A man recently asked me about the lotus flower tattoo that's on my upper inner bicep. I explained that it's a symbol of recovery from my eating disorder-that lotuses sink into mud every evening and reemerge each morning. That the stem is the shape of the recovery symbol, and that yes, I no longer starve myself.
"That's good," he told me, "Besides, it seems like eating disorders are really just an issue of mind over matter."
His response was shocking; in the process of softly man-splaining my own mental disorder, he uncovered how little he actually knew. It reminded me of something a grossly uninformed teacher once said about alcoholics, "Alcoholism is the only 'disease' people pour down their throats," he declared. Of course, if avoiding alcoholism were as simple as deciding to avoid alcohol indefinitely, there would be no alcoholics.
If the solution to eating disorders were simply stronger willpower, no one would be dying from eating disorders. Besides, the willpower required to starve myself was necessarily incredibly strong. My problem was not an issue of mind over matter, because my problem was deeply ingrained in my mind. I can understand his philosophy though; it's eons easier to blame someone for their perceived weaknesses than to attempt to understand the nuanced, uncomfortable reality of an issue like an eating disorder.
The pain encapsulated in the human experience is often uncomfortable and unpleasant. We don't like to feel sad or hurt, so we avoid thinking or talking about the things that sadden or hurt us. This is understandable, but it can also be an enormous disservice. Incredible strength is gained through understanding someone else's world, despite how uncomfortable it makes us. This man wasn't trying to hurt me. I actually felt empathy for him, for his uncomfortability and rejection of nuanced complexity. His was a world of stark blacks and whites. If there is anything I know with full certainty, it is that I cannot completely know myself, much less anyone else, and for this reason the world is never, ever black and white.
I remain incredibly open about my experience with an eating disorder-how I starved myself, binged and purged, used laxatives, and lost any semblance of a social life. How my eating disorder took not only my physical health, but my mental wellness, social life, and ability to connect with others. The idea that I could have thought my way out of an eating disorder is glaringly false, because my eating disorder was not a physical impulse, an emotional problem, or a choice. My eating disorder lived in my brain. And although it was often a refuge, it was also undeniably terrifying.
I hated my eating disorder, and hated myself because of it. Imagine feeling unsafe or uncertain about your own thoughts: that's an eating disorder. I could never escape it, and that was the most exhausting, horrifying thing about it. I still don't entirely understand why my eating disorder plagued me for so long, why it began, or how. But I do remember with intense clarity sitting on bathroom floors, emptying my stomach as tears ran down my cheeks. I remember refusing to eat, even though my body badly wanted food. I remember feeling envious of others who seemed to eat with utter abandon, simultaneously hating my body and loving how small it became. This is not the behavior of a mentally healthy person, and I knew that. What I couldn't do was change. I feel deep empathy for my younger self, who couldn't see the harm she was doing or acknowledge the pain she was causing.
If eating disorders made logical sense, they wouldn't exist. But, eating disorders are addictive, and heavily influenced by brain chemistry. Researchers at the University of California, San Diego School of Medicine conducted a study to understand how individuals diagnosed with anorexia are able to ignore the physiological feeling of hunger. For individuals recovering from anorexia, the brain showed “a decreased response to reward, even when hungry." The study also concluded that individuals with anorexia exhibit a higher sense of self-control than people without an eating disorder. Essentially, those with anorexia have brains that are conducive to starving.
Further, researchers at the University of Maryland Medical Center studied how abnormal levels of neurotransmitters, such as serotonin, norepinephrine, and dopamine, are present in individuals with eating disorders. Serotonin is involved with well-being, anxiety, and appetite. Norepinephrine is a stress hormone, and dopamine is involved in reward-seeking behavior. Imbalances with serotonin and dopamine may explain, in part, why people with anorexia do not experience a sense of pleasure from food and other typical comforts.
While the research definitively suggests hereditary susceptibility, environmental triggers such as abuse or trauma can trigger eating disorders too. But, just because someone is genetically predisposed to have an eating disorder doesn't mean that they will, just like everyone who is genetically predisposed to alcoholism do not become alcoholics.
The same man who espoused the "mind over matter" philosophy also said, "well you look great now." I know he was trying to be complimentary. But clinically overweight and obese people also suffer with eating disorders, and their reality is no less valid than the reality of someone who is clinically under-weight. Eating disorders cannot be identified simply by looking at a person, and they certainly aren't "cured" just by thinking harder.
I wasn't sure how to convey all of this to a man I barely know, but I have a hunch he isn't the only one who does not (or, cannot) understand the horror of an eating disorder. I can't blame him for not wanting to go there. But I can attempt to explain my reality, a little bit at a time, so that some day these stigmas will begin to break.
P.S. If you or someone you love is struggling with an eating disorder, contact the NEDA helpline at (800) 931-2237, find a treatment center or therapist near you HERE, or find an Eating Disorders Anonymous (EDA) meeting near you HERE.