Eating disorders affect millions of Americans every day. Binge eating, anorexia and bulimia represent some of the more severe cases, but emotional overeating is affecting even more Americans struggling in the relationships they have with their food. The underlying emotional problems that can contribute to these disorders vary greatly and so does the available treatment.
A panel of experts, who’ve worked extensively with those suffering from these disorders, spoke with Sundial’s Luis Hernandez about the complex issue.
Dr. Autumn Ning is an assistant professor of psychodynamic psychiatry at Florida International University. Dr. Lewis Jones is the site director for the West Palm Beach Renfrew Center, which has treated tens of thousands of women over more than 30 years nationwide for eating disorders. And Arlene Englander is a psychotherapist and former overeater herself. Her new book is called “Let Go of Emotional Overeating and Love Your Food: A Five Point Plan for Success.”
WLRN: What are the long-term effects of eating disorders, especially if they go untreated?
JONES: Eating disorders can be the most deadly diagnosis that we look at. And so we really have to take these as seriously as possible. So having discussions like these just help raise awareness so people can check in, potentially find resources and get help. We have seen at the Renfrew Center we go into residential levels of care where people have to be on feeding tubes, where they know they need to eat but just simply can't make that choice because of the underlying emotion that drives some of their behavior.
When you meet with a client-patient, what are you trying to get at? Do you have to go deep in their past to figure out where (the eating disorder) is coming from?
NING: We do like to be able to understand what these emotions are from. Sometimes they are from the past and we kind of carry them forward and sometimes they are largely situational. But a lot of it depends on what we understand of what the eating disorder means to them, what it means to actually do these behaviors. People for example, who suffer from trauma may have a particular feeling about food, about taking things inside themselves, about ingesting, about being bigger, about hiding within their skin. So a lot of what we do with food is very much symbolized. Food is very complicated to talk about. It's like talking about money.
Why is that? Why is food tough to talk about?
NING: If we think about food, and this is where some of it differs from say speaking about addiction. We can live without alcohol, we can live without cocaine, we can live without cigarettes, but we really cannot live without food. So we have to find a way to deal with that. And our first even social interactions are around food. From the day one that we're brought into life, we have an interaction with another human being that involves food. Someone has to feed us. We can't feed ourselves when we are born, right?
So right there we have an attachment to someone around the idea of food and hopefully for most of us that attachment is a good one. It is warm, it makes us feel safe and secure. So most of us have a positive feeling about food going into life, we hope.
We live in a world where we are constantly bombarded with images. We were always bombarded with images in the media of what beauty is. With social media, that issue is amplified. But you have a rule, for people to go through the program they have to get off of social media, right?
JONES: We are really starting to incorporate more mindfulness into social media. And so, at our facility, your phone is not allowed in treatment. You know, you check it at the front desk. But in our programming, we start to talk about cutting back on social media and recognizing the unrealistic, unfair expectations that are placed on all of us, but primarily on women. And how that can impact the underlying emotional engines of these eating disorders. So it's very important to increase awareness and educate, and bringing in mindfulness gives people this presence to be able to say, "You know what, I don't like that image and I'm not going to follow that person anymore."
What do you say to folks, who are struggling with [eating disorders], how to approach the holidays? They can be a very stressful, painful time.
JONES: Absolutely. Whether it's the family or the food, the holidays are stressful so we really encourage people, you know, more simply just to slow down, you know, in their own minds and in their bodies and try and really zero in on what they're experiencing and be able to address those experiences in a different way. So those underlying emotions, the anxiety, the stress, as mentioned earlier, the guilt and shame, all of that is going to be there and only amplified around family and holidays surrounding food.