Each Story About Eating Disorders Is Different
Soledad O’Brien at The Renfrew Center Foundation's Eating Disorders Conference.
Posted December 4, 2020
Each story about eating disorders is different. There are some similar themes, but the stories are unique and not necessarily as predictable as we’ve been led to believe. The afternoon-special-version of who develops an eating disorder and how recovery ensues is often off the mark. This is the message I derived from a recent presentation by Soledad O’Brien at The Renfrew Center Foundation's Eating Disorder Conference for Professionals.
Predictable stories make us feel as if our world is understandable. The storyline we’re used to, when it comes to eating disorders, is that of a white, teenage girl who is insecure and desires weight loss. Things get “out of control,” and she eats too little and loses too much weight. Fortunately, caring parents or teachers or coaches come to her aid and with the help of a therapist, she is able to make a full recovery. This is a hopeful story, but reality presents a much messier picture.
In O’Brien’s presentation, she reminded us that sexy headlines sell, but people are all about nuance. What we really need to do is dig into the contradictions of human life and get to know real people and their lived experiences. Without this, all we end up with is a simple caricature of an incredibly serious set of mental health problems and not a helpful understanding of eating disorders.
The story of eating disorders is many different stories. Men, women, children, adolescents, older adults, and individuals of all sexualities experience eating disorders. In fact, there are many eating disorders that include an array of behaviors that are sometimes viewed as “healthy”: exercising, fasting, and concerns about weight and health. People with eating disorders may be emaciated or they may be heavy; you cannot tell who has an eating disorder by looking at a person.
The antidote for oversimplified headlines is to tell our own, complicated stories. In Soledad’s words, “being authentic and getting the story right” is critical. Cara’s story (24 years old; not her real name) is one that begins before puberty and lasts over a decade. Instead of supporting her, Cara told me how her family tried to convince her not to get help for her eating disorder. Her family congratulated her weight loss instead of appreciating that it came at a serious cost to her mental health. Cara pursued intensive outpatient treatment, but her family didn’t participate in any of the family sessions. Today, she’s working towards a healthy body image and eating habits—and healthy relationships with her family. Her recovery is still work; there is no after-school-special summative moment.
Ella’s story (21 years old; also not her real name) involves a supportive family, but she still got the message from the world around her that she should be small and quiet; stoic but light-hearted. She told me that she considers herself fiery, complicated, and opinionated—even a bit wild. She didn’t feel like she could be her true self and she literally starved herself to near-death. Years of therapy and a change in nearly all of her life plans, from the what and where of her college studies to what she’ll pursue professionally, have offered her equilibrium. But she admits to still feeling like the universe has set her and so many others up for failure. Until society embraces the complexities of mental health and stops selling simplified messages of “love yourself no matter what” and “just eat what sounds good to you,” she worries she’ll struggle and others will, too.
People love a tale of redemption; a story that arcs towards failure or illness but ends with a success or a cure. Cara and Ella are but two examples of the chronic nature of eating disorders. The majority of individuals with eating disorders meet criteria for at least one other psychiatric disorder, making a quick recovery unlikely.1 Eating disorders also have a relatively high fatality rate, surpassed only by opioid addiction in terms of mental health disorders’ mortality risk.2 Eating disorders are not glamorous; they can ruin lives. Of course, this isn’t to say that recovery isn’t possible, but it will be facilitated by both professionals and a larger social context that allows people who are suffering to be supported and work through all the messiness involved in mental illness.
In O’Brien’s words, “Each individual journey is unique. Development of an eating disorder—and the recovery we hope will follow—can’t be understood with a passing glance. There is likely to be chaos and suffering but also opportunity in each person’s story. Sharing stories can change—maybe even save—people’s lives.”
1. Hudson JI, Hiripi E, Pope HG Jr, and Kessler RC. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3):348-58.
2. Chesney, E., Goodwin, G. M., & Fazel, S. (2014). Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry, 13(2), 153-160.