There is no singular definition of eating disorder. Simply put, ‘eating disorder’ is a term used to describe eating patterns and perspectives around food and body that would be classified as abnormal and usually detrimental. Nearly all cases have imbedded within them a certain mental obsession with food and eating, and a physical compulsion to persist in maladaptive food-related behaviors, even in the face of a desire to stop. In this regard, eating disorders very closely mirror addiction and are often referred to as ‘food addictions.’
Not all eating-related disorders fit into clean categories. While anorexia nervosa is usually defined formally as being at or below 85% of one’s ideal body weight, many disordered eaters will exhibit symptoms of anorexia on an inconsistent basis. While they may not fit the exact weight parameters, their patterns of self-starvation, obsession with calorie counting, and over-exercise suggest the presence of a disorder.
Anorexics (and most eating disorder sufferers) suffer from a grave distortion in their self-perception. This inability to accurately assess one’s size is known as body dysmorphia. The sufferer perceives herself to be much larger than she actually is. She detects fat where there is none. This psychological self-perception perpetuates further starvation, food restriction, and rigidity. Feeling out of control in life, the anorexic strives for an environment she can be in charge of-her body. Calorie counting, shedding pounds, and having the discipline to reject food and the physical desire for hunger helps the anorexic to feel safe and empowered. In reality, the disease is slowly gaining the upper hand. She is losing control and losing her mind.
Bulimia is characterized by patterns of large-scale binge eating followed by self-induced purging. The bulimic desires massive quantities of food and will eat to the point of sickness. Shortly after, overcome by shame and self-loathing, she seeks to rid her body of the food she has ingested through vomiting. While bulimia typically involves binging, in some cases, the condition can be an extension of anorexia-all food, even the smallest amounts, is purged from the body shortly after it has been ingested. As in the case of anorexia, the behavior is outside of the sufferer’s control. She may know on an intellectual level that her actions around food are unhealthy and even destructive. She may make promises to herself and others that she will stop. But each time she will be overcome by an urge she cannot control and she will repeat the same behaviors. Her obsession/compulsion will not allow her to break the cycle.
Compulsive overeating, or binge eating, can be defined as a full-scale food addiction. The addict is unable to stop eating once he starts. Though he may have the desire to lose weight and the intention to eat healthfully, once he ingests a trigger food (often fried, sugary, salty items), he is unable to stop. Much like an alcoholic, he finds comfort and release in over-indulgence. He feels as if he is acting ‘outside of himself’ since the binge-eating patterns are often accompanied by a sort of oblivion in which he feels no control to stop the course he is on.
Eating disorder sufferers may suffer from one or multiple disordered eating conditions. There are few characteristics that are common to all food addicts. For example, not all anorexics are exclusively food restrictors. Not all compulsive eaters are fat. Many overeaters may also suffer from an inclination towards compulsive exercise. Their excessive physical activity may help keep their weight at bay, but they could hardly be described as ‘healthy.’ They face the same debilitating mental battles that all eating disorder victims suffer.
Like addiction, eating disorders are progressive conditions. They do not go away on their own. In fact, with time, they tend to get worse, not better. The severity of the disorder will determine the type of treatment required. Many bulimics and compulsive overeaters have found freedom from their obsessive/compulsive food behaviors through 12-step based support groups like Overeater’s Anonymous. However, in the case of a prolonged battle with anorexia, more acute treatment may be required. In-patient rehab is almost always required in order to help the anorexic recover. Sadly, even with such strenuous and careful treatment, many anorexics are never able to fully find freedom from the desire to self-destruct through food restriction. Continued support and accountability is required.
In each case, regardless of the way an eating disorder may manifest itself symptomatically, at the core is a mental, spiritual, and physical disorder that drives the sufferer to abuse food and body. In every case recovery will involve deep psychological and spiritual healing.