In supporting people through their treatment and recovery process, one thing I have heard over and over again is, “Well, I’m not [fill in the comparison of weight/shape/size], so I don’t have a problem,” often followed up by, “See, I’m pathetic, I’m not even good at my eating disorder.”
I call BS.
I call BS on the eating disorder convincing you that you are never “thin enough”, “big enough”, “sick enough”, “hurting enough”, or “have-it-bad-enough” for your struggle, your pain, and your fight to be valid.
I call BS on a society and media that continues to reinforce that eating disorders are only about body size/shape and sensationalizes eating disorder behaviors.
I call BS on the, unfortunately, misinformed, that think you can assess a person’s relationship with food and their body (and whether they have an eating disorder) simply by looking at them.
I call BS.
I’ve also had numerous discussions with people who have used their diagnosis or treatment history to invalidate their experiences. If their chart reads “Other Specified Feeding or Eating Disorder” they say, “See I don’t even have a real eating disorder.” However, the reality is that most people diagnosed with an eating disorder meet criteria for “Other Specified Feeding or Eating Disorder (OSFED)”. In a nutshell, the DSM-5 was originally developed with research in mind – and because people are not clear-cut – we cannot be easily divided into diagnostic categories.
Research has shown that individuals diagnosed with OSFED have been shown to:
Have as many medical complications when hospitalized as those diagnosed with Anorexia Nervosa
Score just as high on measures of eating disorder thoughts and behaviors as those diagnosed with Anorexia Nervosa and/or Bulimia Nervosa
Be at equal risk of eating disorder-related death as individuals diagnosed with Anorexia Nervosa and/or Bulimia Nervosa
This diagnosis also encompasses the experience of “transdiagnostic migration”…a fancy little term that means that many people’s eating disorder symptoms/behaviors change over time. This is not the development of multiple eating disorders over time, rather a change (migration) of the diagnostic category, but the SAME eating disorder underneath.
All of this to say that, our diagnostic system is flawed, you are not.
Even with the awareness of mental health and eating disorders on the rise, we still have relatively limited depictions of eating disorders in the media. They typically involve a high degree of focus on eating disorder symptoms and portray a limited range of body types – providing less visibility to the millions of people who do not look like those representations and whose struggle is just as hard.
An eating disorder is all about the body and food….and has NOTHING to do with body and food. If you are living with an eating disorder, you know that it runs so much deeper. That it is not just about what you do with food, exercise, or your body on any given day….but about the amount of time, energy, and preoccupation that the eating disorder chatter takes up in your brain and in your life. The degree that anxiety and shame filter all of your experiences. The strength of the shame and self-criticism in your mind.
I write this because I have encountered so many that avoid, or are fearful of, or feel undeserving of getting help. So many that feel that their struggles are not legitimate, that they are not “sick enough,” or that their challenges with their body are because of their “weakness” or “character.” So many continue in their struggle silently.
The truth is – no matter your body size, size, weight – and – no matter your diagnosis – your struggle is valid.
You are deserving of the support and help you need to heal. You are deserving of making peace with food and with your body. You are deserving of recovery. You are deserving.
- Molly Caradonna, PsyD, LP; Licensed Clinical Psychologist at Edelweiss Behavioral Health