Great post. What hit home was this: "I was starving because I had anorexia. Period." Yes, I've created my own meanings, but I also believe the symptoms are just the result of an illness. I think we do way too much "explaining" in our society. I did this with my husband. I tried to explain his behaviors, link them to his past, etc. Sometimes that's just exhausting. Sometimes a person just has a problem!

I'm glad someone else was annoyed by that clip! Besides the ridiculously over-used "starving for perfection" bit, what bothered me most was the implication that hospitalization is what *cures* anorexia.

This is why I refer people to your writing. Amen.

Wishing you wellness.

Nearly everytime I read your posts, I think, "My god, I could have written that." Or someone I care about immediately comes to mind, someone that I want so badly to help understand ED's...or atleast get some inkling of understanding. Your articles are so on point and so meaningful.....I want to share them with everyone I know!! And, for what it's worth, I too become extremely annoyed with the stories out there in regard to ED's. They seem to make these things seem glamourous and, I believe, it only causes people to WANT to have an ED...as if it is cool, or the "thing" to do. Thankyou so much!

Hi Carrie,

I can see you speak for many, many people, and so maybe this comment is just a reflection of my own minority view. but I've noticed that you tend to extrapolate from your own experience to what anorexia means in general. At the same time, I know how intensely annoyed you are by the endless lectures in the media about what is really going on in the anorexic mind. I wonder sometimes if psychological essentialism ("all anorexia comes from bad families")is really so much worse than biological essentialism ("all anorexia comes from bad brains"). The dogmatism on either side og the argument (including the insistence on scientific backing) seems much the same. -debra

Debra, It does matter how you describe the etiology of EDs for many reasons. Here is the url of a post by Laura Collins on her blog that addresses your comment much better than I can.

http://eatingwithyouranorexic.blogspot.com/
2009/06/why-it-matters.html

Here's a quote with the main idea of the post: "Cause leads treatment approach. Assuming parent pathology leads to marginalized, demoralized, ineffective parents - no matter how good their parenting was before. These assumptions lead to treatment that validates distorted views of family and relationships and undermines parental trust. It means ruining the confidence of good parents, and worsening relationships with poor parents. It creates lifelong sibling rifts, strains marriages, and reframes family histories.

Treatment that assumes parents are unnecessary or harmful to recovery replaces family with what? Therapy? Recovery done in isolation from people? Repeated inpatient stays? Chronic illness? I ask because I wonder what the alternative is: we don't get generally get a second family to choose from."

I so agree with Carrie (and Laura Collins) that eating disorders have to be viewed first and foremost as illnesses that require immediate aggressive treatment and full nutrition, with no blame attached to anyone.

Thanks so much for this post, Carrie. This post really struck home for me. I feel like I've spent the past two years of my life going over and over all the possible reasons for my eating disorder and rehashing all the bad things that have happened to me in my life. Like Kim said it was exhausting and completely unhelpful. The only explanation that makes any conceivable sense to me is that I had a disease and for some reason or another my brain chemicals stopping working right (or never really worked right to begin with).

And in response to Debra's post, I think cause does matter because our perception of cause does influence treatment. I do hesitate to extrapolate too much from my own experience and claim that it covers all experiences of eating disorders, and I do think that it is important that people take care to keep open minds and avoid dogmatism on both sides of the issue. For me the point is not necessarily that we must have hard-core double blind scientific studies or whatever proving one type of treatment or the other works but that the treatment being used is actually getting results for the individual sufferer. I know that in my experience--which I understand is not everyone's experience--that ruminating about my horrible father (and believe me he really was horrible and abusive by anyone's standards) did not help my disordered thinking and behavior. Nor did well meaning advice that I should just rethink my priorities and stop making thin-ness so important in my life. Nutrition did help, although nutrition was not a 100% cure like I think many people hope and would like to believe.

Aside from my own experience however, I do think there is valid science that helps explain some of the underlying biology of eating disorders, and I think this information is an essential part of any effort to raise awareness or understanding about eating disorders. One of the things that my eating disorder has made me understand is how difficult it is to explain to someone who has never experience a mental illness to fully understand what it means to be biologically unable to regulate behavior or thought processes. And I think that the more we can emphasize that eating disorders (and other mental illnesses) are biological conditions akin to cancer or diabetes, the better treatment options will become because society will prioritize these conditions as real health problems deserving effective treatment and research, not just the result of moral weakness or a lack of willpower on the part of the sufferer.

http://www.synecdocheblog.blogspot.com/

Also, just to clarify, I do think research is critical because without it we will not be able to design treatment that is effective for large numbers of people.

http://synecdocheblog.blogspot.com/

I think they've got the causation wrong. It's not starving *FOR* perfection but rather starving *AND* perfectionistic. The same underlying biochemical imbalance is causing both the disordered eating and the perfectionism.

Debra,

If saying that eating disorders are fundamentally rooted in biology makes me an essentialist, then so be it. I have NEVER ONCE said that environment isn't important and doesn't play a large role in eating disorders. It takes both nature AND nurture, culture AND chemistry to create an eating disorder--indeed to create any disease. Biology IS essential. Culture is essential, too. You can't separate them.

I didn't start restricting food until I was about 20 (though some obsessiveness started at 18 as a freshman in college). I ate just fine for the first 20 years in my life. The factors that made me vulnerable to anorexia were always there, they just hadn't been activated. These factors were things like perfectionism, they were OCD, and they were also growing up in a society where dieting is normal and losing weight is good and the key to happiness. I initially only wanted to lose five pounds and maybe exercise more regularly. I thought it might make me happy. If virtually every woman in America has been on a diet, why don't more people have eating disorders? That's where biology is important. That's where some people get caught in the trap of restricting, of bingeing, of purging, and others don't.

Crimson Wife,

You nailed it. The starvation exacerbates the underlying perfectionism, and most people with AN tackle their weight loss quest with the same perfectionistic verve as anything else. It's about losing the most weight, being the thinnest, etc. It's the mindset, not the goal.

Thank you all for your fantastic thoughts on the subject- I think it's a dialogue we all need to be having.

I am, however, almost brain dead right now so I don't have the energy to respond to everyone individually. Just know that I appreciate everything you have to say.

We want to know why...but my advice is only to search for the why long enough to get you to the HOW.

"If virtually every woman in America has been on a diet, why don't more people have eating disorders? That's where biology is important. That's where some people get caught in the trap of restricting, of bingeing, of purging, and others don't."

Honestly, I think a whole lot more people have eating disorders (though perhaps not diagnosable by perfect DSM standards) than what is talked about. Why do I think this? Because when I was much younger I was on countless "pro-ana" websites and the LARGE majority of girls had never sought help, been diagnosed, or been treated. When I went to treatment, most of the girls there had at least one friend they knew who had, at some point, displayed eating disordered patterns of behavior. And then in college I lived in an all-girls dormitory with 300 women and I cannot tell you how many different girls I knew who had eating disorders or had had eating disorders and were currently in recovery. Soooo many girls I talked to said they never considered themselves as having an eating disorder because they "only threw up when they ate way too much," or explained away their drastic calorie reduction as necessary for sports, not disordered.

I would go out on a limb and say that I think half of all eating disorders are reported or known to the medical world. At most. And that both frightens and saddens me.

hey that anorexia news- hattiesburg american... i wrote that!