2020 has been a year fraught with tension, fear, and a constant need for adjustment thus far. We as a people rely on routine and safety, and this time has been tumultuous and scary to say the least. Many of us have learned to use coping skills that have been destructive this year, whether it be a short temper with the kids or a few too many cocktails at dinner. Imagine for a moment what life would be like right now if your primary coping skill was manipulating your food or exercise regimen. This year certainly would be a challenge. I’m talking about a specific grouping of people that are not talked about nearly enough, the individual who struggles with an eating disorder. On the surface, it’s easy to see that gyms closing, memes poking fun at binge eating while in quarantine, the impact of social media influencers with seemingly “perfect” bodies, and lack of structure could contribute to some discomfort among those who rely on nutrition and exercise as self-medication. The relationship with food and body are, however, really secondary outward responses to what is happening internally. I would urge you to take a deeper look. People often learn unhealthy relationships with food, body image, and exercise at very early ages. Food is the primary abusable substance available to us all from day one. For a child whose home is out of control in some way, food may bring a sense of calm and “medicate” the uncertainty of day to day. For the child with rigid or strict parents, refusing food may be the one thing that they feel they can control. For the child with a parent obsessed with athletic performance, exercise and sports may be about a much deeper issue- gaining much needed approval from an otherwise unavailable parent. For a child who faces sexual trauma, weight gain may provide safety, a proverbial “cushion” from further abuse. For the child who has learned that their needs are not important in the home, becoming virtually “invisible” through restriction of food may become important. These patterns are lifelong. Though eating disorders are the number one cause of death among mental health disorders, many people are able to live with eating disordered behaviors for a very long time. Comparable to the way some people are “functional alcoholics,” many individuals have found a way to have “functional eating disorders.” Often it looks normal, even healthy. These are the people who don’t eat carbohydrates for a decade, take stimulant medications with a primary goal of curbing their appetite, go to the gym everyday like it’s a religion and can’t tolerate not going, have self diagnosed gluten intolerance, binge eat sugar and starches until they attain a coma-like feeling in order to sleep, sometimes make themselves purge in secret after eating a particularly caloric meal, abuse laxatives, add an extra workout to punish themselves for having the slice of cake...the list goes on and on. For these people, an unflattering picture of them, an innocent criticism by a child, or a social event involving foods that they deem dangerous can absolutely send them into a tailspin. It’s important for me to mention that eating disordered behaviors don’t discrimInate against gender or race lines. We all have a picture in our heads of a rail thin, white ballerina as the poster child for eating disorders. Not true. From over a decade in the field, I can tell you that there is not a certain “type” that struggles with food and body image. It’s widespread, obliterating race and gender lines. It is over looked, often undiagnosed by professionals, and it needs our attention now more than ever. Make no mistake, the disease is, at its best, a mental battlefield, all-consuming and wreaking havoc on self esteem and overall functionality. At its worst, it can be fatal. We, as a culture, need to start talking. We need awareness of the severity of eating disorders and we desperately need mental health intervention. For anyone struggling or concerned about a loved one struggling, a skilled therapist can make all of the difference in the world. There are countless resources available and speaking up and getting help is absolutely critical, now more than ever.
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