By Samuel D. Horton
What is the most deadly psychological disorder today? If you guessed an eating disorder, then you are right. According to WebMD, eating disorders are illnesses that cause a person to adopt harmful eating habits. So, does this make WebMD just a great resource, or is this really true, and is an eating disorder really a dangerous illness? Most sufferers of an eating disorder are often mocked about their problem, and they are not taken seriously. People should not misinterpret or disbelieve sufferers of an eating disorder because it is, in fact, a very serious illness. There are, however, minor cases of eating disorders but there are far too many deaths related to them, thus we must take this issue very seriously and approach it with care.
At Center for Change, we have asked many patients over the years to share from their private experiences what the Holidays have been like during the years they suffered with an eating disorder. The women quoted in this article are of different ages, but all suffered with the illness for many years. As you read the following passages you will feel something of the agony of suffering with an eating disorder at this festive time of year.
"Unlike any other normal teenager, I always hated it when the holiday season would roll around. It meant that I would have to face my two worst enemies - food and people, and a lot of them. I always felt completely out of place and such a wicked child in such a happy environment. I was the only person who didn't love food, people, and celebrations. Rather, holidays for me were a celebration of fear and isolation. I would lock myself in my room. Maybe no one else gained weight over the holidays, but just the smell of food added weight to my body. My anorexia destroyed any happiness or relationships I could possibly have had." -Nineteen-year-old woman
Women who suffer with binge eating or bulimia often live out this painful eating disorder hell in private and in secret, and often feel great self contempt. To many of their family and friends things may look positive and normal even while the sufferer feels significant despair and negativity about their loss of self-control. Those whose family members know about their eating disorder carry this awful feeling that they are the main attraction at the holiday dinner, where every trip to the food or to the bathroom is seen as a major defeat and disappointment to their family.Christmas is the hardest time with my bulimia. So much food, so much love, and so much joy, but I could not feel the love or joy, so I indulged in the food as a replacement. It was hard to see everyone so happy before I made the trek to the bathroom. I felt unworthy to be happy. I didn't deserve the love and joy. I've discovered that if I can focus on the love and joy, everything else falls into place" -Eighteen-year-old-woman
According to the article "Eating Disorders and Body Image in the Media" by Heather Mudgett, media can be very hypocritical because while the media shares news about celebrities dying from eating disorders, it also contains images of underweight celebrities modeled as if everyone should look like them. We might also see an article about a person dying from an eating disorder in a magazine, and on the next page we might see an underweight model, modeling a popular product. The underweight images of people in the media give consumers the wrong idea that being skinny is OK and that there is nothing wrong with it, when, in fact, being that skinny can lead to a person's own death. Consumers spend so much money on products and services that will help them lose weight, such as weight loss drinks, nutrition bars, pills, laxatives, weight loss videos, and they even take weight loss classes. People also misuse drugs and liquids in order to force themselves to lose weight, and this can be very stressing to the body. Any time that we do something against our body's natural functions, we hurt our body and put ourselves at great risk to further health problems in the future.
Some family dynamics, such as conflict, can be triggering to those with eating disorder difficulties. Struggles with perfectionism, feelings of rejection, disapproval, and fear of being controlled, are all cited frequently by women who suffer with the illness. Harboring strong feelings and beliefs that parents, family members, or friends find them unacceptable, inadequate, or disappointing is challenging for anyone, but is particularly devastating to someone with a painful eating disorder. Being immersed in a family setting during the holidays has the potential to dredge up old issues, fears, conflicts, and worries about family relationships. The resulting emotional disruption can feed the eating disorder and exacerbate the problem.Holidays, with all the food and family commotion, are pure hell when you have an eating disorder. For me, when the focus isn't on food and is on the real reason for the holiday, it's a big help. My family helped me out with this one, but I had to do most of it internally. Remember, it's just food, and we have more power than food." -Thirty-nine-year-old woman
The following suggestions resulted from a survey question we asked patients in treatment: "What three suggestions do you have for family and friends who want to help the holiday season go a little better for a loved one suffering with an eating disorder?" The women offering these suggestions range in age from fourteen to forty-four, and their suggestions offer some valuable insight and understanding that could be helpful to you as a friend or a family member. Being compassionate about the struggles of the eating disorder illness can help make the Holidays less of a battle for those you love. The suggestions are: Do not make a big issue about what your loved one is eating. A little bit of encouragement is okay. - Do not focus too much on food, it may only fuel the eating disorder. - Ask her how she is doing and see if she needs any help. - Do not become angry about how the she feels, just do your best to support her. - Offer a lot of support and be aware of what may be creating anxiety and try and understand what she feels. Be understanding, kind, and supportive. - Spend quality time with your loved one. - Make sure that the primary focus of the holiday is not on the food but rather on the family and the valued time you will share together. - Allow for other activities that do not involve food, such as games, singing carols together, opening gifts, decorating, and spending time just talking together. - Allow her to make a dish that she would feel comfortable eating. - Before the Holiday itself, and before family gatherings, make agreements about how you can best help your loved one with food. Honor the agreements you make. - Do not give her loud and attention drawing praise when she does eat. - Do not talk about diets, weight loss, or weight gain. It causes great anxiety and may increase a felt need to engage in eating disorder behavior. - Do not stare. - Learn enough about the illness and the triggers to help your loved one develop skills as well as strategies to defy eating disorder thoughts and urges. - Know something about her struggles, triggers, and behaviors. Then, if you see those, you can approach her after a meal in private and suggest ways she might be helped in some of those behaviors and learn ways you can be helpful and supportive. - If you see her struggling, ask if she wants to talk, but ask this in private. - Focus on how she is feeling inside, what issues she is worrying about, what her fears are, what she needs, rather than just how much she is eating or not eating. - Try not to focus too much attention on the eating disordered behaviors. - Be patient and nurturing. - Treat her with love and respect no matter what is going on. - Let her know that she is loved. - Help her take her mind off of food by generating a conversation with her about general or important topics. - Don't allow her to excessively isolate. - Be there for her emotionally and physically with hugs and messages of love.
There are several themes that are evident in these suggestions for loved ones and friends by those suffering with eating disorders. One of the most important is to keep the primary focus and interest on the family member or friend - the individual beyond her eating behaviors or eating disorder. Consider well these suggestions, they are actually heartfelt requests. How Family and Friends Can Help During the Holidays Family members and friends need to know ways to help a loved one suffering from an eating disorder during the holidays. In addition to those suggestions offered above, the following suggestions from clinical professionals may also be helpful: - If your loved one is a child or adolescent in treatment, and/or if you are involved in Maudsley/Family Based Treatment, then continue with your regular outlined treatment plan through the Holidays. - If your loved ones is a child or adolescent with anorexia, then learn about the Maudsley/ Family Based Treatment approach. It is important to give this approach consideration. - If your loved one is an acute medical or self harm risk then arrange for intensive medical/psychiatric care immediately. - Get professional help for your loved one with those who have experience and expertise with eating disorder treatment. - It is important for everyone to be honest and up front with each other. - It is important to emphasize the purpose for the celebration of the holiday and focus less on food or meals. If the focus is on the holiday itself and its true meaning and purpose rather than on the food or eating disorder, it will be easier for your loved one to focus less on it herself. Emphasize time together, activities, and traditions that transcend meals and eating. Let food become a support to the holiday rather than its central focus. - It is important for family and friends not to feel responsible and guilty for the eating disorder. Additional support can come from extended family, other friends, community, and even treatment team members. If you recognize the benefit of these additional support people during the holidays, you can encourage this extra involvement rather than be hurt and offended by it. Sometimes, a person with an eating disorder might not be ready yet to receive the full love and support family and friends offer, but support and love them anyway! You can send the message, "We're here to support you and it's okay if others support you as well. We want you to have all the help you need during this time."It is important for family and friends to remove any unreasonable behavior expectations or pressures of performance. Sometimes you want so much for things to be better that you do not realize how your disappointed hopes and expectations actually play out as triggers for the eating disorder. Letting go of these specific expectations in your own mind frees you up to respond to and enjoy whatever your loved one is capable of during the holidays. It would be more helpful to express a lot of warmth, love, kindness, and acceptance toward the person - "There is no pressure to prove anything to us during the holidays. We just want to focus on being together the best we can." Eliminating specific, overt, or implicit expectations will be more beneficial than almost anything else you can do.It is important to offer care "giving" and not care "taking." Being a self declared nurse, dietitian, therapist, or detective takes you out of your most important role - "loved one"
A lot of people are confused about what "normal eating" is so they need nutritional counseling to help them get back on track. Not that many people who suffer from an eating disorder go to get treated for it. According to the South Carolina Department of Health , only 1 out of 10 people who suffer from an eating disorder go to get treatment. The cost of treatment for an outpatient is very expensive. Costs for outpatient treatment can be over $100,000. In the US, the cost of treatment for an eating disorder per day is anywhere from $500 to $2,000. On average, a person in inpatient treatment has to pay $30,000 a month. People with eating disorders need approximately 3-6 months of inpatient care in order to recover. The cost of treatment for an eating disorder is ridiculously high, and the high costs might be a reason that people do not go to get treated. It is very hard for most families to pay for the treatment of their illness, especially when insurance companies don't usually cover eating disorder costs. Another way to help reduce the number of people with eating disorders is to educate people about the dangers of eating disorders through media. The media is a good tool to help educate people on the dangers of eating disorders, but it is also a tool that hurts people by condoning the appearances of skinny people who suffer from such disorders. Another way that eating disorders can be treated and minimizes is through the "Doll Experiment". People were shown that if a human being had the same attributes as a Barbie doll, the body would not be able to hold itself because of its awkward shape and structure. This is a good way to show people that a Barbie doll isn't necessarily what women today should aim towards looking like. In the same way, the celebrities we see on TV are not people who we should try to look like either.
I believe that as long as the media continues to idolize thin celebrities, the effects of education about the dangers of eating disorders through the media will not be effective. For each step that they take forward to solve the problem, they take two steps back by continuing to idolize thin celebrities. It is not a question of what effects have a greater likelihood of causing an eating disorder, but it is a fact that media does contribute to people developing and maintaining eating disorders. There are other causes of eating disorders, such as interpersonal or biological factors, but if the problem of media influencing eating disorders can be changed, there will be fewer cases of eating disorders. We have to take one step at a time in order to solve this very serious problem of eating disorders, and a great place to start is to change the fact that media influences eating disorders. There is not one cause of eating disorders, but media is a big influence to them since media reaches so many people. Personally, I think that group therapy very helpful in the treatment process of an eating disorder. Victims of an eating disorder are able to ask questions and receive answers in order to better understand their situation.
