Understanding Eating Disorders: From Control to Dysfunction

February 25^th starts National Eating Disorders Awareness Week. According to the National Eating Disorders Association, 30 million Americans suffer from issues with disordered eating (ED).

If you’re familiar with EDs, you know they can result in chaotic outcomes for the individual: drastic weight loss, binge eating, or obsessive exercising are just a few possibilities. What you might not know is this chaos often has a very different starting place — control.

Illusions of Control

We usually think of control as a good thing. When our lives are “under control,” everything is ok, right? Our habits, goals, and accomplishments drive our sense of who we are. Unfortunately, trying for too much control can have the opposite effect, wreaking havoc instead of bringing peace.

Unhealthy controlling habits often come from childhood experiences with caregivers. Research suggests controlling parenting styles are more strongly associated with EDs. When children believe their parents only love them for achievements such as grades, or external factors such as appearance, they learn that they themselves aren’t valuable as people. Only outward factors matter.

Not only do overly controlling parents make children question their self-worth, they dominate kids with rigid rules. They discourage the independent thinking and self-reliance kids need to manage life’s challenges.

As a result, kids in these situations often lack coping skills, which can make them anxious or depressed. They rely instead on rigid control over things such as grades, sports achievements, or even diet and exercise, to feel competent or loveable.

We all need goals and routines, but when control leads to perfectionism, worry, and self-doubt, the risk for eating disorders rises. In fact, studies have shown perfectionism is not only associated with higher risk for EDs, but it also makes EDs harder to treat.

Underlying Chaos

Unfortunately, with EDs, the harder people try to control their lives, the more things fall apart. The following factors add to this brewing storm.

Rumination

Thinking about negative things over and over, or obsessing over certain ideas is common for those suffering from EDs. Those thoughts often revolve around low self-worth and failure. It’s hard to contain this type of thinking, which grows more scattered and disruptive as the illness progresses.

Eating and exercise behaviors

Rituals around food or exercise become more rigid as the person adopts unrealistic, unattainable standards. Trying harder to control exercise and eating, they find it difficult to eat any meal without elaborate planning. Similarly, excessive exercise takes time away from other activities, so important tasks fall by the wayside. Life gets so out of balance that chaos sets in.

Self-esteem/perfectionism cycling

Low self-esteem leads to perfectionism, which, of course, dooms us to fail. The ruminating mind magnifies those failures, further damaging self-esteem. It becomes a cycle: self-esteem plummets, perfectionism takes over. Behaviors and emotions become unmanageable. Food and exercise choices grow more rigid and obsessive, making it harder for the person to see their choices realistically.

Reigning in the Chaos of Eating Disorders

Eating disorders are serious medical conditions; people with EDs need professional help tailored to their individual circumstances, especially physical health. Still, research suggests several strategies that might be helpful when working with professionals.

Reduce rumination and perfectionism

Understanding the link between these two symptoms can make people more aware of these habits. One study says therapy targeting perfectionistic tendencies directly may provide additional help.

Increase self-esteem to prevent perfectionism

Another study suggests that building self-acceptance and reducing approval-seeking could reduce perfectionistic behaviors, which may be hard to let go of when people don’t feel good about themselves.

Improve ability to regulate emotions

Some research indicates that difficulty coping with strong feelings can be a risk factor for ED, especially when paired with perfectionistic tendencies. Learning to deal effectively with difficult emotions may reduce ED risk.

Treat perfectionism early in children and teens

Perfectionism often starts young and poses a risk for EDs later in life. Individuals with perfectionistic tendencies may benefit from learning ways to keep such habits from taking over.

Understand the role of controlling family

Just like many other studies before, a 2016 study found parenting style has a clear impact on ED risk. If you are a parent who struggles with controlling behaviors, or if you grew up in a controlling home, getting help for these problems could reduce that risk.

Therapy Can Help With Eating Disorders

While EDs are complicated problems with many contributing factors, it’s easy to see how the concept of control actually facilitates chaos for sufferers and their loved ones.

If you think you have ED symptoms, consider contacting a therapist experienced in treating EDs. The therapist will need to work closely with your physician to treat the complex physical outcomes of EDs as you work on your mental health. With good treatment, peace is possible.