Great exposure, mediocre coverage
Eating disorders (and related issues) have appeared numerous times in the New York Times this week. Besides informing everyone of what I read while I enjoy my first cup or two of coffee, I am glad to see coverage of EDs beyond what celebrity is now doing Master Cleanse. The stories covered thorny issues such as midlife eating disorders, EDs in men, and when your parent has an eating disorder. That these issues would get such wide exposure in such a well-regarded publication is fantastic.
So that's the good news. The actual substance of some of the coverage (besides the major article on midlife EDs), however, was a little lacking. To be fair, I should be specific, which leaves me a little squeamish but deep breath, here it goes. I was really disappointed in the "Consults" blog extras relating to the midlife EDs story. Not that Dr. Zerbe isn't qualified to be a correspondent for such an article, but I felt that she focused almost exclusively on psychotherapy and environmental factors related to EDs to the detriment of what the latest science indicates.
In her responses in the blog post titled "Seeking Help for Anorexia, Bulimia, and Binge Eating Disorder," Zerbe addressed issues of biology and bulimia (it's roughly in the middle of the page). Although she definitely said that EDs have a genetic influence, she was quick to tell the person to look at issues of culture and try to figure out the reasons "behind" their eating disorder. To help with that, she recommends sufferers read stories written by ED survivors.
These stories of recovery in the face of life’s inevitable traumas and struggles paint a broader picture of what it takes to get better and why someone may have arrived at struggle with body image in the first place.
In the most recent blog about "When a Parent Has an Eating Disorder," Zerbe also failed to mention the well-known (in the ED world, anyway) fact that EDs run in families, due not just to shared environment but due in no small part to genetics. Could the man writing in have been helped also by learning that the traits with which he and his parents have struggled are genetic in basis and aren't simply due to bad parenting? Sure, these traits can cause parents to do things that are less-than-helpful, and a good therapist can help deal with the aftereffects. The biological basis hasn't absolved me of all anorexia-related guilt, as I still carry plenty, but it definitely took a weight off my shoulders.
What is wrong with saying that some people got smacked with the shit stick when it comes to EDs and body image? Yes, our culture has a multitude of issues about weight and shape and appearance, but that's not exactly an eating disorder. In fact, it's astounding to think that more people don't have eating disorders when you look at our messed up world.
Am I being nitpicky? Perhaps. But this is also one of those things that never fails to get my panties in a knot. When it comes to eating disorders, I was always told psychotherapy, learn to love your body, figure out what's causing your eating disorder, and my, isn't the idea of size zero pretty effed up? Well, yes, it is, but all those years of looking at those issues did me almost no good. Why are people so hesitant to say "It's the biology, stupid!"* Saying something is based in biology is a far cry from turning us all into DNA code-reading automatons. But it's the way forward in determining better treatments for EDs.
*This is a quote adapted from Dr. Tomas Silber, who I interviewed for my Washington Post article. His direct quote was "It's the nutrition, stupid!" It didn't make it into the actual article, but it's a great quote. Those of you who have heard him speak will know of the hypnotic accent in which he expressed it, too.
3 comments:
I agree with you that it is biology. I think a lot of people don't want to think this because they like to think it's something they can change very easily. They like to think they can THINK about it really hard and figure out what it means and get it out of their lives. Seeing it as a biological illness means accepting that it may always be there, in some way. For me, as for you, this is a huge weight off my shoulders. I've struggled so much with trying to "get it," to find the key to recovery. I realize now that I just got hit with the shit stick when it comes to anorexia predisposition. Knowing that has actually helped me get better...but, I can see how it may be depressing, initially, to some people.
I think it seems depressing because we equate biology with determinism. And this has been coupled with a misunderstanding about what EDs really "are" and "aren't."
And I think there's a subtle difference between accepting that my vulnerability to an eating disorder will always be there, and the ED itself will always be there. Will I ever be nonchalant about food again? Nope. Will my vast calorie counting knowledge ever go away? I doubt it. But it doesn't mean that calorie count will have to determine what I eat.
Nicely stated. I've also heard several people refer to the genetic link as "genes load the gun; life pulls the trigger."
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