Being anorexic or bulimic isn't just about not eating or not wanting to be fat. It's about self image or lack of it.
People who have eating disorders are not ignorant people. They know they need to eat to stay alive. They have average to above-average intelligence and know intellectually that what they are doing can be dangerous.
But the pull they feel toward being thin, the fear and anxiety over eating, is much stronger than anything they might know about eating disorders, making their thoughts about eating irrational by normal standards. To understand why a person with anorexia and bulimia thinks irrationally about their body image, you need to know what is going on inside their mind. While it might not be the same for each person, there are some parallels that can be found in people who have eating disorders.
Historically, the perfect woman's body has always been portrayed as thin and beautiful. It's the definition of thin and beautiful that has changed over the years and skewed our thinking.
Take the BarbieTM doll, which made its debut on March 9, 1959, at the New York International Toy Fair. Since then, it has been a benchmark as the perfect female form in the minds of many young girls. Before that, we had buxom female movie stars like Jane Mansfield, Jane Russell, and Marilyn Monroe who were the envy of all girls.
But let's really look at the Barbie doll and how realistic it would be for people to use "her" form as a benchmark for the perfect body. If the Barbie doll were put into human form, she would stand six feet tall and weight 101 pounds. 101 pounds! A woman with a small frame who is six feet tall should be an average of 138 to 151 pounds to be healthy. With a larger frame, the woman should weigh more.
To suggest that we should all be Barbie-doll-like figures would mean that we would have to be 35-50% below a normal body weight based on our height. Using this model, it is easy to see how a young girl who feels pressure to be perfect in body form could obsess over her weight.
Many feel that the Barbie doll, while a fun plaything for children, has done a major disservice to young adult women. However, it's not the Barbie doll's fault or the even the manufacturer of the Barbie doll. Let's face it; we could all use ShrekTM as a model as well. But that is not what the fashion world at large uses as their criteria for perfection. And people who have eating disorders strive for that perfection.
So where does the fault lie? That's hard to say. The average woman does not wear a size four dress like the Barbie doll. Statistics show that the average woman wears between a size 11 and size 14 dress, yet most store mannequins are size six. It seems everywhere we turn there are unrealistic expectations for women to use as benchmarks for the perfect form.
Without even realizing it, many women internalize these ideals of perfection and begin to obsess about attaining them. The problems happen when losing 10 pounds to fit into a sexy dress or that really cool pair of jeans turns into fitting into a size zero when the person's frame can't possibly handle the kind of weight it takes to fit into a size zero and still be healthy.
What's worse is that even if the person reaches their goal of size 0, they won't see the "rewards" of all their hard work. They see something altogether different, as people with eating disorders continue to see a "fat" body even when they are in a skeletal state.
Despite the fact that these women are intelligent, they have thoughts that are irrational and unrealistic, almost bargaining with themselves about their body image. For instance, they might say something like, "If I lose 10 pounds, I'll feel better about myself."
It sounds like something any woman might say and it doesn't necessarily make her anorexic or bulimic. The difference is, women with anorexia and bulimia either don't have 10 pounds to lose or it becomes an obsession to reach this goal. They plan their day around it and think about it all the time. They become so preoccupied with their weight that they think of nothing else.
Once they have reached the goal, they set themselves up for another unrealistic goal until they're wasting away. But no matter how many goals they reach and how much weight they lose, the image they see in the mirror isn't the image they see in their mind. A person with anorexia or bulimia loses the ability to see reality accurately. Instead, they live in an almost alternate reality that no one else can see.
This is the hardest cycle to break and the one that presents the biggest challenge for healthcare workers and family members when trying to help a person with anorexia and bulimia. It can become a control tug of war. On one side, the person with the eating disorder is trying to maintain their sense of control. On the other side, doctors, psychologists and family members try to break them of that control to help them heal.
Unfortunately, people with anorexia and bulimia also become very skillful at hiding their disease. Not only will they think about not eating and obsessively exercise, but they will craft ways to hide it from people they associate with. People with anorexia or bulimia are often perfectionists or have obsessive-compulsive disorder.
For instance, if you sit down for a meal with a person with anorexia, they may appear to be eating, but often times they are chewing tiny portions of their food a lot so no one will notice they haven't taken another bite. Sometimes they will stuff their food in their cheeks or around their gums and discard it later.
A person with bulimia may appear to be eating, but will chew their food until it is mashed. They may eat a lot, but they'll drink a lot of water while at the dinner table, too, as this helps with purging. They will plan the optimal time to excuse themselves so they can vomit in the bathroom before their stomach has had a chance to absorb any of the nutrients and move the food into the large intestines.
No matter what conversation is being said at the dinner table, no matter what food is being served, the mind of a person with anorexia and bulimia shuts down to those around them, even if they appear to be part of the conversation. Their only concern is getting rid of the food they've just consumed.
Some, but not all, people with anorexia and bulimia also have feelings of remorse when they eat. They don't believe they deserve to enjoy food or even eat it. They use food as a way of punishing themselves because they believe they are not worthy. This is a very dangerous condition because instead of the condition being present for purposes of becoming thin, or for controlling their lives, the person is actually trying to do themselves serious harm or cause death. Unlike other people who attempt suicide as a form of bringing much-needed attention to their problem, the anorexic or bulimic person who does this believes they should be punished for their imperfections or something they've done.
Many times, they have difficulty expressing their feelings and dealing with the stresses of their life. Instead of being able to get angry, they turn their anger inside, hurting themselves. In some cases, the feelings from an incident from the past that was traumatic, such as the death of a loved one or physical or sexual abuse can manifest through an eating disorder.
While it may appear that the person who is injuring themselves is purposely doing it, they are not. In their mind, they deserve it. Only through psychoanalysis and treatment can the feelings that are causing this problem be explored and hopefully resolved.
These are just some of the things going on in the mind of a person with anorexia or bulimia. Through treatment with a therapist, the person with an eating disorder can discover what is causing them to harm their bodies with their behavior. Only then can they begin to change their behavior and heal.
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