Jess Thompson
As a nutrition student, I have developed an immense appreciation for food and have become infinitely grateful for the role that nutrients play in keeping us alive and healthy. So I was very surprised when my younger sister fell ill with anorexia nervosa. She had watched a set of emotive health documentaries and had read numerous articles that slam key dietary components such as sugar, while promoting healthy eating and weight loss. This prompted her to follow a so-called “healthy diet” with the aim of losing weight. This shocked me because my sister already had a slim figure and had never been one to care about her health.
Weeks passed with her meal sizes decreasing, her exercise increasing, and her care for healthy food progressing from an interest to an obsession. She became consumed by health gurus on social media and took every false health claim to heart. Her healthy eating stint progressed to the point where she would refuse to eat any foods containing preservatives or oil, was suddenly a self-proclaimed “coeliac” and “vegan”, and was “lactose intolerant”. Eventually she was admitted to hospital with a weight of only 41 kilograms and an alarmingly slow heart rate of 29 beats per minute. She was at risk of heart failure, and we did not know if she would survive.
With my background in human nutrition, I found this time extremely frustrating. It was inconceivable that eating food was the only medicine that would save her, yet it was the one thing she could not bring herself to do. It also seemed absurd that the influence of “health” messages she was exposed to in the media had resulted in her developing such a negative relationship with food.
Despite my sister surviving this ordeal, anorexia nervosa can be fatal. We urgently need to find ways to respond to this illness, because its incidence is increasing. The rise has coincided with anly increasingly outspoken public concern for obesity. An obesity epidemic is now in full swing, resulting in endless media messages that emphasise the need to exercise and eat healthily to lose weight. Young people like my sister are very vulnerable to the messages portrayed in the media and can tend to take them quite literally. I believe the media can influence people’s relationships with food and may have a role in the development of disordered eating. It was certaintly a strong influence in my sister’s case.
After being introduced to the concept of “intuitive eating” in my nutrition class, I realised that intuitive eating may prevent eating disorders by helping to promote a truely healthy relationship with food. Intuitive eating opposes the common trend of restrictive dieting. It’s based instead on the practice of eating mindfully by tuning in to your body’s internal hunger and satiety cues. Intuitive eating focuses in particular on initiating eating when you are feeling physically hungry, and terminating eating when you are feeling physically full. At the other end of the spectrum, disordered eating results in a huge disconnect from appetite cues, leading the body to override instinctual self-regulation of food intake. This loss of mindfulness can be triggered by the misguidance of the dieting industry.
Throughout my sister’s recovery process, along with getting help from appropriately trained health professionals, she has had to learn to reconnect with her body’s food instincts and teach herself not to override them. Overall, she is learning to honour her hunger and make peace with food – two key principles of intuitive eating. Her experience illustrates that eating intuitively may not only help to prevent disordered eating, but may also assist in the recovery process.
Intuitive eating is something that anyone can safely adopt: the focus on internal satiety cues helps prevent over-eating, while the focus on hunger cues can prevent restrictive eating. Intuitive eating is not going to prevent all eating disorders, but it seems a very good place to start. And perhaps by using media to convey messages that inspire positive relationships with food, rather than constantly promoting messages of dieting and restriction, we can help deter behaviors that may lead to disordered eating.
Finally, I want to say that it’s important to recognise how difficult living with an eating disorder can be, not only for the person with the illness, but also for the person’s family. Below is a list of helplines that focus on support for families of those with an eating disorder. Never forget you are not alone and there are services out there to help you. Stay strong, noho kaha.
Jess Thompson is a third year human nutrition student at the University of Otago, Dunedin.
Eating disorder support helplines:
- Families Empowered & Supporting Treatment of Eating Disorders (F.E.A.S.T) website: https://www.feast-ed.org/
- Eating Disorders Association of New Zealand (EDANZ) website: https://www.ed.org.nz/
- NZ Eating Disorder Specialists website: http://nzeatingdisorderspecialists.co.nz/
Read related articles on Corpus:
- Love your tummy! by Sara Boucher
- A scoop of chips and a pinch of enlightenment by Annette Rose
- The ethnographer’s stomach by Susan Wardell
Dear Jess,
Thankyou for your article, and I hope your sister continues to remain well. Like your sister I developed as eating disorder in my teens, not because I thought I was fat but because I was trying to eat a ‘healthy’ diet and at the time the punitive treatment regiment that was considered best practice was designed to encourage weight gain as fast as possible, leaving me with no sense at all of what normal eating habits were, and even more strongly associating food with putting on weight, and it was more than a decade before I found a programme that helped me ‘relearn’ how to eat (although it is still a struggle). During my many hospital admissions I met many people who had developed eating disorders after following one or other dietary fads that involved excluding specific food groups (orthorexia), and I am very concerned about the burgeoning of such restrictive practices (gluten free, ketogenic etc) because of the potential for them to tip people with a genetic predisposition over the edge. That said, intuitive eating can be very scary, particularly because when a person is very underweight the desire for food can be very intense and people need to be carefully supported in the early stages and reassured that their appetite will become more ‘normal’ as their body recovers.
I also echo your acknowledgement of the strain eating disorders place on everybody involved, and encourage them to seek support for themselves too, up to and including stepping back and letting health professionals take over care if necessary. Sometimes the best way to help your loved one is to take care of yourself. Aroha nui ki a koe.
Dear Jess, I’m really pleased your sister has good help and support from you and I agree with Cushla about the need to look after yourself as well. And I love it that both of you shared this on Corpus because there is too much silence in the growing creep of eating disorders dressed up as privileged choices.
And I hear you about intuitive eating and mindfullness but I’d also like to say that I’ve learned that sometimes a chocolate biscuit is just a chocolate biscuit and sometimes food is just fuel. Even to frame it with intuition and mindfulness can be something to choke on.
I found that in ‘recovering’ from anorexia, there’s a part of you that wants to keep the safety net of restrictive eating. The anorexia force is strong within. And that force can sure as heck do a good impression of intuition. Then, and for a long time after, you need, I needed, I need, to eat a lot more than I want to or think I need to. And sometimes I need to be very not-mindful, in order to get the food down and keep it down. Still now. So I feel quite strongly that intuitive eating can actually be harmful for people’s recovery, replacing one food ideology with another – it cannot be safely adopted in the throes of an eating disorder.
I read this blog post about recovery eating vs intuitive eating last year and it made me want to do those little air punches of agreement, she says much better and stronger what I’m trying to say here.
https://tabithafarrar.com/2017/06/anorexia-recovery-problem-intuitive-eating/
I’d also like to add that while it’s easy to see that food is the immediate problem and the immediate solution, but there are other factors at play with anorexia that, for sure, can be helped by maintaining enough weight to actually think straight, but also need addressing in their own right.
Thanks again for sharing.