Editor’s Note: This story is part of an occasional series covering disordered eating and diet culture.
CNN
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Being diagnosed with an eating disorder happened to Emily Boring by accident.
She went to her university’s mental health office to talk about the anxiety she was feeling, and through the conversations learned that her eating behaviors were classified as an eating disorder, she said.
Now 27 and a graduate student at Yale Divinity School in New Haven, Connecticut, her journey to recovery and recovery has taught her a lot about how to take care of herself and others, she said.
During the Eating Disorders Awareness Week in late February, Boring spoke with CNN about the misunderstanding, shame and stigma surrounding eating disorders to better understand them.
This conversation has been edited and shortened for clarity.
CNN: What do you wish people knew about eating disorders and eating disorders?
Emily Boring: I want people to know that it is everywhere. Most people will experience some type of dysfunctional relationship with food in their bodies, simply because of the culture we live in.
The first thing I would say is that eating disorders — and this applies to formal eating disorders as well — don’t look a certain way. They affect everyone regardless of gender, race, ethnicity, age, socioeconomic status. Disordered eating and eating disorders are not associated with a “thin” or underweight body.
CNN: How do you understand eating disorders and treatment?
Boring: Eating disorders are now classified as metabo-psychiatric diseases — metabolism which refers to the way the body processes energy, and then the psychiatric component which relates to the brain and behaviour.
This confirms the experience of people with eating disorders. We for decades — and also clinicians — have noticed that eating disorders tend to become active when a person falls into an energy deficit or does not take in enough calories to support their body.
Eating disorders are nothing to be ashamed of. They are not a choice, and they are not a failure. There is still some lingering stigma around the thought that eating disorders are something you choose. I will add to that: if someone is on the precipice of realizing they have an eating disorder or has received that diagnosis from someone else, I would stress the importance of early intervention. And I would say that the first step in recovery is finding a really good eating disorder team (including a) therapist, dietician and a doctor.
CNN: How should loved ones communicate with people in recovery from eating disorders?
Boring: I speak mostly from my own experience, but I have also coached several teenagers through this process. I’ve learned the hard way what’s not helpful to say to them, and I’ve been on the receiving end (of unhelpful comments).
As much as you can, avoid the comments and actions we associate with diet culture. Especially in this country, the way privileging appropriability in popular culture is antithetical to recovery. Diet culture often hides under the banner of health — that is the common belief that there is a standard of fitness and fitness that everyone can achieve if we just work hard.
There is a whole body of literature — scientific literature that shows that health and weight are not all causally related. So higher weight does not necessarily equate to poorer health outcomes.
CNN: What do you mean when you say don’t use the “eating disorder’s own voice” to talk about it?
Boring: Let’s say I show up at the doctor’s office, and I’m scared of what’s happening to my body. I’m afraid I’ll gain weight. And a clinician might say nicely, “Don’t worry, your body won’t change much. You don’t need to gain weight.”
Regardless of the truth of that statement or not, that just plays into the belief of the eating disorder. It’s so easy to try to reassure (your loved one) using the eating disorder’s own language, and I’ve found that doesn’t really work in the long run.
CNN: What are ways to talk to people without using the eating disorder voice?
Boring: Some questions I encourage people to ask themselves are things like, “Am I saying that some bodies are better than other bodies? Or that some foods have more greater or lesser moral value?” Also try to avoid mentioning anything with numbers, whether it’s weight or calories or number of hours exercising per week.
Don’t assume someone’s inner state based on how they act or don’t look on the outside. As much as people can, step back and ask questions, instead of making assumptions.
An example: “I see that you are improving on these behaviors, as we set the goal last week. How are you feeling? How did your mind react?” So the process of gentle questioning instead of statements and assumptions is really key.
CNN: What do people need to know about recovery?
It’s boring: That it’s not a failure, and that it doesn’t have to lead you back to the worst pain you’ve ever experienced. You can catch it early, and you can turn things around.
What I wish I knew about relapse is that it happens faster and more suddenly and all-consuming than I thought.
If you’re someone who has the genes for an eating disorder — whether it’s anorexia, bulimia, binge-eating disorder, any (disease) on the spectrum — you probably always have to be careful and vigilant about maintaining nutrition, eating plenty and a variety of foods, freeing yourself from diet culture. Because it can happen so quickly — a few days of restriction, a few pounds shed and all of a sudden, you’re back to eating disordered.
And I would also say that going back is a learning opportunity. It doesn’t always feel that way in the moment, but the times I’ve come back, I look back and realize each time, I’ve discovered something about what recovery means to me.
I guess that’s just a way of saying, be gentle with yourself and be open-minded that yes, relapse is a crisis, and you have to do everything you can to get out of it. But also, it’s not a failure and it’s not a sign that you’re going to suffer through it forever.
CNN: What have you learned about recovery?
Boring: When I first started in recovery, people — mostly clinicians, but also in some of the books and blogs I read from people in recovery — framed recovery, mostly in terms of emptiness. When you heal, you won’t have these troubling symptoms, or you won’t spend a lot of time thinking about food in your body.
In truth, what it feels like to recover is entirely about presence. It is an ability to show relationships around you in things that interest you. It is also a physical presence of awareness of your own body, ability to feel sensations, ability to listen to your body’s cues of hunger and fullness.
The eating disorder is completely gray, and it feels like I’m dragging myself a little bit as the days go by. … When I recover, the world will return to color.