It seems counterintuitive that an eating disorder may inherently not be about or because of food. How can that be, you ask? A good question in need of explanation.
Clearly, eating disorders of all kinds manifest through a person’s relationship with food. There is either limiting your food in some way, or bingeing, or purging, or both bingeing and purging, or overeating, etc. That said, the use of food in an eating disordered state is that of a vehicle to express ourselves when we feel that there is no other channel available to us. When used this way, food helps give voice to any inner emotional turmoil and struggle surrounding feelings of helplessness and being lost. Food becomes a mechanism for taking back control when one feels that this needed control is either unavailable to them or they feel deprived of it in some way. The eating disorder patient is looking for an outlet to help sooth their raw, painful, and difficult emotions and they don’t know of another way to express them. This is played out in the realm of feast or famine.
The groundwork for an eating disorder can be laid out many years in advance of the clinical onset. But then, this small seed that has lain dormant for years can sprout when any number of stressors are placed upon the person. The stressors can include anything from trauma to abuse to difficult or abusive parental relationships to low self-esteem, negative body-image, fear of the future, academic pressure, peer pressure, perfectionistic pressure, familial or religious expectations, anxiety, depression, any combination thereof or even a host of other factors. None of these are necessarily food focused or food-based triggers, but as food can be used to either nurture or neglect ourselves, it is a readily available outlet for emotions and feelings that are unchartered or complicated to process, especially for young girls and adolescents.
The relentless stress on needing to look good and be thin that surrounds us on a continual basis is a real and consequential source of stress and struggle. It is almost socially and societally necessary and expected to be pulled into it on some level. This complicates how emotional health issues play out for people. Food becomes an expression of an underlying problem, not the problem itself. Therefore, by addressing the food issues only, you are only treating a symptom of the illness and not the underlying cause.
I met someone recently whose daughter had been in a local hospital for eating disorder treatment. She said that the program consisted of force feeding her daughter and not allowing her to be left alone. She was not suicidal and in fact, she had only started restricting for about a month or so. This young girl ended up getting worse as her emotions and underlying reasons for her restricting were not being addressed and she was being treated as someone without any control over her life. Obviously, life and death situations demand immediate attention, but clearly it is imperative to locate the source of the issue and work from there. Only addressing the symptoms will not suffice.