Tuesday, October 2, 2012

Competition among the eating disorders

Reader Krista brought up this point of comparisons between those with eating disorders, and asked if she is the only one seeing that anorexia is glorified while bulimia is looked down upon. And, no, Krista, you are not the only one seeing this. I see it all the time and take a number of steps to try to avoid this in the group that I run, though certainly I understand I cannot change what is going on in each patient's mind.

I think the root of this is that our society glamorized dietary restriction. Which frustrates me to know end because I am very aware eating disorders are lethal; the most lethal of all psychiatric diagnoses. So, to have such a lethal behavior glamorized certainly shows the level of ignorance, but also just really irritates me, honestly! Those who restrict, whether in an ED or not, are seen as having control, willpower, strength, and power. Now, those with eating disorders generally know nothing could be farther from the truth. Sure, engaging in an ED can create a feeling of power and control at times, but most realize having an ED actually is a feeling of being out of control and powerless against the voice in your head.

Bingeing or bingeing and purging is simply not seen as as glamorous, so restricting is seen as the symptom of choice. In reality, those who binge and purge, the vast majority of the time, also restrict; that's the physiology that sets up the binge. But it is interesting how often those who binge and purge, and binge without purging, overlook their restricting because they feel such intense shame around the bingeing behavior.

Something that I think is also related is this concept of those with low weight eating disorders being able to use their body, their disorder, to communicate. Those without the low weight, I think, do not necessarily have that way of showing others that they need help, and so I think, for some, they may want that lower weight so that they are less invisible, ironically. This is just a thought on my part, nothing I have seen confirmed by research findings.


  1. I definitely have used a lower weight to signal a problem. And I see it happen all the time. Not that I expect that to be seen in research findings. Also, it is simply to get coverage for treatment.