Dr. Linda Helps - I know they are called “eating disorders” but they are not just about food. Dieting and weight focus may be an obvious beginning to an eating disorder, but there is much more involved. Otherwise, we’d all have eating disorders!

Most eating disorders emerge around the time of puberty and when a young adult prepares to leave home. These are developmental times of stress. As a child’s body changes and she is faced with emerging sexuality and pressure to develop her own identity, she may find herself obsessing on food as a way to control feelings that seem out of control.

Another time of intense stress is during the time of developmental launching which usually begins in high school and continues as teens move out to attend college or enter the job market. This developmental transition requires independence and firming up of identity.

Many things can influence the development of eating disorders--the tremendous cultural pressure to be thin and beautiful, gender role expectations and changes, family patterns, personality factors, physiological predispositions and experience around loss, abuse and other trauma. As you can see, eating disorders are not caused by one single thing.

Because of the above, counseling is recommended. It is important to help girls, women and men free themselves from cultural prescriptions of beauty and body image. They often need help setting realistic expectations regarding performance at school and in the workplace. Relationship issues are primary. People with eating disorders often try to be perfect, compliant and stuff negative feelings away.

Conflict is avoided or handled in a poor fashion. Many people think in all or nothing terms-things are either all bad or all good. There is no middle ground or balance in thinking or behavior.

Family members are often frightened by the eating behavior because of the seriousness of related medical problems and because the person is misusing food. People with eating disorders often try to take care of other family members or other people in their lives, while denying their own needs and care. Typically fathers are emotionally uninvolved and disconnected; mothers are over or under-involved; and siblings are not connected as a group.

Typical family patterns included difficulty communicating, directly managing conflict and negative emotions. Usually there is marital conflict in which the person with the eating disorder becomes the peacemaker or deflector.

In anorexic families there is usually little emotion expressed. Family conflict is denied and the child tries to be perfect. In bulimic families, problems aren’t denied, they just aren’t resolved. The eating symptoms are an unsuccessful attempt to control and resolve problems.

Parenting is often done in extreme fashion – overprotective or chaotic. This results in the child feeling guilty, overwhelmed, lonely and avoidant of her need to developmentally separate and face the challenges of growing up. Eating disorders are a desperate attempt to push away from the family system. You can see the conflict--the child wants to grow up but at the same time, is frightened and feels unprepared to do so. The eating problems keep her family involved in caretaking.

So remember, when you hear about an eating disorder, it’s not just about food. Much more is involved.

Dr. Mintle – author, professor, Approved Supervisor and Clinical member of the American Association for Marriage and Family Therapy – is a speaker and media personality, as well as a licensed clinical social worker with over twenty years in psychotherapy practice.

For more articles by Dr. Linda Mintle, visit www.drlindahelps.com.

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