability or flatness of expression
Fear of how others may react if they see you eating
Do not care about themselves
Some of us do have a disordered association with food from time to time. This may be relatively harmless and just be a phase. The person may be perfectly able to make choices related to this behaviour and associated beliefs.
With an eating disorder the reality of compulsion to comply with a set of beliefs around food is the driving factor. In effect the person has surrendered their choices around food and exercise so as to achieve the desired perception of body image. The control of compulsion has replaced the freedom of choice.
A brief look at the main types of eating disorders
If left untreated this could result in death by starvation. It is a process by which the person severely restricts the amount of food they eat. Their weight may become dangerously low in the context of their age and height.
It can have severe physical and emotional effects as the body simply loses energy and nutrients needed to support normal living.
Treatment is a combination of psychological and medical interventions.
If the physical condition is dire the person may need admittance into a hospital where restoration of an appropriate body weight is the first priority. While psychological support will be part of this it is secondary. However restoration of weight will be short term without a high level of ongoing psychological support from a dietician and counsellor.
The person needs to be part of the planning of their dietary recovery through meal planning and social consumption of food.
Simply put it is eating too much, too quickly and not paying attention to feeling full. They will feel guilty over their loss of control and feel powerless to do anything about it.
This can lead to obesity and all its associated health risks of diabetes and cardiac problems.
The treatment is a similar process as with anorexia with perhaps more emphasis on the therapeutic approach.
With bulimia the person is cycling between binging and severe dieting. When the person binges on food for a season they feel guilt and shame for their loss of control. They respond by trying to lose any gained weight through forced vomiting, laxative abuse or excessive forced exercise.
People with bulimia are completely caught up in the decisions related to food. They will try to keep their problem hidden. It is possible they could do this because their body may overall keep a normal weight and appearance.
Physical symptoms can include excessive gastric reflux and stomach acid in the mouth, sore throat, excessive diarrhoea etc. It can lead to anorexia.
A healthy co-planned eating plan with psychological support is the main treatment. Antidepressants may help also.
A word on families
Chances are you are reading this because someone you know has or may have an eating disorder. When a family member develops this condition others in the family feel guilt. They begin to believe they possibly caused it. The behaviour of the ill family member can cause a lot of stress in the family. There can be a lot of deception and manipulation by the person with the eating disorder. This can make family members doubt themselves and their ability to help. They may even turn against their family member.
Blame is an easy road to take. Blaming yourself or the person with the disorder. It is also easy to get drawn into the person’s behaviour and thinking which increases everyone’s anxiety over time.
It would seem the key is to stay committed to the family member, reassuring them of your ongoing support. While being supportive the family should not get engrossed in the impact of the disorder. This will help the family to not get caught up with the same issues as their sick family member is experiencing.
A family can avail of Family Based Therapy from a systemic family therapist. This is a phased process of behavioural work with psychological support that a family can work on at home in conjunction with a professional team.
There is good support to be found at Bodywhys.ie, the website of the Eating Disorders Association of Ireland.
If you need help related to eating disorders
At Prevail I am happy to sit with you if you are the person with an eating disorder. Or perhaps you need support in supporting someone else with the condition. The main focus of my work is to accept the person while discouraging the behaviour that is hurting them.
Perhaps you need to talk with someone about the decision to enter a rehabilitation programme. You may be worried about potential relapse. Maybe you have just finished a programme and feel you need ongoing support.
During the work the main issue is to stay physically healthy. If physical health is ever in real danger then referral to appropriate medical care is needed.
While the road to full recovery can be slow and frustrating, it is possible and it is essential for all concerned to not give up hope.