(Image Source of an "ad" that I like :: Katie Green Bean)
So Serra's doing some self care on this Friday - feel better doll! So you're left me with me.
This past weekend, I had an off weekend (way more on track since then - you don't have to allow a day or a weekend to become a week, eh?). I honest to goodness didn't feel like eating or doing much of anything. I went for a couple of runs and found myself at work Friday, Saturday, and Sunday despite only actually being scheduled for one of those days - on-call another. This is not a post about that. So don't be mistaken.
I mention this not to be passive about it or to just throw it out there, but because it made me think about the fact that I can eat in a way that feels completely normal and without guilt for a patch of time and then not at all-- which oftentimes makes me wonder if I do still, in fact, have an eating disorder.
This line of thinking caused me to wonder why this is the case and I truly believe it mainly comes down to one word... "typical"
I think when you think of a typical eating disorder patient you probably immediately think of those over published ads featuring an emaciated girl looking into a mirror and seeing a much larger girl as her reflection. Or maybe just an emaciated girl.
If you do a google image search for "eating disorder" you'll find emaciated figures, plates with just a few veggies on them, scales with the word "HELP" emblazoned, and then a LOT of those aforementioned adverts (you'll also see E.D. therapists as well as happy "after treatment" pictures of people - but the volume of those does not nearly compare to the aforementioned)
I won't even post one of those adverts here, because I hate them.
Just like the word typical, I feel they contribute to the belief that you have to fit into a certain pattern to truly have a problem. You have to be emaciated and look into a mirror and see an overweight individual. When truly that is not the case. I cannot help but believe that those ads have perpetuated the belief that people with eating disorders don't eat, see themselves as fat, are mainly young Caucasians in their teens or early twenties, and spend a lot of time looking into the mirror (making them appear shallow). They've taken a large group of people and have made one ad (due to how widespread it is and its many variants) representative of all those included in that group... which is dangerous.
Eating disorders come in a lot of different flavors, even within classifications.
I have been diagnosed with pretty much every one (except COE and BED). Anorexia Nervosa first in the military, then Anorexia purge subtype, then incorrectly (in my opinion) as bulimic, then ED-NOS right before my exit. I can tell you that I was probably, health wise, more sick as ED-NOS (heart monitor at one point, electrolyte issues, and other weird issues) than I was when I was in the Anorexic category. At every diagnosis while my weight and behaviors may have been different (though overlapping in some aspects) I still had an eating disorder.
I've never had a fear of gaining weight. You're probably like, "what?" but I'm serious. Weight really has never been my number one issue.... worth has. I remember in IOP (I had an ED-NOS diagnosis at this point) when we had to write out why we didn't want to eat, why we engaged in certain behaviors, etc... while everyone else wrote down concepts that could be broken down "I('ll) feel fat" "I'll gain weight" etc, I just wrote down something involving worth. Something that couldn't be broken down further. I was just already at that highly broken down point. I had been for years and years.
Even under an anorexic diagnosis.
Did I still restrict and over exercise? Yes. Was I underweight as a result? Yes. Did I see a much larger self in the mirror? No... Was I that girl depicted in that ad? Absolutely not.
Did this affect my own mindset? Yes. Do I think it affected health professionals (early on) and their views? Yes.
That is a problem.
Much in the way that DSM criteria, I believe, feeds into the same problem.
I think that this standardization via criteria and this portrayal of a typical eating disorder patient HEAVILY impacts the group itself. I think it alters the self-perception of severity of one's physical and mental health and of one's behaviors in general. I take you back to my first paragraph. If those ads were not out there, if this idea of a "typical" eating disorder patient were not present do you think I would've thought the same things.
How many men do you think (due to the inclusion of menstruation in the DSM) have altered perceptions of severity or feel alienated by the present (not proposed) DSM criteria? I imagine a lot (and an increased amount of stigma)
The DSM is slowly changing and I have hopes it will continue to change... but those ads?
While the advertisements may be raising awareness, they are raising awareness of what has become a typical eating disorder patient. Creating an image that if someone tells you they know someone with an eating disorder appears. An image of an emaciated person. That image hurts and hinders a lot of individuals.
yes and yes and yes. i never lost my period which ruled me out of the AN diagnosis. i am lucky in that health care is free here and so it didnt affect me getting treatment however i stigmatised myself to begin with, all that oh im not as sick as them stuff... ive long since made peace with that and am grateful i didnt suffer worse consequences that could have come if i had in fact lost my period. anyway, it makes me so sad seeing people strive to fit into those DSM criteria and you are right there are men who will never meet DSM criteria before they die, and there are post menopausal women, pre puberty girls... my friend had a hysterectomy so how does she fit the criteria? it makes me mad.
ReplyDeletehave you read Arielles article on EDNOS?
and thank you for filling in for me, ill be back next week :)
Oh yep! I am definitely putting a link to this post up on my blog - I just love it! It is so true how 'typical' can cause you to hesitate to act, or even disbelieve your instincts, because you don't fit into some sort of mold.
ReplyDeleteI am far too old to be 'typical'. I have a husband and children and a great career. How can I have an eating disorder? Even my mothercraft nurse commented that it 'just didn't seem to fit'. But there it is. I do have an eating disorder. And if 'typical' hadn't been hanging over my head for so long I might have been able to seek out treatment a long long time ago :)
Yes yes yes. I absolutely agree. We need to move from generalizations to discuss the wide range of realities within all diagnosis. I personally also never feared weight gain. I feared lack of control in being able to handle strong emotions. It was my stress release, something that calmed me, it was never about weight, and in recovery fear of weight gain or changes wasn't a part of this. I think at times I am grateful for being in an addiction rehab place because they didnt know much about ED, and I had an individual therapist i could talk to. I think not getting pinned in typicals and finding a way that worked for me was a strength. The question is now - how do we promote awareness, as well as make notes of trends. Because trends may tend to be generalizations, they are also helpful at times in the awareness/advocacy movement./
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