Author: Shernide Delva
Over the weekend, I watched the movie To the Bone starring Keanu Reeves and Lily Collins. The film took us inside the life of Ellen, a 20-year-old woman who has consistently struggled with an eating disorder. She enters a residential treatment program with several other women struggling with eating disorders.
The film received a plethora of controversy as many thought it was triggering. However, after watching the movie, I felt it did an excellent job of allowing the viewer to understand the urgent and severe nature of an eating disorder. Often, films only focus on how little the patient is eating or how much weight they have lost. Yet, this is only a small component of having an eating disorder. Eating disorders go much deeper psychologically, and weight is simply part of the problem.
While the movie does an excellent job explaining what it is like to have an eating disorder, it does not explain what causes eating disorders in the first place. Eating disorders are complex with a broad range of variables.
Treatments for eating disorders vary in efficacy. There is no one size fit all treatment. This is elaborated in the movie as we watch Ellen transfer from one treatment center to another. Finally, she ends up at a treatment center she connects to and has a great therapist played by Keanu Reeves.
Often patients deny the severity of their condition at first. The lack of seriousness only progresses the disorder further. For example, in To the Bone, the women struggle to understand why their eating behaviors are considered abnormal. In fact, they believe that their compulsive eating behaviors are necessary to their survival. The idea of eating any other way is difficult to grasp.
Furthermore, patients lie about the severity of their condition which hampers their treatment options.
Most clinicians agree eating disorders stem from a variety of factors:
These factors range from:
It is possible there is a genetic link that causes eating disorder. Significant studies on depression and anxiety allow reason to be hopeful. Many people had anxiety and depression prior to the development of their eating disorder. Eating disorders can be a reaction to mental illnesses, in an attempt to manage symptoms of depression and anxiety.
Anxiety can be controlled through food restriction and purging. Symptoms of an eating disorder can elevate the mood as sufferers rely on their weight to fit in with society. Since depression and anxiety have a genetic component, there could also be a clear genetic connection to eating disorders.
Neurobiology is a branch of biology concerned with anatomy and physiology of the nervous system. When it comes to eating disorder, individual ones like anorexia nervosa over activate the inhibition control networks and under activate the reward systems. When looking at bulimia nervosa, there seems to be a dysregulation of both the inhibition control networks and reward pathways. These abnormalities are common among eating disorder patients. However, it is uncertain whether these abnormalities are the result of eating disorder behaviors, or if these abnormalities were present prior to the development of an eating disorder.
The Psychology of Eating Disorders
Needless to say, there is a strong psychological component to eating disorders. Most of what we read regarding eating disorders discusses the psychological component. Psychological elements of an eating disorder range from familial, relational, cultural and social. Most researchers agree that eating disorders and psychological disorders are co-occurring.
Some treatment processes focus on behavior and cognitive changes. These treatments include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT,) Family Based Treatment (FBT,) and others. However, there is more research needed on how to treat the behaviors rather than solely focusing on the cause. In addition, families need to understand the root of eating disorders in order to understand how to best respond to them.
Overall, the reality is there is so much to be learned when it comes to eating disorders. Eating disorders are a result of a variety of factors. Furthermore, just like addiction, eating disorders are not a choice. People with eating disorders need treatment. If you are struggling with an eating disorder, mental illness or addiction, please call now. You do not have to do this alone.