The task of truly defining and explaining recovery from an eating disorder is one that I do not take lightly. When I stand in a room full of students or adults and describe my journey with an eating disorder, one of the first occurrences to take place is the sweep of the eyes over my body, as if my history with an eating disorder will be evident by the way that I currently look. I quickly debunk the myth that an eating disorder is in any way obvious according to weight or appearance.
I could spend an entire piece describing how painful it is for those struggling that this misconception is still so widely believed. An eating disorder is a mental disorder and while it impacts the brain and the physical body, an individual can have a debilitating eating disorder and his/her weight is not impacted for one reason or another.
Additionally, this misconception takes into account anorexia nervosa and the classic images of young women staring in the mirror to a “bigger reflection” or perhaps an emaciated figure. In reality, anorexia nervosa is the least prevalent eating disorder. Binge eating disorder and bulimia nervosa are more prevalent, but anorexia nervosa gets the most attention not only because the symptoms can lead to serious medical complications (this is also the case for the other disorders, a not commonly known fact) but because the “thin ideal” is one that is highly endorsed in our society.
When I continue to describe my journey toward recovery I emphasize the barriers and explore parts of the process that are often not discussed or are unknown, such the timeline, prevalence of relapse, the behavior and emotional change, and the resistance toward recovery.
One element of recovery that raises questions is how to cope with the body changes and/or acceptance of the body. The recovery process has two vital components: behavioral change (learning to normalize eating, manage symptoms of depression, anxiety etc.) and emotional processing (exploring the feelings that led to the development of the eating disorder and challenging beliefs about self that continue to give the eating disorder a purpose or function). The eating disorder can also be called a disorder of avoidance, communication or development as clients with an eating disorder often have difficulty in these areas. While in recovery, individuals are prone to focusing on the body rather than on the more difficult issues at hand such as trauma, pain, loss etc. as that too serves as a means of avoidance.
In my own recovery process I was adamant about and terrified of refeeding and accepting the body at its natural size. The factor that can make this even more challenging is that often—but not always—individuals with eating disorders develop them before the brain and body are fully developed and therefore there are some individuals who do not know what their natural body size truly is. Other times, they are aware of their body’s natural size but the thought of being in a “bigger body,” or of needing to accept the body size that they need to maintain a full life, feels unbearable. This includes all types of eating disorders, as it includes those whose bodies will change and those whose bodies won’t, but the key factor is acceptance.
What can truly make this process more complicated is when the client’s supports also express that they have difficulty accepting that the person’s body may change—or stay the same—as there is a desire for the individual to have a “smaller body.” What this means is that there are those families or supports who only want for their loved one to get better, but have difficulty understanding/accepting that this may include gaining weight/staying in a “bigger body,” as there is such a negative stigma associated with a higher weight in the general society. This does not happen all the time, but I’ve worked with numerous clients whose families were truly emotionally supportive, but also wanted the client’s weight to stay below a particular range, though that person was medically healthy above that range, and had to manipulate her body through maladaptive means to achieve this range.
We must recognize our own judgments and thoughts on the “healthy” body and challenge any type of mindsets that will exacerbate the issues or even encourage the use of disordered eating. To be clear, I am not encouraging the denial of some health issues caused by being at a higher weight. But studies show that being above average weight is medically healthier than being below average weight and so when making the effort to support eating disorder recovery we must check our own judgments at the door and practice understanding of the human being beyond appearance or body size.
When I recovered I did not simply accept my body. I processed my emotional experience and learned new ways of coping with historical and current issues. Moreover, I accepted that my body will continuously change. It is not about accepting the body at a certain size. Rather, it is that I accepted that my body is a vessel and one that will continue to change through the years. I do and will continue to care for this body but also recognize that it is not my essence and that changes in size—which have occurred, even recently—do not result in anything beyond reflection that I am taking care of myself both mentally and physically.
As we continue to learn about supporting those struggling with eating disorders we must always review and reflect on any obstacles that we bring to the table such as judgments or lack of understanding, and seek out knowledge and support for ourselves so that we may be better able to give love and help to those around us.
By Temimah Zucker, LMSW
Temimah Zucker, LMSW is a primary therapist at Monte Nido Manhattan as well as a public speaker and writer on the subjects of body image, self-esteem, eating disorders and disordered eating. Temimah also sees private clients who are looking for guidance in these areas as well as overall mental health issues. Temimah will be facilitating an upcoming group catered to Jewish women struggling with eating disorders, and will be an adjunct professor at Wurzweiler School of Social Work.
