Many years ago, when I was in 10th grade, we had to do a “pig lab” in which we dissected a baby pig. As a sensitive 13 year old, this horrified me and I spoke with my Biology teacher about how I would rather not participate. To which he replied, “Do you eat bacon?” The next day I became a vegetarian. By the time I went to college, 4 years later, I became actively anorexic. My concern for others had tipped into self-destruction. I had to spend the next few years sorting out what was helpful and what was not helpful for my recovery in the midst of the concerns I had for others, the world, and the difficult life transitions through which I was travelling. As we say in eating disorder treatment recovery, “it’s about the food and it’s not about the food.”
I recently gave a talk on eating disorders at a bay area hospital and one of the doctors asked me “What do you think of the Paleo diet?” To which I responded
“I am not a fan of any diet.” Or, as two of my eating disorder therapist colleagues say “This is not a die-t; this is a live-it.” (Wachter and Marcus, 1999)
Paleo, Atkins, Vegan
I have spent the past decade and a half working in eating disorder recovery programs and I cannot tell you how common it is for people with eating disorders to be vegan, vegetarian, “Paleo,” “Atkins,” or sugar/gluten free. For the record, there is nothing “wrong” with any of these. And people with sensitive temperaments, physically, psychologically, emotionally, tend to be strongly affected by what they eat. Neuroscience is now showing what we have intuitively known: what, how much, and in what way we eat changes our brain chemistry. Sometimes there are also medical reasons for special food needs. People with celiac disease need to eat gluten free; women with gestational diabetes need to eat in a particular way during pregnancy as a health necessity. However, that being said, from a clinical standpoint, I have noticed a few things:
- 1) Western culture is obsessed with “good” and “bad” foods as well as diets. The trend changes from Grapefruit, to Atkins, from “juicing,” to Paleo, but there is always one that has the attention of people and the media as the “right” way to eat. Usually this includes moral judgments about how some foods are “good” and some foods are “bad” (with the subtext of how you as a person are “good” or “bad” according to how you are eating.)
- 2) This same culture of diet-obsession is also obsessed with body sizes/shapes, and how the current “diet” will provide the right body size/shape/weight. Let’s be honest, there is an undercurrent of “The Thin Ideal.” In one 2004 study “Exposure to thin-ideal magazine images increased body dissatisfaction, negative mood states, and eating disorder symptoms and decreased self-esteem, on women.” (Hawkins et al 2004)
- The thin ideal assumes that thinner is “better” (more attractive, successful, intelligent, young, and on a deeper existential level, provides “freedom” from mortality).
- 3) People who have a temperamental risk toward internalizing stress, being over-achieving oriented, struggle with anxiety or depression, and are caring toward others (often at the expense of themselves) often obsess about food as a way to resolve complex life problems and issues.
Diets don’t work
This has been proven, again and again. Diets do not work. According to the National Eating Disorders Association (NEDA):
- • 95% of all dieters will regain their lost weight in 1-5 years (Grodstein, Levine, Spencer, Colditz, &Stampfer, 1996; Neumark-Sztainer, Haines, Wall, & Eisenberg, 2007)
- • 35% of “normal dieters” progress to pathological dieting. Of those, 20-25% progress to partial or full-syndrome eating disorders (Shisslak, Crago, & Estes, 1995)
- • Even among clearly non-overweight girls, over 1/3 report dieting (Wertheim et al., 2009)
- • Girls who diet frequently are 12 times as likely to binge as girls who don’t diet (Neumark-Sztainer, 2005)
Geneen Roth, who has been writing and teaching about the connections between emotions, food, and spirituality for decades, came up with a beautiful fourth law of Physics, which states “Every diet has an equal and opposite binge.”
Diets don’t work. They are a set up for deprivation that inevitably has a backlash. And obsessing about food is never about food.
Canaries in the Coal Mine:
So if diets don’t work and disordered eating is not about the food, what IS it about? That is the (hopefully less than) 10 million dollar therapy question that takes rigorous and compassionately curious work. I often think of people with eating disorders or people practicing disordered eating (including dieting) as canaries in the coal-mine. They are the ones that are extra sensitive to family, cultural, and environmental toxicity. If there is something not right in the family system, in the environment in terms of treatment of other sentient beings, or in the balance of power culturally (Have you ever wondered why women and GLBTQ people often struggle more with body image distress than straight men? And what they do and do not have access to?), then the person who develops the eating disorder is going to be the one saying (or acting out) “Something’s not right here! There is suffering! We’re not all going to survive!” They are the ones that are showing things are out of balance.
I share with my clients recovering from compulsive eating that putting a sign on their fridge stating “Its not in there” can be helpful. If you are looking for something in the food or a diet that’s not in the food, I invite you to ask the question what are you truly looking for? Is it kindness toward yourself and others? A feeling of well being? Is it to be seen or feel loved? Is it comfort or companionship? Relief from disappointment, embarrassment, resentment, jealousy? Is it a friend to be with you during grief? Connection with your family or community? Food can’t provide any of these. It’s not in there. I want to invite you, the next time you are considering going on a diet or eating ice cream in order to resolve any of these, to turn toward the discomfort of what is going on within you. Try not to fill it up with the distraction of food. Imagine
“…feelings like disappointment, embarrassment, irritation, resentment, anger, jealousy, and fear, instead of being bad news, are actually very clear moments that teach us where it is that we’re holding back. They teach us to perk up and lean in when we feel we’d rather collapse and back away. They’re like messengers that show us, with terrifying clarity, exactly where we’re stuck. This… [how to stop protecting your soft spot, how to stop armoring your heart] is the perfect teacher.”
― Pema Chödrön, When Things Fall Apart
Dr Linda Shanti Mccabe is a Licensed Clinical Psychologist that specializes in eating disorder and postpartum recovery in san Francisco. To read more about her, you can visit www.drlindashanti.com or her blog at www.recoverymama.com
This blog is not intended to diagnose or treat any mental or physical illness.
Scott E. Moseman, MD Medical Director, Laureate Eating Disorders Program Investigator, Laureate Institute for Brain Research, “Neurobiology for Clinicians” 2014 International Association of Professionals Treating Eating Disorders (IADEP) conference
The Thin Ideal:
Hawkins N1, Richards PS, Granley HM, Stein DM. “The impact of exposure to the thin-ideal media image on women,” Eating Disorders: The Journal of Treatment and Prevention, 2004 Spring;12(1):35-50.
Your Dieting Daughter (Chapter 7 “The Thin Commandments”)
By Carolyn Costin
National Eating Disorders Association (NEDA) website