Eating disorders can cause obsessive scale-watching

Eating Disorder Treatment Center Ebook

Excerpt from Eating Disorders eBook

This book was written for an Eating Disorder treatment center as a lead magnet. It required exceptional research skills, but the primary focus of this piece was on examining the online communities of ED sufferers. This is one excerpt of a larger book.

Eating disorder sufferers are painted by the media in very limited terms. Whether it’s a Lifetime TV movie or a news article, the media has a tendency to ascribe eating disorders to a very small population. According to the media, ED sufferers are:

  • White
  • Young (teenagers or college students)
  • Depressed
  • Upper middle class or upper class
  • Naturally thin
  • Female

In reality, EDs can affect anybody. However, EDs are much more common in certain populations than the media would portray.

As we’ll discuss later, EDs are never really “cured”, because EDs are a symptom of a larger problem, usually depression, anxiety, PTSD, OCD, or another mental or emotional illness. In order to better understand the types of people impacted by ED, it’s important to understand why certain people develop EDs and others do not.

In reality, there are four very different motivations for developing an ED. The specific type of ED is less important than the individual motivations.

ED as Self-Destructive Behavior

On the ED forums, you can recognize these people by their signatures. You see, most people on these ED groups will list several weights or BMIs in their signature: their highest weight (HW), their current weight (CW), a few goal weights (GW), and an ultimate goal weight (UGW). For example, one signature read like this:

HW: 172

CW: (changes)

GW: 160

GW: 150 (no longer an overweight BMI!)

GW: 140

GW: 130 (lowest weight since high school!)

UGW: 120

ED sufferers with severe depression would sometimes use their ED as a form of self-destructive behavior, so their signature would look like this:

HW: 140

GW: 130

GW: 120

GW: 110

GW: 100

UGW: Death

Sometimes their UGW would be listed as “nothing” or “invisible” or some other variation, but their UGWs would be listed as something that indicated their desire to shrink until they stopped existing.

For these ED sufferers, treating the ED requires treating the underlying depression. These ED sufferers are exhibiting suicidal ideation, but their means of committing suicide is by starving themselves until they no longer exist.

ED as a form of control

By far the most common motivation for eating disorder is to exercise control. This is a common motivation in people with underlying trauma, especially trauma resulting from violence against them.

An eating disorder is a way to exercise control over your own body. For rape victims and victims of personal violence, they may often feel like they were unable to control their bodies during their trauma, so controlling the food that goes into your body is a means of taking back control over your body. In some cases, this may be paired with a desire to control not only the intake but also the outcome, by forcing your body to take on a certain appearance or characteristic.

ED sufferers with this motivation cannot be treated without addressing the underlying trauma. In many cases, this form of ED is paired with anxiety disorder which must be treated as well.

ED as an identity

This one is often seen in younger ED sufferers, but it can manifest at any age. For some ED sufferers, an eating disorder begins as something akin to a hobby or an experiment. People with autistic tendencies may be fascinated by the process of counting calories. Those with obsessive-compulsive disorders may take great satisfaction in the mathematical process of weight loss. However it begins, ED can quickly develop into an identity.

Sometimes this identity is appearance-based. The ED sufferer takes pride in being “the skinny one”. ED sufferers with this motivation are very resistant to treatment, as their ED may be the only thing in their lives that they can view as being positive. The ED speaks to their willpower, their determination, their ambition, their drive, and their uniqueness.

ED sufferers who view their ED as part of their identity are more likely to seek treatment but less likely to recover. Treatment for these people must include treatment for their underlying depression and low self-esteem.

ED as body dysmorphia

This category is the one most frequently mentioned by the media, but it’s actually incredibly rare. The idea of a skinny girl looking into the mirror and seeing a fat girl stare back at her is compelling, but hardly accurate. Most ED sufferers know that they’re skinny, but that makes little difference to them. A few ED sufferers, however, will suffer from body dysmorphic disorder (BDD), causing them to view their bodies differently than they actually are.

ED Sufferers as Adults

Eating disorders are more likely to manifest in youth, but because they are never “cured”, they can recur in adulthood, or they can continue into adulthood. Adult ED sufferers tend to be more functional than youth ED sufferers for several reasons. First, because adult ED sufferers often have other responsibilities and obligations (family, work, etc.), which require them to maintain functionality. Second, because adult ED sufferers often develop coping skills to help them as they age and these coping skills often increase their functionality.

While ED sufferers can be found in any occupation, they are incredibly common in fields where the body is prioritized. For example, eating disorders are obviously common in modeling and acting, but they are also incredibly common in the military. Worse, they are tacitly encouraged in the military.

The U.S. military performs regular weigh-ins and body fat checks on their troops, and weight management is a hot topic among military members. Prior to a weigh-in, some soldiers will use slimming wraps, diuretics, laxatives, fasting, and sodium manipulation in order to drop a little weight or cut an inch off the waist. For military members, their ability to maintain a slim physique is essential to their career progression. Failing a weight or body check means mandatory medical intervention, additional physical training (which eats into personal time), disciplinary action, and loss of promotion potential.

Another area where many ED sufferers are found is in medical and healthcare fields. Part of this is image-related. For example, a nutritionist who is overweight is going to find his or her nutritional advice less accepted by patients. But another factor is that the traits commonly found in ED sufferers are also advantageous to medical providers. For example, healthcare professionals tend to have a strong attention to detail, a tendency toward obsession, and a “Type A” personality that likes having control.

Eating Disorders in the Trans Community

One factor that greatly increases the risk of eating disorder is being transgender. Trans people are frequently forced as children and teens to live as a gender that feels “wrong” to them, and they develop a sense of hatred for their bodies at an early age. For trans men who had to endure puberty as a woman, the fat deposits of puberty around the breasts and hips can be especially troubling. And since trans people are more likely to endure sexual violence than cis people, trauma can also play a strong role.

Once transition begins, trans people are more likely to focus intently on the condition and appearance of their bodies. This focus can easily inspire or feed an eating disorder. Trans men may be trying to lower their body fat so that their breasts and buttocks will shrink. Trans women may be trying to lower their weight so that they’ll be perceived as being “attractive” (skinny). In any event, the early body hatred and feeling of being out of control of the bodily processes of puberty can create an eating disorder that can last a lifetime.

Eating Disorders among People of Color

As with trans people, eating disorders in people of color may stem from early childhood feelings of being out of control of their bodies. People of color raised in primarily white societies may have a sense of feeling “different” from an early age. Racism (both overt and subtle) can play an important role in encouraging disordered eating with people of color. There may be pressure to “look white”, which encourages everything from skin lightening to hair extensions to trying to be “skinny”. And there is societal pressure on people of color to “look white”, which is reflected in media and marketing.

Non-white models and actresses tend to have more Caucasian features: a narrow face, a slim body, long and straight hair, and lighter skin tones. While media doesn’t necessarily feed eating disorders, it does express a societal version of what is “pretty”.

In addition to racism, people of color are more likely to be victims of personal violence, which can lead to trauma-based eating disorders.

Eating Disorder among Men and Boys

Men and boys are usually considered to be exempt from eating disorders, but nothing could be further from the truth! Socially, muscular men are considered to be more desirable, but even these muscular men tend to have very low levels of body fat. 

Male ED sufferers among the gay community are common, in part due to some of the same factors that encourage ED in trans people (discrimination, abuse, trauma, body image, etc.). Even heterosexual men can suffer from eating disorders. Men have body image issues, too, and men also suffer from depression, anxiety, trauma, OCD, and other mental illnesses that are generally comorbid with EDs.

Eating Disorders among the overweight

The standard media image of an ED sufferer is that of a young woman who’s already skinny but wants to be skinnier. In actuality, ED sufferers can be found at any weight, and EDs are frequently encouraged when the sufferer is overweight or obese.

It’s important to remember that binge eating disorder (BED) is an eating disorder just like anorexia and bulimia, and BED can lead to obesity. It’s also important to remember that ED sufferers don’t just stop disordered eating; “recovered” anorexics and bulimics can and frequently do transition into a period of BED, putting on excessive weight.

For people who are overweight or obese, eating disorders are often viewed as healthy behaviors, even when they are not. Medical professionals will often subtly or overtly encourage overweight patients to develop eating disorders. When patients are overweight or obese, doctors can encourage disordered eating habits. Several people reported being told to lose weight by doctors, even when they were already under-eating or malnourished. A few reported that doctors thought they were “lying” when they reported their eating habits to doctors, and that doctors encouraged them to eat even less.

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