Eating disorders can happen to anyone

It is Eating Disorders Awareness Week from 27th February to 5th March 2017, and there is still stigma attached to those who suffer with an eating disorder. There is an undercurrent of ‘they brought it on themselves’ or, especially for those suffering obesity ‘they are greedy and lazy’.

In this article, I want to highlight how our relationship with food is not totally of our own making.

There is a genetic element to eating disorders, whether it is related to the amount of brown adipose tissue we have (this is more able to burn extra calories off as heat, rather than store it) our body-type, our mental predisposition or our environment. We are not in control of our genetic make-up.

Then there is the social context of our birth. Currently in the West, we have an aesthetic that suggests women are more feminine and desirable with less body fat and men more masculine and desirable with a six-pack. (Unfortunately, our binary approach to gender also contributes to this acceptance of our bodies looking either feminine or masculine) In the 21st century this way of thinking is powerfully represented in every media 24/7. By artificially creating a ‘desirable’ representation of the human form we have become numb to the beauty of difference. This profiling of what we should look like can have a greater impact on certain individuals, those with low self-esteem especially but also in families or social groups where to be ‘normal and fit in’ is very important. Consequently, some individuals feel they need to change their natural body shape, or that of their children to feel acceptable both to themselves and to their peers. This continual struggle for individuals to modify their natural body shape causes mental health issues, one of which can be an eating disorder.

Food is a source of nutrition, necessary for survival, health and well-being. How we feed has implications. There is no blame here, attached to how we feed our children, the accumulation of many things; genes, social context, family culture, and past experience all influence the impact our feeding style has on our child rearing. Whether to choose to feed our babies from the breast or bottle can create anxiety in the mother, what weaning foods are recommended and when to start weaning, all these milestones are influenced by health policy, a mother’s autonomy and maternal instinct are often undermined. The types of food offered, the variety, the timing are all influenced by the rules our society has adopted regarding meals and what is ‘healthy’. As a baby grows into an infant and then child they are not encouraged to listen to their bodies, trusting it to tell them when they are hungry but to follow the ‘rules’. This may result in cravings and urges for foods that are ‘forbidden or bad’ we are not empowered to self-regulate our intake and food choices.

Again not wanting to attribute any blame but I want to show how our culture is the cause of many of these eating issues. Food, very early on is a tool for power and control either for parent/care giver or for child. The child who tantrums at meal times is gaining attention which they crave, or the parent denying pudding or snacks, are adopting ways to control behaviour at the expense of physiological need. Food is a reward system, a soothing, self-caring resource. Its purpose of providing fuel and nutrients to facilitate growth and survival is lost. This can be confusing to the child whose emotional intelligence is naïve and under developed. The consequence is adolescents, and adults who have an emotional relationship with food that has nothing to do with its physiological purpose and everything to do with them feeling safe and nurtured or self-efficacious.

This is demonstrated by our medical model of treating obesity or of force feeding those with anorexia nervosa. Bariatric surgery has amazing health benefits, weight loss, loss of diabetes (type 2) and many others, yet there is a recognisable group, post-surgery who develop other ‘unhealthy’ behaviours including alcohol and drug addictions. Re-feeding those with anorexia can be useful to enable them to be in a better cognitive state to enter psychological treatment but it does not cure them just because they get to a normal BMI. Taking away their control can actually do more harm than good. Providing appropriate psychological support as part of a treatment package is fundamental.

Eating disorders are multifactorial, many of our own society’s creation, it is therefore even more upsetting that the resources to support those with eating disorders are so stretched that those in most need and most likely to benefit (teenagers) are least able to access local care.

When you see someone who you believe to be too big or too small before you make a judgement, remember they are just like you, surviving in this complicated world with the tools they were given.