There is rarely a simple cause-and-effect relationship when understanding the development of an eating disorder.
Eating disorders most often surface as a consequence of a complex interaction of factors. Because of this complexity, eating disorders need to be tackled on a variety of levels. The internal struggles causing the disorder need to be addressed and at the same time new coping skills need to be acquired to replace the function of the eating disorder. It is essential that current relationships are mended and new, supportive relationships are forged. Treatment recommendations may include: individual, family or couples therapy as well as consultations with a physician, registered dietitian and psychiatrist.
It's not about the food.
Eating disorders, contrary to common belief, are more about managing stress, feelings and self-esteem than about food or weight. It becomes “simpler” to shift focus from one’s feelings by re-directing that energy externally, towards the pursuit of managing food intake and body weight. The eating disorder provides a false sense of control. When internal experiences clash with outside expectations, one way to avoid the confusion and conflict is to utilize an eating disorder.
For example, imagine that you have been told all of your life that you are” too sensitive” and should be able to “shrug it off”. The expectation, in those relationships, is that you always look “stable” and “not make waves”. It implies that expressing emotion is somehow a bad thing, instead of a positive aspect of your personality and an effective way to communicate. To disappoint those around you feels impossible. Then the eating disorder enters your life and all of your focus goes to maintaining it. The eating disorder provides the appearance of calm, which is really numbness as a result of physical exhaustion due to bingeing, purging or restricting. These eating disorder behaviors cause you to become more isolated, irritable and anxious. It does not resolve the issues, but actually exacerbates them. The eating disorder produces more complications because the emotional, relational and physical consequences of an eating disorder are so dire. The therapeutic relationship is an opportunity to identify the internal struggles underlying the eating disorder, and explore how these struggles impact relationships and livelihood, and to then help discover new, positive ways of coping with support.