When they find out that I counsel people with eating disorders, many people ask me the same question: “Why don’t they like food?” Or, “I could never imagine throwing up all the time – how awful!” We usually get into a discussion (a good one) and, as they are usually uninformed about eating disorders, I typically tell them that they are not really about food at all, but rather about control. Most people who suffer from eating disorders have issues with control in their lives. They may feel out of control, which means that food is the only thing that they can control. Or, they may find the world around them so chaotic that controlling their food intake is the way in which they can feel that they are in control themselves. In this article, I outline the reality of eating disorders and look at ways to address them.
What Causes Eating Disorders?
Whatever the case may be, eating disorders often run in families. Whether it was the mother or the father who had issues with overeating or undereating, these do appear to be passed down as children model their parents in everything that they do. In addition to the control issue, children and/or teens may develop eating disorders as a response to stress in the home or at school. Some people over-eat when they are stressed out, while others tend to under-eat or not eat at all. Our bodies also process things differently from each other, which also plays a part.
The Extent of Eating Disorders
What are the statistics on eating disorders? Well, according to the Washington State Department of Health (www.doh.wa.gov Mental Health-Eating Disorders, August 27, 2016),
Approximately 1% of adolescent girls in the United States develop anorexia nervosa and 2-5% of adolescent girls develop bulimia. Anorexia is the third most common chronic illness among adolescents in the United States. The prevalence of eating disorders in males is much smaller than females but an estimated 19-30% of anorexia cases diagnosed in older adolescents are male.
These numbers are staggering, especially considering that adolescents have enough to go through as their bodies begin to change physically and their brains begin to change developmentally.
With regard to the adult population, it was found that eating disorders are a daily struggle for 10 million females and 1 million males in the United States. Four out of ten individuals have either personally experienced an eating disorder or know someone who has. Over a lifetime, the following percentages of women and men will experience an eating disorder:
- .9% of women will struggle with anorexia in their lifetime
- 5% of women will struggle with bulimia in their lifetime
- 5 % of women will struggle with binge eating
- .3% of men will struggle with anorexia
- .5% of men will struggle with bulimia
- 2% of men will struggle with binge eating disorder (National Institute of Mental Health, nimh.nih.gov, Eating Disorders, August 27, 2016).
What Do People with Eating Disorders Need?
These statistics don’t mean anything for some, but for those of us who treat individuals with eating disorders, or struggle with them ourselves, these numbers are sobering. What can we as a society do to help those who struggle with these issues, especially young children and adolescents? Individual and family counseling is a must, and sometimes medication is also necessary in order to treat the co-morbid disorders, such as anxiety and depression, that go along with eating disorders. Group counseling can also be very beneficial, depending on the individual’s personality and comfort level in groups. The main thing that those who struggle with eating disorders need is the full support of their family and friends to seek out treatment.
Eating Disorders are a Form of Addiction
Eating disorders are a form of addiction. Just as alcohol, drugs, sex, and shopping can be an addiction, so eating disorders can also be a form of addiction. Many people don’t realize this, but it is very addictive for an individual to become “obsessed” with losing weight or looking a certain way. A condition called “Body Dysmorphic Disorder” (BDD) can also correlate to eating disorders. The DSM-5 categorizes BDD in the obsessive-compulsive spectrum, and distinguishes it from anorexia-nervosa. Wikipedia describes Body Dysmorphic Disorder as a mental disorder characterized by an obsessive preoccupation that some aspect of one’s own appearance is severely flawed and warrants exceptional measures to hide or fix it.
The Need for Support
Another helpful tool for someone struggling with an eating disorder is to have a team of people around them to encourage them on their journey to recovery. This typically consists of a team of professionals, including a counselor, dietician, psychiatrist (medication purposes), and support counselors for meals if the individual is in a treatment facility. This raises another point: Some treatment centers are inpatient-based, which means that the individual has to stay there for anywhere from one to twelve months. This depends on an intake evaluation by the treatment facility. Alternatively, a counselor or family member may have referred the client to a facility. The other option is for an individual to receive outpatient treatment, which typically consists of individual counseling, appointments with a dietician and a psychiatrist, and group counseling and meals. All this occurs within a facility at which they do not stay overnight.
Helpful Activities when Dealing with an Eating Disorder
What other activities can someone engage in to help ease their struggles with an eating disorder? What can family members do for someone they love who is struggling with an eating disorder? I worked in an eating disorder clinic for almost a year, while also treating clients in my private practice. Moreover, eating disorders run in my own family, and at one point I struggled with anorexia for quite a few years. So I completely understand the struggles behind this very difficult disorder. Here are some things that I saw in the clinic where I worked and I can recommend as helpful based on my own personal knowledge:
1) Individual counseling to work through eating issues, body image issues, family issues, and what life was like before the eating disorder took over.
2) Prayer, yoga, meditation – whatever works for you and brings peace of mind.
3) Healthy amounts of exercise, which typically consist of three days a week, 30 minutes at a time. Any more than this amount can become obsessive for those struggling with eating issues.
4) Structured meal times with helping professionals (typically these are support counselors) in order to learn how to eat in a healthy, balanced way.
5) Appointments with a dietician to learn about food, including what is good for you, what your body needs, how much to eat, and from what food groups.
6) Appointments with a psychiatrist for medication to treat any co-morbid disorders that may be behind the eating disorder (which is very common). Examples can be anxiety, depression, bipolar, alcoholism/drug addiction, or a combination of different issues.
7) Reading, journaling, art projects, listening to music, and creating something that you are proud of.
8) Helping others when you are becoming healthier yourself. We often begin to feel more grateful for our own lives and blessings in them when we help others.
Prayer and Bible Reading for those with Eating Disorders
Another very important and beneficial activity for getting well is time spent in prayer and Bible reading. This can often change our mood, help us to feel less alone, and let us know that God is always with us in times of trouble. Even when we can’t feel his presence or think that he has left us, he is always present with us right where we are. God sees you as beautiful, even if you feel like a beautiful mess. He still loves you, no matter what you are struggling with. We are human and it can, therefore, be easy to drift away from God or to forget how much he loves us, especially in a world that can be so damaging to the human spirit.
Here are some scripture verses that are specific to eating disorders and recovery. I hope that you find encouragement and peace of mind and that you discover that you are not alone.
My darling, everything about you is beautiful, and there is nothing at all wrong with you. – Song of Solomon 4:7
Charm is deceptive and beauty is fleeting, but a woman who fears the Lord will be praised. – Proverbs 31:30
For the kingdom of God is not a matter of eating and drinking, but of righteousness, peace and joy in the Holy Spirit. – Romans 14:17
Don’t you know that your body is a temple that belongs to the Holy Spirit? The Holy Spirit, whom you received from God, lives in you. You don’t belong to yourselves. You were bought for a price. So bring glory to God in the way you use your body. – 1 Corinthians 6:19-20
The Lord is near all who call out to Him, all who call out to Him with integrity. – Psalm 145:18
Do not be anxious about anything, but in everything by prayers and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus. – Philippians 4:6-7
Cast your cares on the Lord and he will sustain you; he will never let the righteous be shaken. – Psalm 55:22
The only temptations that you have are the same temptations that all people have. But you can trust God. He will not let you be tempted more than you can bear. But when you are tempted, God will also give you a way to escape that temptation. Then you will be able to endure it. – 1 Corinthians 10:13
Christian Counseling for Eating Disorders
As a Christian counselor, I hope that this article provides some hope, peace of mind, and knowledge that there is help available. I have worked with and treated many people with eating disorders, both individually and in groups. They are one of my favorite populations to work with because I fully understand their struggles behind closed doors.
“Take a Break,” courtesy of Peter Busse, Flickr CreativeCommons (CC BY 2.0); “Sunset Wish,” courtesy of Michel Curl, Flickr CreativeCommons (CC BY 2.0); “Butterfly – So Free” courtesy of Sergi Planas, Flickr CreativeCommons (CC BY 2.0); “Field of Peace,” courtesy of Joao Paulo Correa de Carvalho, Flickr CreativeCommons (CC BY 2.0)