You can't tell whether a person has an eating disorder by his or her looks. Some are skinny, some are large, and some are in between. They also have different habits: Anorexics starve themselves, binge eaters overeat, and bulimics do various things with food — some overeat and throw up, some use laxatives or diuretics, some exercise excessively to burn off calories.
But what they all have in common is that the fear of fat rules their lives, and shame about weight or eating behavior permeates their sense of self.
We know that repeatedly bingeing, purging, or starving harms your health, your emotional well-being, and your self-esteem. Plus, secrecy about what you do in private with food can alienate you from others.
But resolving an eating disorder is very hard to do. Bingeing, purging, and starving can feel good. For overeaters, food is the most comforting mood-altering "drug" on the market, for anorexics their ability to control their hunger can feel virtuous, and bulimics feel thinner and cleaner for having eliminated the excess food in their stomachs.
And so, to free yourself from an eating disorder, you need to get to the point where the pain of the secrecy and the shame outweighs the temporary relief of bingeing, purging, or starving.
As a psychotherapist and director of The New York Center for Eating Disorders, here's what I tell my patients about the steps to recovery:
1. Find new activities to replace destructive habits.
Eating disorders are a vicious cycle of habit that gets set in motion by restrictive diets. The cycle goes like this: diet, feel deprived, binge, purge, guilt, binge, diet. Since dieting always leads to deprivation and then overeating, you have to get off the merry-go-round by breaking the cycle at the point of the restrictive diet.
Resist overeating, purging, or starving by any healthy means possible: Go to sleep, polish your nails, call a friend.
For example, when one woman was working to break her pattern of bulimia, she took seven showers a day! "I found the water soothing," she explained, "And sometimes I just screamed in the shower until I got out all my tension." Choose activities that are incompatible with your eating disorder.
2. Separate food from your feelings.
To quell the binges, identify the people, places, and things that most trigger your emotions and cause you to reach for food when you're not hungry, or resist it when you are hungry.
Then, find your own GPS, or "growth-promoting strategies," to move your mission of health forward. Your GPS could include journal writing, an enjoyable exercise class, a support group, a nutritionist, psychotherapy, or medication.
A major key to recovery is replacing your isolation with food with intimacy with people.
3. Explore other contributing factors.
Honestly evaluate whether there might be other factors at play. Are you depressed, anxious, or obsessive compulsive? Do you have panic attacks? Do you drink and use drugs excessively?
This is especially true if you have a family member who is depressed or alcoholic, since strong family genetic and biochemical cause can contribute to these disorders.
Eating disorders often have a biological component that can be helped through medication. When your body chemistry is restored to a more optimal level, your emotional eating will improve.
4. Decode your obsession.
Bingeing, purging, or starving are a way of coping — a creative solution to deal with difficult and troublesome feelings. I believe all eating disorders are emotional communications from our inner self.
A bulimic person should attempt to translate into “feeling language” what her eating disorder is trying to express. I will ask a bulimic patient, “If your vomit could talk, what would it say and to whom?" Or to a binge eater, "If your fat could talk, what would it say?”
With this technique, eating disorder sufferers are led to reclaim their true self-expression that they have detoured through this hurtful behavior. They learn to use their mouths for speaking their inner truth and not for bingeing, purging, or starving.
You do not have to suffer alone. You do not have to recover alone. There is help if you reach out for it.
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