What’s Eating Your Child // Eating Disorders //Part 2: Interview
Part 2 of 3
To get another perspective from someone who has a decent knowledge of eating disorders, I interviewed a therapist who has worked an Eating Disorders program in Illinois for just over a year. She provides individual and family therapy, facilitates their Family Awareness Support Group, and also provides groups on art and expressive therapy to patients in the Partial Hospitalization Program. She received her Masters of Arts Degree at Southern Illinois University Edwardsville in Art Therapy Counseling.
I asked her about factors and myth about eating disorders, things she’s seen throughout her job, and her outlooks on recovery.
1. Good morning, please introduce yourself?
- Hello, I’m Lisa, a licensed clinical professional, currently working with eating disorders.
2. How long have you been working there? How long have you been working with eating disorders?
- Well, I’ve been working here for a year, and before here I’ve done interning at a residential facility. So, all together… a long time.
3. What’re some of the other positions working with mental illnesses you’ve had?
- Well, since I graduated in 2011, I’ve worked with at risk teens for anxiety and depression, I’ve worked with people on the autistic spectrum, with post-traumatic stress disorder, pretty much the full range.
4. What got you interested in eating disorders? Were you interested much in working with them before this job?
- Well, after doing a few internships, my professor recommended I intern at a residential facility for eating disorders, especially because of my major in art therapy. Art therapy can be beneficial for eating disorder treatment. A lot of times, eating disorders can have a lot of difficulty making sense and there are a lot of cognitive distortions, so art kind of externalizes that a lot.
Art therapy is used fairly commonly in treating eating disorders, as it can become an outlet for self-expression that can be used to encourage the patient to accept not always being perfect in at least one aspect. This article lists the benefits in greater detail.
- And it’s really like that, so when I got this position, it was kind of like a calling. I’ve also took a lot of women’s studies classes in my past, [studying] a lot of women’s rights and gender issues.
5. What’re some of the bigger things you’ve learned working with eating disorders, and mental illness in general?
- I think overall you have to, and this is my life philosophy, you have to treat someone like a book you’ve never read before. You have to go into it without judgmental, preconceived notions, and you kind of have to start at the beginning and work at the client or patients pace, trying to rush, isn’t going to help the situation, you have to work step-by-step at their pace.
6. Including what you had learned through women’s studies, would you say you had a decent understanding of eating disorders before actually working with them?
- I think so, and since I’ve actually had this position, I’ve had friends come to me and tell they had eating disorders. Then I thought, “oh, that makes sense now.”
- My teacher in grad school gave a pretty good understanding of it. [Learning,] it’s not just about food and losing or gaining weight. There’s more to it. Which I think is a common misconception in the media and community.
Going along with her statement that it’s about more than food or weight, many people think of eating disorders as more of a medical illness; instead eating disorders are generally a way to cope with stress. One could lose tons of weight, but they still wouldn’t be “happy.” Because the underlying reason for wanting to starve, binge, or purge isn’t only to lose weight. It’s often a way to numb or distract from things that trigger stress in their lives.
7. What’re some of the other misconceptions people have?
- I think a lot of people don’t necessarily see it as a mental disorder, saying [things like] “just eat,” when clearly it’s more than that.
- I think another misconception is that only females have eating disorders, when men and boys do as well.
While females tend to have eating disorders more often, there are plenty of males who have them as well.
In the video above you hear about a teen boy’s struggle with bulimia. His story isn’t uncommon. Studies suggest that up to a quarter of people with anorexia or bulimia are male, and almost an equal number of males and females suffer with binge eating disorder.
- Another is that only teenagers, or younger kids have eating disorders, especially white middle class adolescents, which isn’t true. It could be any gender, race, ethnicity.
- Or that it’s always about size or weight, when anyone can be any weight, and there’s a wide range of eating disorders, not just anorexia.
- I think something that I see often working with families, is that many feel like it’s a choice. But what families need to see is that overall, it’s like any other illness, such as diabetes or cancer, it’s a disease that is never chosen.
- There’s actually a lot of good resources that talk about the myths of eating disorders. One is the National Eating Disorder Association that does a good job at educating the public. They do have a website with a good list of these myths.
8. Do you think that it’s something that can be cured, or simply treated?
- I think that it can be treated and managed, I don’t think that it can necessarily be cured, [like] cancer, but it can be treated and managed. [Through that,] people could manage and possibly not have [eating disorder] thoughts for the rest of their lives. Some may need more treatment or check-ins, I think it depends on the person, their support.
While it’s true that eating disorders can go into remission, many people think that simply going through treatment means that you’re better. Think about an alcoholic going through treatment. Would you take them straight to a bar? Or would you expect them to still need to stay away from drinking, because they would still have temptations? It’s sort of like that. Support and stability is still needed.
9. What types of eating disorders would you say you treat the most?
- It’s hard to say, actually. One of the common diagnoses that we see, the DSM now calls it “Unspecified Eating” or “Eating Disorder.” That’s basically someone who doesn’t meet the main 3 eating disorders listed in the DSM, the diagnostic manual, which are anorexia nervosa, bulimia nervosa, and eating disorder. If someone doesn’t meet this exact criteria, by maybe not using symptoms weekly, or has more of a mix of symptoms. So that’s the one I see a lot, but again someone with this diagnosis isn’t any less important than someone who purges weekly or daily.
- Each disorder can have different medical complications, but they equal across the board, it depends on the frequency and duration of symptoms, medical history, low weight and high weight, that depends on the severity and not necessarily the title.
10. What’re some of the complications that you see in someone with anorexia?
- Well there’s always the low weight, if someone has traditional anorexia, which can bring many complications and heart issues, low glucose, electrolyte imbalance, which can lead to passing out, kidney failure, G.I. issues, hair loss, brittle nails, and you see lack of clear, cognitive thinking. Death can also be a side effect of all those things.
11. What medical complications do you see with bulimia? Are they pretty similar, or do they different variables?
- Well, there are always [differences,] but with vomiting you [still] see electrolyte imbalances, unstable sodium levels and potassium levels, causing heart issues and dehydration. You can rupture your esophagus, because vomiting can start tearing away at your esophagus over time. Your teeth can decay and lose enamel. Someone with bulimia in their 30’s can could need several teeth replaced. With laxative use you can see G.I. issues, damage to their colon and their intestines.
12. What about with binge eating disorder?
- If someone is binging on a frequent basis, you can have obesity, which can obviously cause things like high cholesterol, heart disease, blood pressure issues, diabetes, and sleep apnea. It overall just has a lot of effects on the body.
- A misconception I see is that someone with binge eating has to be overweight, when you can in fact be a normal weight.
13. What’re some of the issues you see yourself working with eating disorders the most?
- Working for Partial Hospitalization therapy, I see unstable lab work, low blood pressure and heart rate. If someone over-exercises I see joint problems. Not working at an inpatient unit I don’t see a lot of the complications like heart failure, because most patients with more severe complications go to a higher level of care.
14. What’re some the factors [that cause] eating disorders?
- While many different things that can be a risk factor, but there’s always biological factor, you can be at more of a risk if there’s a genetic link. There’s a lot of ongoing research there.
- There can interpersonal factors, nature vs. nurture. Like difficulty with bullying, and socio-economic status. If you look at [American] environment, you see glorified thinness, like on social media. If someone strives for perfection and are told that’s what perfection is, that can play a role. I wouldn’t say cause, but trigger, because there are many factors that tie together.
- Also physical, psychological, and sexual abuse can be a factor.
15. What do you think it takes for someone to be successful in recovery?
- That’s a good question… it depends. One thing that you need is the want to change. You have to want a life separate from your eating disorder. You need that hope, the hope that you can be free of symptoms one day. Then there’s also consistent good therapy and doctor visits, and a good support system. But if you’re not there, I can’t force that.
Here is a good post that sums up key aspects of recovery.
16. Why do you think it’s so hard for people to let go of their eating disorders?
- I think that is an independent question. I think it’s about coping, and it’s about fear of what would happen if you do let go. But I think it’s a matter of finding that out with someone.
17. Is there anything else you’d like to close up with?
- Well I think that as a community we need more education, that this is just like any other disease. But even more than that, we need hope. As therapists, as friends, as families, we need to see that there’s hope in the situation.
Thank you for taking the time to hit such key points. I agree entirely.
