Eating Disorders: The Ugly Security Blanket
By Jessika Endsley
Eating Disorders are a vastly misunderstood sector of the psychological field. In looking for information on Eating Disorders of any type, you're likely to find the symptoms, risk factors, and treatment options. This information is very surface-level and often misinformed; Eating Disorders have very little to do with weight loss and everything to do with control and emotion, much like alcoholism has very little to do with vodka tasting fantastic and everything to do with emotion. Eating disorders are marked by chaos and control surrounding the emotional spectrum. This is precisely what indicates the difference between an Eating Disorder and a diet. A diet is actually about weight loss.
Eating Disorders (Anorexia, Bulimia, EDNOS, Compulsive Overeating Disorder, and Orthorexia) are an (often subconscious) attempt to make the entire life better or more bearable through the control and obsession over caloric intake via restriction or fasting in the case of the Anorectic, or through the binges (sometimes meticulously planned and sometimes not) and purges in a Bulimic person. EDNOS is generally a combination of these two or one who displays the characteristics of one or the other without meeting official criteria, or are Eating Disorder "Switchers." Compulsive Overeating Disorder is characterized by over-eating to null the emotions which results in an addiction to certain types of food or food in general. Anorexia and Bulimia are the terms most commonly thrown, and also the two most likely to be personified as a "friend" or "enemy" by the sufferer, so I will explore those for now.
Eating Disorders are also thought by some professionals to be a way to seek and gain approval through negative attention. Although this can be true in certain cases that generally involve a pre-existing condition such as Borderline Personality Disorder (known for developing Eating Disorders and other self-destructive behaviors that can result in negative attention) or Histrionic Personality Disorder (a Personality Disorder that thrives on dramatic forms of gaining any form of attention) I must argue that for most, Eating Disorders are not a way to gain approval through negative attention. "Gaining approval" through anything considered "negative" is nearly oxymoronic. If the most "at risk" for Eating Disorders, are, as statistics indicate, middle to upper class white females, negative attention is the last thing desired by these girls and their families.
Anorectics' concealment and denial
Girls and women (and yes, even males) developing Anorexia will go through lengths to hide what they are doing such as lying about having eaten, wearing layers once weight loss occurs, and lying about their weight. They may be taking extra warm baths to keep warm, but they certainly are not shouting it to their entire family as to why they're doing such. The Anorectic will paint her nails to hide the weakening state of the enamel and even go as far as to learn new ways of styling her hair to hide the hair-loss that goes along with the disorder. People with Anorexia often do not believe they have a problem (and unless they have an extremely low BMI, neither do professionals,) rather that others are over-reacting to their weight-loss regime. They believe that everyone else has a distorted vision or are outright lying to them rather than they themselves have a distorted perception of their bodies. They just want to fix "the problem." If someone doesn't believe they're doing anything negative, it cannot be logical to assume they are looking for attention that is negative.
Often, they don't want any attention at all.
While not part of the diagnosis of Anorexia (since none of the criteria has to do with personality), an instantly recognizable trait of many Anorectics is blatant, self-centered lack of empathy. A lack of empathy can occur for many reasons, ranging from onset Personality Disorder to obsessive addiction. What may have one been your "normal, caring, straight-A student" of a daughter is now sullen. She's obsessive. When you're not watching, she's meticulous, so even as you are openly distraught and worried about her decreasing physical existence in this world, she insists on eating separately from the family. She seems to love her obsession more than she loves the people who love her.
Addictive starvation high
After all, the obsession helped her feel in control when no one else could. She may feel weak, but the starvation high can feel worth it at times and yes, it is as addictive as the endorphins a Bulimic gets from purging.
Another piece of the Anorexic world that is often overlooked - probably due to the majority of the Eating Disordered being female - is that the behavior consistent with Anorexia also happens to be an unusually narrow and restricted interest and extreme repetitive behavior. Are we supposed to ignore entirely the excellent systemizing and attention to detail that Anorexic patient's display? Apparently, because that is beginning to sound a bit like the resistance to change that one would see in someone on the Autistic Spectrum and yet in some patients, the only difference between an average female Aspie and themselves is that their narrow interest is food and body shape. While it may not be the majority-case, it couldn't be less than beneficial to explore the entire personality and thought process of the Anorectic to see if, perhaps, an undiagnosed Aspergers female is under your care. Then we could begin the treatment program appropriate for that particular Anorectic.
Signs and symptoms of Bulimia
Those suffering from Bulimia often experience nothing short of shame if they are discovered partaking in their binge-and-purge cycle. Although Bulimics are less likely to have drastic weight changes or ever become underweight due to the nature of binge-food being high-caloric and sugary which means fast absorption (though they are more likely to seek help on their own and will receive it if they binge and purge at least twice a week for three months) there are physical symptoms to hide such as bloated face from purging via self-induced vomit, broken blood vessels around the eyes that make you look like you've been screaming for hours, and scraped knuckles. Not to mention the less-than-lovely smell of vomit and hiding the retching sounds, or in many cases, the laxatives. Non-purging Bulimia also has to be taken into consideration - these women and men go through lengths to hide their binge food and then make their fasting or over-exercising version of "purging" look like regular behavior. And it does - until the dreaded moment when someone finds your stash of junk-food or listens to what you're actually doing in the bathroom after supper. Then, the Bulimic feels ashamed and guilty for a whole new reason outside of weight.
While Anorexia can go untreated due to the denial of the Anorectic themselves of anything being wrong, the only hope for the Bulimic to go untreated is to go undetected; restricting food to become skinny is acceptable in our culture. But there is absolutely nothing socially acceptable about altering how or when the digestive process is completed via vomiting or laxative abuse.
What primarily sets Bulimia apart from Anorexia in the process of thought is that Bulimia represents chaos and abnormality. While an Anorectic controls the chaos within or around her by means of controlling her food intake, a Bulimic becomes a representation of all chaos in her mind and in her life. It's much as if Bulimia showed up to the stressed, frustrated, self-loathing girl who, after an entire day of restricted eating "on her new diet," is staring into the freezer at her potential ice-cream-victim and asked "Hey, would you like to work for me?" Bulimia is then met with reluctant acceptance and soon enough, it's all the Bulimic can think about. "I should not eat today" followed by "I can't help it" followed by "What have I done and how can I undo it."
Stress response in Bulimics is extreme which may be why it is extremely common in those with Borderline Personality Disorder and why the disordered behavior of the Bulimic resembles the emotional world of a Borderline. The Bulimic feels empty, and then do something so that they don't but what they feel now is far too strong and they're far too full, so they do whatever they can to feel empty once again. Unlike the typical Anorectic, who will react to stress by locking down to maintain control, a Bulimic is moved along by the stress and the emotion like they are caught in a very rapid current. It is not uncommon for a girl, after an emotional breakup, to be found eating cookie-dough from a carton, crying. It's also not uncommon for a girl who reacts poorly to stress to become nauseated and then vomit after an emotional breakup and then retreat to her room, defeated.
This is the essence of Bulimia.
Why EDNOS "switchers" alternate
It is not uncommon for some patients to switch back and forth between behaviors of both Eating Disorders. This is only one form of "Eating Disorder Not Otherwise Specified," usually called EDNOS. The personalities of these people tends to lean either towards a "Bulimic" personality or an "Anorexic" personality, but which behaviors they are using at any given time is reactive to what is going on in their life and with their emotions and who is around them. They've manipulated the system. These people are extremely adaptive and generally older than onset Bulimics and Anorectics; they can be much harder to detect, having years of experience with both Eating Disorders. "Switchers" know they have a problem and they have probably attempted recovery in the past, by force or on their own, but have and understanding that these behaviors help them cope and that they may not be ready to recover, if ever.
All Eating Disordered people (and most human beings in general) tend towards some form of neuroticism about a specific area in their minds, and Switchers are overwhelmed by the fact that outside forces can cause changes within their emotional spectrum and in their behavior, so all neuroticism that they have is channeled and therefore muted via their use of Eating Disordered behavior. Long-term Switchers are like versatile criminals; if you catch them in the act, they'll deal with the consequences and then change their style of crime, learning more and more how to hide their mode of coping.
How to replace the ED security blanket?
There is so much more to all disordered behavior than just the behavior itself. Much like a professional should not tell a cutter to "stop doing it" and ignore the prodding emotion behind the self-destructive action, the entire personality and emotional well-being of the Eating Disordered patient should be examined and monitored prior to any attempt to make them simply "stop" being who they are. These people have found a way to cope; ripping away their security blanket will be met with resistance unless a better, prettier security blanket that has been tailored entirely to their individual personality has been created and presented.