Unraveling the Complexity of Eating Disorders-
We live in a society struggling with negative body image, little size acceptance, unhealthy relationships with food, increased stress, increased demands and decreased time for relaxation. The result? Every year we see the number of people struggling with eating disorders rise. For the first time in history, the numbers of men struggling with eating disorders is increasing at a rate faster than that of women. Eating disorders doesn’t discriminate- EVERYONE is at risk regardless of gender, age, ethnicity, socio-economics, sexual orientation….
I often hear, “I’ve tried over and over to stop____” in regard to people’s struggle with eating disorders. Eating disorders are complex and effect all aspects of a person, making it almost impossible to recover without the assistance of a professional treatment team who can help you explore ALL the components of the struggle.
You may be wondering- Why would you need a team of people helping with this? The individual struggling acts as the team captain meaning that they get the opportunity to hear all the information from everyone; but in the moment out there on the playing field of life, they are making the call about what happens and when. In addition to the therapist, it is important to include other professionals such as: primary care physician, nutritionist, as well as sometimes a psychiatrist or personal trainer depending on the unique characteristics of the eating disorder.
As with all treatment, there are a variety of treatment theories; however, the one I find most realistic and successful in facilitating recovery is the bio/psycho/social/spiritual model. As you might guess, this model takes a look at four different areas of an individual’s life, biological, psychological, social support and spiritual foundation.
Biologically, there are many possible factors to consider. Research demonstrates time and time again the genetic pre-disposition present for those in the throws of an eating disorder. Eating disorders have been linked to a chemical imbalance in the brain. As we look at a family, we screen for a history of depression, anxiety, substance abuse or eating disorders. This doesn’t mean if you have these things in your family you’re “doomed” to have an eating disorder. It simply means you are more at risk to develop an eating disorder and should be more aware of risk factors. Other things included in this group are things such as: gender, ethnicity, any medical history, as well as bodily functions (metabolism/exercise levels…).
Psychologically, there are multiple things to consider. Many times those working through an eating disorder have other mental health concerns such as a history of depression or anxiety. We explore patterns of behavior often present for those afflicted by eating disorders such as: perfectionism, control struggles, a desire to please others, and limited self-esteem.
Socially, it is vital to discuss the environment the individual is living. Where do they feel the most stressed? Where do they draw the greatest support? What are their relationships like? Who is aware of their eating disorder? Are they seeking treatment for themselves or because someone else asked them?
Spirituality gets explored from a broad definition of the word in my work. For example, do you see yourself as a spiritual person? From a broad perspective of life, how do you define your role here on earth? Do you believe there is a purpose in life, is so what is that?
When someone first comes into therapy for an eating disorder, they often feel, tangled up, knotted up; like a bunch of necklaces in a jewelry box that has been turned over and over until there appears to be no end points, only one big mess. As the therapist and treatment team, works with the client on each area of the client’s life (biological/psychological/social/spiritual), together, they start to take a look here, explore there, discuss one item at a time slowly unraveling each piece of the chain. This partnership of discussion allows for things to sort out in a time that feels safe, in an order that feels “right” until the person who was struggling left with the option to see each part of the struggle as an independent, more manageable “piece of the chain”.
The key is remembering the sooner you come in to sort through the gems in your jewelry box, the less likely they are to be knotted too tightly!
Michelle Roling, M.Ed., LMHC