When I started treatment for my eating disorder, I was always given the line, "It's not about the food, it's about the feelings."
As I've moved along in my recovery, I've learned that an eating disorder IS about the food as long as you are starving yourself, bingeing , purging and/or underweight. Your brain isn't functioning right.
However, I'm learning that feelings are involved, though not in the way I think the therapists meant.
I don't know that my eating disorder was ever a "coping mechanism." And if it was, it certainly never was intentional. I didn't stop eating to "cope" with feelings of inadequacy, emerging sexuality, or enmeshment with my family. That just wasn't how it worked. I thought that losing weight would make me happy and healthy. And then...I don't know what. It blurs together, stops making sense.
Anorexia and bulimia both are self-perpetuating illnesses. In a person predisposed to anorexia, a small amount of starvation feels...good...somehow. And the person keeps going. The same with bingeing and purging. They perpetuate themselves. Once you pass a certain point, you literally can't pull yourself out. You just can't. The disease takes on a life of its own, and you're simply along for the ride.
But the feelings.
Ah, the feelings.
Starvation and over-exercise are very numbing. They do neutralize those feelings of inadequacy and anxiety. They neutralize all feelings because the brain can't afford to produce those neurotransmitters involved in emotions. They're unnecessary.
Research has shown that people with anorexia* have inborn difficulties with processing emotions, with anxiety, with appreciating pleasurable things. If you're starving, you have no emotions to process. Losing weight is the ritual that helps decrease your anxiety. So the system works, in a sense.
Then you regain the weight and all of the same stuff is there, only you don't have that starvation neutralization effect going on. This is the part of ED treatment that really gets me: why therapists and hospitals and everyone seems so willing to back off once a sufferer gets to a healthy weight and stops behaviors. The worst is over, they think. They've done it. It will get better now.
Only the sufferer is more miserable than ever because there's no buffer from the eating disorder, and they still don't know how to deal with all of these crappy feelings.
This is where I spent years searching for answers. I was told that if I could understand where all of these feelings and behaviors came from, I could overcome them. "Why are you starving yourself?" I was asked. "Hell if I know," I said. So we would search and search for answers.
Insight wasn't my problem. I knew from the start that I was anxious, depressed, a perfectionist. I knew I was brutally hard on myself, but I thought I had to be. Learning that- shocker of shockers- I needed to be gentle with myself got me precisely nowhere. Except another visit to the psych unit.
What I needed was skills.
Do I understand why I developed anorexia? I had a genetic predisposition. That I know. The OCD and mood disorder didn't help things, either. Neither did perfectionism. But why I thought that losing weight would make me happy? I don't know. And I don't need to know. Maybe there is no answer, no good reason why. Maybe I just got dealt a shitty hand of cards, and I have to play the hand I was dealt.
Could eating disorders be women and men trying to be perfect? To live up to society's expectations? To look like models? I doubt it. That's part of it. It's the cultural context of the illness. In the Middle Ages, women (most of the recorded cases were in females) who starved themselves were considered saints. They fasted to get closer to God. Some, like Catherine of Siena , got hooked. It felt good. Her explanation was of faith. Ask a sufferer today, and a lot of it seems to be 'healthy eating' and images of supermodels and the idea that you can Have It All. It's no more a reason than faith. But it is a context. It does explain the triggers, the psychological environment from which an eating disorder develops.
One of my OCD fears was that I was going to catch AIDS from someone, or that I already had AIDS and was going to give it to someone else. Regardless, it was OCD . But if I was about 15 years older (the OCD AIDS stuff started in about 1993-1994, when I was 13-14), AIDS wouldn't have been on the radar. It might have been another disease. It might have been something else entirely. A person with schizophrenia would not have feared the CIA listening in on phone calls 100 years ago. First off, they probably wouldn't have had a phone, nor would there have been wire taps, and lastly- there was no CIA. Diseases have a context. But that doesn't mean that AIDS fear mongering caused my OCD , nor that the CIA causes schizophrenia.
My recovery had to begin with weight gain. That is still the foundation. Think Maslow'shierarchy here. If you're not eating right and taking care of your basic needs, learning how to handle setbacks isn't the most useful of things.
Will I ever be less anxious? Less depressed? Well, with medication. But that is my personality. I don't think I have it in me to be a total slacker. Can I learn to be more tolerant of my mistakes? I hope so.
*Unfortunately, research on bulimia lags far behind that on anorexia, though I'm assuming my assumptions will hold true for all people with EDs .