Ok, I have to start this conversation. I understand that in this image saturated world that some people feel pressure to believe that their body has to look or be a certain way. Might I add that these images are often just that … an image and NOT a reflection of health. There are negative physical, mental and social health consequences for obesity, underweight and bodies of normal weight range, if unhealthy diet and compensatory behaviours are the engaged in.
BUT CAN WE PLEASE STOP SAYING THAT ALL PEOPLE WHO HAVE EATING DISORDERS HAVE BODY IMAGE PROBLEMS! I know this is contrary to what is often put out there but it needs to be said. In a clinical report published by the American Academy of Pediatrics called Identification and Management of Eating Disorders in Children and Adolescents, it is stated that ‘studies have shown that more than half of all children and adolescents with eating disorders may not fully meet all DSM- IV-TR criteria for AN or BN because they do not articulate body-image dissatisfaction or because their inadequate nutrition is manifest by growth failure rather than weight loss to less than 85% of expected weight’. MORE THAN HALF DO NOT HAVE BODY DISSATISFACTION!
Does this mean that they are not treated appropriately? This was certainly my experience. I NEVER had a problem with my body weight or body dissatisfaction prior to having anorexia in my late teens. I was depressed. I did not know how to manage the emotions I felt or the circumstance at the time. I did not know how to express what I was thinking or feeling. The restricted dieting and excessive exercise became a maladaptive coping mechanism. I physically recovered but the underlying emotional and low self worth were still there. Fast forward 30 years and I am diagnosed with clinical depression. I have three children and I like my body, but when my marriage broke down and all the same emotional issues resurfaced, it was then I had psychological help. This help was not for SIGNS of an eating disorder but for the CAUSE of the problem in the first place, that formed part of many false beliefs I had of myself.
My fear is that if we keep saying that eating disorders are BODY IMAGE issues, then more than half of adolescents (and adults) that are suffering may not seek appropriate treatment or even get it because they will feel misunderstood or misdiagnosed because ‘they don’t fit the criteria’. Eating disorders are comorbid with other illnesses of the mind, such as depression, anxiety and PTSD. As unhealthy as the behaviours are, they serve a purpose for the individual at that time and these behaviours become scary to live without because THEY DON’T KNOW HOW TO EXPRESS OR COPE WITH THE UNDERLYING ISSUE.
I did not live my whole life with the associated behaviours of anorexia but I did live with false beliefs of low self-worth for over 30 years. These affected my thoughts, emotions and behaviours until I could be honest with myself and get the help I needed. This came at a high cost and I will not, I cannot sit back and know that many people who have eating disorders or disordered eating, and who do not have body dissatisfaction may not be getting the help and understanding that they need! If this has been your experience or that of someone you know, then please start a conversation! Please email me at firstname.lastname@example.org