There are many potential causes of eating problems, but a robust psychology of eating disorders must also explain why they seem "helpful" to those who have them. The eating disorders themselves are self-destructive, so there must be other "benefits."
Eating Disorders Seem to Soothe Difficult Emotions
A common theory is that eating disorders are (unhealthy) ways to regulate difficult emotions. These emotions include anxiety, sadness, loneliness, boredom, anger, shame, guilt, hopelessness, and more. But why try to soothe these feelings with disordered eating? One reason is that eating disorders are powerful mood changers:- Anorexia nervosa: A person with anorexia avoids not only difficult emotions, but emotions of all kinds. No matter what happens, this person maintains a generally "flat" and distant emotional stance.
- Bulimia nervosa: There is numbness during binging in bulimia that may feel relieving compared to other, more stressful feelings. But there is high anxiety after a binge and before purging the food. Calm returns after purging. The problem (aside from other issues) is that this calm gives way to a sense of lingering shame. Shame reinforces underlying stress (which isn't changed), leaving the person even more vulnerable to another cycle of binging and purging.
- Binge-eating disorder: Many of the same dynamics of binging in bulimia apply to binge-eating disorder (BED). Those with BED may be better able to tolerate the anxiety that those with bulimia feel after binging. But the shame is definitely there, and any weight gain the person experiences increases that shame.
The Psychology of Choosing Predictable Bad Over Unpredictable Good
It seems that the "cure" is worse than the problem for those with eating disorders; the eating problems damage the emotional world more than they help. So why do people find them so attractive?Here eating disorder psychology strongly parallels other psychological issues. Making any significant life change is hard because it takes us out of our comfort zones. Most of us like things that are stable and predictable. And as chaotic and out-of-control as eating disorders can become, they provide a "predictable unpredictability" -- the problem is clear, the routine becomes second nature, and thoughts and behaviors fall into patterns that feel "normal."
Order Relieves Stress
These predictable patterns are soothing in that they give order to life. The emotions underlying the eating disorders are anything but orderly; they feel overwhelming. Disordered eating tends to shrink life down, eliminating free choice. Life becomes simpler.
A person with anorexia, for example, may have the same tiny meal at lunch every day. She may need to be in the same room at the same time as well. Go out to lunch with friends? Easy choice. The answer is no. With bulimia, a person may become preoccupied with making sure that the restaurant his friends choose for lunch meets his needs for convenient purging. He has no time to worry about the tension in his relationship with one of those friends. Scoping out the restaurant is much easier than scoping out reasons for relationship problems.
Understanding the Past, Hoping for a Future, Deciding on a Present
As convenient as it is for some to bottle up stress with eating disorders, there is nothing that relieves negative emotions and improves self-worth more than understanding the emotions and correcting the problems that feed them. What are the real fears of living life fully? Where is the anxiety? Usually, past events have fed these negative emotions. Some fears have no basis in reality; others are very real (such as threats from an abusive spouse) and must be addressed with very intentional changes.No matter how hard it may be to make these changes, it seems rare to find a person who believes that an eating disorder will provide the way to reach his or her most treasured goals. Considering the person's desired future can make it clear that the short-term stress relief of eating disorders actually gets in the way of larger desires.
Once hope for something better exists, there's more incentive to change the present. For example, to have a future that includes a family, a woman may recognize that she must choose the present moment to end her binging and purging. She may delay for a time, but eventually that cycle-ending "today" must arrive. The choice to eat differently does not eliminate hard days. Instead, it opens a person to the possibility that living in the tensions of a full life makes for a better life story than living in the predictable patterns of disordered eating.
