Food, shame, and rapid recovery narrative

"I used to be anorexic, but I'm better now."

I mull that phrase over in my mind over and over again. It is shallow. And I know for myself that it is a lie. But I know I'm not the only one who says it. I’ve read or heard something similar from clients that I work with. What I'm learning is that in our therapeutic culture, it’s perfectly acceptable to have a past history of addiction or illness — as long as one claims to be working on it, or to have recovered.

As experts on eating disorders will tell you, there are few compulsions that are more difficult to overcome than bulimia, anorexia, and the other diseases that surround food. Though the number of men who suffer from eating disorders has risen since the 1980s, the overwhelming majority of sufferers remain women. And though not all those who are afflicted are young, teenagers and 20 somethings are especially vulnerable.

One of the most unhelpful ways to talk about the struggle against poor body image is to describe it as a temporary developmental phase. A 16 year-old girl tells us that she hates her body, and too many adults make soothing noises saying “it’s something most girls go through” or simply “it gets better.” Of course, “it” can get better. But it rarely does so on its own. Self-loathing is not a natural biological phase through which girls must pass; it’s not a developmental trait that comes along with breasts and body hair and menstruation. Self-hatred is socially constructed — and the work to undo the damage done by peers, parents, and the media is often a long and challenging one.

Many young women I work with feel genuine guilt for not having recovered swiftly enough from an eating disorder. One said to me recently: “It was bad enough when I was a freshman in high school. But that was four years ago, and I’m still struggling with this. I hate my body but I also feel like I’ve used up my allotted time to get help.”

What she and others like her end up with is a classic double bind. On the one hand, they’re still struggling to reach an unattainable ideal, coping often as well with the physical triggers that can drive and sustain bulimia or anorexia. On the other hand, they’re keenly aware of our societal longing for quick recovery narratives of the sort one sees on TV: girl hits puberty, girl develops eating disorder, girl gets help, girl gets better, all in the space of a one-hour program.

The winding road of recovery, replete with often multiple relapses, is much longer and more complex. And while recovery from any compulsion or disorder is rarely rapid, it is especially prolonged and enduring for those with eating disorders.

Many young women have an initial recovery after treatment, and then go “public” (at least to family and friends) about what they’ve been through. They then often get showered with love and attention and praise; parents are grateful that their daughters are “better now.” But so often, when a relationship goes south or the academic pressure builds, or sometimes just “because”, a young woman slips back into an old pattern. Except it’s worse, because now she gets to cope with the shame of relapse. Young women with eating disorders are usually people-pleasers; they’re keenly aware of how worried and disappointed others might be if their initial recovery isn’t sustained.

She feels as if she’s letting everyone down.

I work with a lot of these women in college. Many begin by opening up about their pasts, telling their “I used to binge and purge but then I recovered” stories. Sometimes, those stories are true and the recovery is enduring. Sometimes, as any of us who work in this field know, the story they’re telling is incomplete. The past is still the present. But admitting that is so desperately difficult.

There is no simple solution to eating disorders. While an alcoholic can stay away from booze, an anorexic or bulimic must eat. And she must do so while bombarded with images and messages she can never entirely escape. Recovery is prolonged and difficult, and to some extent, will always be just a little bit incomplete. The goal is getting to a place where one feels a sense of peace most of the time — and accepts that the bad times may come again.

Healthy recovery means giving young women permission to say “I’m having a hard time… again” without fear of exasperating those around them who wanted a quick and permanent resolution. It means acknowledging that young women are forced to swim through a toxic soup of unhealthy messages, and that sometimes, they’re gonna need someone to throw them a life-line. That’s hard for many with eating disorders to accept; so many are perfectionists who idealize self-sufficiency and fantasize about imperviousness to pain.

It’s a long road to recovery and health. And we need to remind ourselves and everyone else that with all addictions, but especially with those around food, relapse is part of that recovery. So the next time you hear the “I used to have an eating disorder” line, remember that it may well be true. But it may also be covering up an ongoing and agonizing present reality.