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Frequently asked questions
In a general sense, eating disorders are experienced as disturbing thoughts about their eating habits, and are accompanied by physical and emotional distress. They lead to a deterioration of physical and psychological well-being, and ultimately can cause death. To understand what an eating disorder means for the person experiencing these difficulties, it is more helpful to think of the eating disorder as something that a person has developed, in order to feel that they can cope with their lives. However, the more the person relies on the eating disorder to cope, the more they need the eating disorder to cope, and very quickly they spiral into a situation where they feel they will only be able to cope and live if they hold onto the eating disorder. The person's sense of who they are comes to depend on them holding onto the eating disorder and this is why it is so difficult and terrifying for a person to think about letting go of the eating disorder. Therefore, while it is clear to everyone else that the person is harming his / herself, the only way the person with the eating disorder feels they can survive is by maintaining the eating disorder.
It is impossible to say exactly what causes an eating disorder for any particular person. An eating disorder develops from a combination of factors (biological, socio-cultural, familial and psychological) that are particular to each individual person. At some point, controlling food or engaging in disordered eating behaviors (skipping meals, repeated dieting, restricting food intake, vomiting, bingeing, over exercising) gives the person a sense that they can cope with something they have experienced as overwhelming or distressing. Instead of experiencing the feelings and working them out, the person blocks them by controlling their food. However, the sense of security the person gains from the eating disorder is fleeting, and they need to continue to control their food in order to regain and hold on to this sense of security. This is how the eating disorder develops and establishes itself in a person's life - they get trapped in a vicious cycle of having to progressively increase their control over their food (and body) in order to feel like they can cope and survive.
The short answer to this question is YES. People with eating disorders can and do make full recoveries. People sometimes describe recovery as learning to re-connect with oneself, building up a trust in one's ability to cope without needing to control, not translating life issues into food issues as a way of dealing with them, letting go of the need to control food intake in order to feel okay. Recovery has a very individual meaning for each person so it is difficult to generalize and give a time scale to the recovery process. Factors such as how long the person has had the eating disorder and the quality of support they receive will influence the length of time the recovery process takes.
It is extremely important to support someone who has an eating disorder and is going through the recovery process. People often experience confusion, frustration, and desperation as they witness a person they care for experiencing the difficulties and set-backs that are a natural part of the recovery process. The person in recovery is facing the task of re-learning how to cope and live their life without using disordered eating behaviors. This can be extremely difficult and frightening for them. Therefore recovery often occurs slowly and why the role of supporting strugglers is so vital. There are a few things to remember about supporting someone: try to accept the person as they are and show your willingness to be there for them; listen to their needs without judgement and without trying to fix or problem solve. Let the person know that you love them and value them for who they are. Communicate a belief that recovery is possible and your belief in their ability to recover. Take the focus away from food and eating and bring it to how the person is feeling. Communicate an appreciation of the energy it takes to struggle with an eating disorder. This same energy is the person's most valuable resource for recovery. It is also very important not to put the needs for the person you are trying to support above your own needs. Looking after your own needs first not only models healthy behavior but will put you in a stronger position to be of support to them.
The following are a few questions you may ask yourself to try and answer this question: Do you feel that the way you eat and behave around food is dependent on how you feel about yourself, on your emotional state? (Are you using food to make yourself feel better?) What behaviors are you engaging in that lead you to ask this question? Do you feel trapped into your behaviors around food and eating? Maybe it's not about getting an answer, but something prompted you to look up this website. What do you feel you need to do for yourself right now?
Many children are fussy eaters and come to use food as a currency in their relationship with their parents and caregivers. This does not necessarily mean that they have an eating disorder. An eating disorder is a manifestation of something that the child is experiencing as difficult or overwhelming at an emotional level. The child copes with a difficulty by controlling food intake. It is useful then for a parent who is concerned about the way their child is eating to try to bring a focus on how their child is feeling rather than on what their child is or is not eating. Creating a safe atmosphere to explore feelings will be of huge benefit to the child who feels unable to express what they are feeling without resorting to eating behaviors as a means of doing this. If a parent has any concerns they should visit a GP and remember that early intervention of a supportive nature is very beneficial.
There are many people who are preoccupied with dieting in today's world, and not all of these people have an eating disorder. However, if you are concerned there are a few things to think about which may give you a clearer understanding of whether or not your child has an eating disorder. An eating disorder is a manifestation of something that the child is experiencing as difficult or overwhelming at an emotional level. The child copes with a difficulty by controlling food intake. It is useful then for a parent who is concerned about the way their child is eating to try to bring a focus on how their child is feeling rather than on what their child is or is not eating. Creating a safe atmosphere to explore feelings will be of huge benefit to the child who feels unable to express what they are feeling other than through their eating habits. If a parent has any concerns they should visit a doctor and remember that early intervention of a supportive nature is very beneficial. Do you feel that the way your child eats or diets depends on her / his emotional state? Is she dieting to make herself feel better? Are there issues about body image that could be talked about and addressed? Do you feel your child is trapped into a dieting cycle? How would your child be if she were not able to diet? Are you aware of what was going on in your child's life when she began to get preoccupied with dieting, and has this preoccupation intensified since then? These are all questions that will help you to gain a better understanding of the role that food (and eating / not eating) is playing in your child's life. There would be concern around an eating disorder if your child is depending on food and body control to feel ok about herself / himself.
Media influence is frequently blamed for breeding a normative discontent in relation to body image and this is often seen as being a causal factor in the development of eating disorders.
The causes of eating disorders are multiple and very complex. A whole range of factors combine to contribute to the development and maintenance of an eating disorder. However, two of the major risk factors for eating disorders are low self-esteem and dieting.
A culture which promotes obsession with appearance and which markets a particular body shape (thinness in women / leanness and muscularity in men) as desirable and as a means of achieving success and/or happiness can contribute to the erosion of self-esteem in vulnerable individuals. In this context, the constant promotion of dieting also can contribute to creating an unhealthy relationship with food and body. It is in the light of this that the media can be seen as playing a part in the development of eating disorders.
The effect of the media is to further undermine those individuals who are already vulnerable to developing an eating disorder; and to exacerbate and maintain eating disordered thinking where it is already established. This is why it is so important recognize the potential impact of messages that have the capacity to undermine healthy self-image and self-esteem which are the cornerstones of mental well-being.
It can be extremely frightening and frustrating for a parent when trying to understand why their child just can't eat. This seems to contradict everything that they take for granted about being ill, about feeling hunger, and about how they have brought their child up as a healthy individual. This is why it is really important to understand the role the eating disorder plays in your child's life. The eating disorder, and the disordered eating behaviors that are part of it, are ways your child uses to feel safe and in control. He / she can't just eat (at the moment) because it takes some time to re-learn how to cope with life without using the disordered eating behaviors. Through the recovery process, your child will slowly begin to eat and re-learn what feeling hungry is like and why it is okay to eat and nourish him / herself. The eating disorder works as a coping tool because it helps the person disconnect from their feelings, which also includes feeling hungry. So, the person often does not feel hungry when they are in the midst of the eating disorder. When a person starts to eat again, it can be very frightening to suddenly begin to reconnect with their feelings. This can be experienced as overwhelming. This is why it is so important not to rush or force a person to eat. They might feel so threatened that they will defend themselves by further retreating into the eating disorder.
Yes. Eating disorders are not specific to women and girls. Most literature asserts that one in ten people with an eating disorder is male, however, more recent studies suggest that the figure may be substantially higher. It is often more difficult for men to seek out help because eating disorders are still perceived by many to be something that only affects women and girls.
The question to ask yourself is what do you feel is the right course of action for you to take right now? In some ways, the fact that he doesn't know that you know, gives you some time to think through how you are going to handle this situation. This is a delicate issue. Rushing into reacting may cause your son to retreat and defend his behaviors more. Before approaching him about this, you might find it helpful to read through our information on approaching someone. This will allow you time to think through how you can approach the situation in as constructive and supportive a manner as possible. Before you approach your son, inform yourself as much as possible about eating disorders. Your son may be experiencing feelings of shame around his behaviors and it will be important that you approach him in as gentle and safe a way as possible. Try to view your son's behavior as a way he has developed of coping. It then becomes possible for you to understand to what extent it will be important for him that this coping mechanism isn't threatened by how you approach him. So, it is about trying to dialogue with him in such a way that he feels he can talk to you about why he is doing this at the moment. Eating disorders are manifestations of underlying emotional distress. The most important thing for him will be that he feels listened to and not judged. Try to accept him where he is at, and to focus on how he is feeling rather than what he is doing. If you think it would help, you can contact Magen Avrohom for further guidance. They can provide you with a space to explore your own feelings which can put you in a better position to be the non- judgmental listener that your son needs you to be at this time.
The first thing you can do as a teacher is to inform yourself of the issues that can be involved when a person develops an eating disorder. Early intervention in eating disorders greatly improves the outcome. It is important for you to take clear concise notes of the incidents and observed behaviors that have led you to believe there is a problem. Although you cannot "diagnose" what the issue is with the pupil in question, your notes will assist a health professional in the assessment and diagnostic process should this need arise. It is important that you share your concerns with the school counsellor, or the person in charge of pastoral care. Then decide who is the most appropriate person to approach the young person and his / her family.
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