I'm with you here. Food is a major part of the problem, and a major part of the solution. People say food is not at the root of the ED. Yeah, okay, sure. But if you address the root, I'm not going to magically learn how to eat again. Eating needs to be addressed too and treated with focus and attention the same way the "underlying issues" are treated. I was talking to my therapist yesterday, and I said "Okay, I know supposedly eating disorders aren't about food or whatever but...." She interrupted and said, "They are most certainly about food. Can you imagine if I were to tell you, you don't have a problem with food. You have a problem with perfectionism and ocd-behaiviors and anxiety and self-criticism. Food isn't the issue. Telling that to a person with an eating disorder just makes no sense. Of course food is also the issue - a very big issue. That's not to say it's the whole issue but it most certainly can't be ignored! And, to the person with the eating disorder, it can feel like food is the entire issue. So to disregard that is to invalidate the sufferer's experience." I thought my therapist had a good point. Also, as for food being the solution... I've never started doing better without my eating also improving. It's when I can find a way to eat 3 meals a day in a "normal" way that I start to actually feel free from the ED. Putting my effort towards eating nutritiously has been the only way I've been able to make progress. It's the only way I've gotten my brain freed up to do any of the other "work" anyway. My experience has ben that food is a big problem and, the way I've felt the most free... in other words... the most helpful "solution" i've ever experienced was when I had help eating regular meals in a normal way. In that way, it was a big part of my solution. This was a pretty repetitive coment; sorry!

I agree too, but only in part. Food is definitely a major part of the solution, because without proper nutrition and weight restoration is it impossible to recover from the changes that malnutrition causes in sufferers brains which perpetuate the disorder. But on the other hand, I get where the person who came up with this statement was coming from. Food was not the problem for me. I was starving myself because it was such an effective way of numbing my anxiety and depression, and I was scared that I would go crazy if I stopped. Remembering that starving myself does not solve my problems long term has been a big help in recovery. I think maybe you're looking at this a little bit too literally - from the perspective of someone who is currently suffering this might be a revelation, because in the middle of the disorder people are often genuinely convinced that if they could only eat/weigh less then everything would be OK. You have the benefit of knowing the science behind the disorder, but most people with eating disorders remain under the impression that their behaviours are rational responses to their 'greed' or 'lack of control' - partially because the media keeps telling us that that is what eating disorders are about. I know that when I first realised that I was abusing food to distract myself from other problems when I was in my late teens (anxiety and trauma, mostly), it was a huge help in the process of learning that the disorder 'convinced' me of some things that were completely false.
I have no idea if I explained what I meant properly, it made sense in my head!

I'm taking the phrase more literally ... It's mostly true that food isn't the solution, from a strictly re-feeding standpoint. Hospitals wouldn't see a patient more than once if that were true. Patients who are weight-restored wouldn't relapse, b/c the re-feeding would have been the solution. People wouldn't "feel fat," because nutrition would have fixed that distortion/perception.

If you depend on nutrition for remission & recovery, you're apt to be stymied, because just eating and gaining weight won't "fix" it anymore than not eating and losing weight fixed whatever neurological/emotional states, termperamental what-have-you, and life circumstances.

Food is medicine, but not a curative one. There is food ... and then there is all the rest. Current treatment practices have the food part down, but the rest is a web of maybe helpful, somewhat promising coping skills, thinking and behavior therapies, and self-regulatory interventions that still fall short and leave researchers to conclude no uniform, universally effective treatment for anorexia nervosa has been proven.

When I say I see food a major part of the solution I don't simply mean swallowing it. I mean coming to not fear it, getting used to it, interacting with it in a healthier way. I don't simply mean biological nutrition - i need soul-full, spiritual nutrition through the process of eating as well.

This quotation seems to apply more to emotional eaters - those without EDs who use food to soothe themselves. In reference to people with eating disorders, however, I disagree with this quotation entirely, and in fact I believe the opposite is true. For people with EDs, food most definitely is a problem (not the only problem, but certainly a major part of the problem). A person could have the genetic/neurobiologial wiring for an ED, including all of the tempermental traits such as anxiety, obsessiveness, perfectionism, harm avoidance, and dysphoric mood, but she will not develop an ED in the absence of a nutritional deficit (through dieting, "healty eating," overexercise, illness, depression, etc.). In addition, for people with EDs, food is a necessary (but not sufficient) solution. Without a well-nourished brain and body, therapy and medication and improved coping skills won't make much difference.

I also disagree with M's comment that "Current treatment practices have the food part down, but the rest is a web of maybe helpful, somewhat promising coping skills, thinking and behavior therapies, and self-regulatory interventions." I think, in fact, that the opposite is true. Many current treatment practices, such as Maudsley FBT, DBT, CBT, IPT for bulimia, and SSRI's for bulimia, have shown great promise in treating eating disorders. However, most treatment programs, with the exception of Maudsley FBT, fail to take into account that an ED patient requires extensive meal support and full nutrition, full time until she reaches her ideal body weight and stays there for 6-12 months. Most outpatient programs provide little or no meal support, and most residential programs keep patients for 4-8 months at the most, discharge patients below their ideal body weight, and expect them to continue weight restoration on their own. Even in better scenarios, when patients are kept in residential treatment for several months and discharged at their ideal body weight, they haven't maintained their weight long enough for full brain recovery, and they have little or no meal support at home. This is a recipe for relapse. I genuinely believe that if treatment programs incorporated the knowledge that brain recovery requires intensive meal support and full nutrition, full-time for a year, many more people would recover for good.

I think it's talking about emotional eating. One of the things I struggle with is binging as a way to cope with negative feelings. Food is not the solution to my feeling anger, sadness, loneliness, frustration, etc. The problem is whatever is upsetting me, and that's what I should be dealing with.

I also heard the expressions (many times) "its not about food" and "fat is not a feeling" until I was sick of them. They felt just flung out there to counteract my questioning and silence us doubters. Frankly, I thought it was like having a pink elephant in the room and no one wanted to see it. I wanted to scream "It is TO about the food and she MUST EAT!!!" Darn it all. It made me crazy. I know, on some level, what they meant. They meant that they thought her anxiety and depression over something in her life had caused her to stop eating and it was about that...and 'that' had to be uncovered and fixed. Or at least worked on and changed in small steps. But, I knew, knew, knew she had to eat. That was just so clear and simple to me. Maybe not so simple how to get her to do it. But, in my mind, it was surely and certainly about food.

food's a problem. i think it's always been a problem -- our ancestors had to forage for food and work REALLY, REALLY hard to get it.

we don't really know how much food to eat -- we know how much fuel our cars need, we're fairly sure what to feed our animals and plants, BUT from my view, most of us don't know how much and what to eat. i hear a lot of people complaining that they ate too much, they "shouldn't have eaten that"...

YES!
I SO agree with you!

Food IS a big part of both problem and solution!

AND Fat IS a physical feeling! like feeling hot or cold or itchy!

PS-I definitely developed the ED because of MANY factors, and usually feelings trigger symptoms, but sometimes FOOD triggers symptoms!

I hate when I say I am feeling fat and people ask what I am really feeling.

I also hate when people don't get that a food situation can be triggering. Why do I hate certain restaurants?-not because I had any traumatic emotional event there, but because the FOOD overwhelms me. I can go to a lot of restaurants, but some things like BUFFETS are just NOT meant for ME!

For me, food was (and still is) a huge part of the problem. Fear of food. Fear of what food could do. Thinking about food. Dreaming about food. People trying to shove food at me.

Then in recovery, struggling to eat the food. Not wanting to eat food. Wanting to eat food to get better. Getting so sick of the sight of food I could scream. Wishing food would just go away ... etc. etc. etc.

And when I say, "I feel fat," that's exactly what I mean. Fat is a feeling (but, as you might remember, try arguing that with Dr. S)!

Angela,

I argue *nothing* with Dr. S. Except, perhaps, his taste in lava lamps... ;)

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