Wednesday, November 21, 2007

Media misunderstandings

I suppose I should be glad that my local newspaper is covering eating disorders in this article on a 41-year-old woman with bulimia.

But you know, it's hard to feel encouraged when you read lines like this:

Thanksgiving, challenging for anyone on a diet, is particularly problematic for people with eating disorders, whose troubles with food generally stem from deep psychological issues, therapists say.

There's a whole lotta sloppy thinking and reporting packed into that one paragraph. For one thing, it conflates "anyone on a diet" with "people with eating disorders," as if an eating disorder was the same phenomenon as a diet, only taken to an extreme.

And of course the line about "deep psychological issues" is just the same old b.s. we've been hearing since Hilde Bruch started writing about anorexia.

We know a hell of a lot more about these diseases now than Bruch did. We know they're biological illnesses. We know that genetics plays a huge role. And we know that you don't need "psychological issues" to develop anorexia or bulimia.

SOmeone who's lived with an e.d. for 20-some years may well have "deep psychological issues" with food. But it's a chicken and egg thing. The illness comes first, the "issues" come later.

The article goes on to describe how the woman with bulimia has been hospitalized seven times (six times at Rogers Memorial) for her eating disorder and still struggles with it. The tone smacks of prurience--"She actually might get up from the Thanksgiving table and vomit!"--and the continued conflation of eating disorders and dieting leads to comments like "Therapists encourage people with eating disorders — and anyone with more routine concerns about overeating on Thanksgiving — to plan ahead. Consider what items might be served and decide how much of each you'll eat."

Um, that sounds exactly like eating disorder talk to me.


mary said...

Too bad they don't know how to offer that one can actually PLAN to go easy on themselves and ask for support if they need it. I know how hard a day it is for those with an ED.
My advice would be to try to remember this about's ONLY's ONLY another day. It's really not so scary to eat and enjoy it as you would have when you were little. Go ahead and try it. You are much stronger than you think.

Harriet said...

I wonder if one of the issues here is how phobic so many of us are about food, or certain types of food--the good food/bad food dichotomy. I know I've felt that myself--as if a piece of cheese might literally kill me. It seems that this level of fear is part of the context for our generally disordered relationships with food--making it a symbol of fear, loathing, longing, etc.

Millions of people have these feelings about food; relatively few have anorexia or bulimia. The feelings come from our human need to explain and understand and create narratives around our experiences and feelings. I wish we were better at separating them from the realities of food and eating.

Fiona Marcella said...

Having recently made my first foray into the world of the media I realise that it is difficult to get good coverage of such a complex issue. Our local press were actually quite good, but the preferred angle is always as Laura has blogged before, a sob story of extreme illness, followed by a miracle cure, or the plea for money to purchase one. Keep writing Harriet - the world needs informed journalists otherwise how is it going to get an informed public? The scientists doing great work are usually not particularly good at getting their message across to the "real world" whereas for profit organisations have usually had expensive training in doing so.

Harriet said...

Too true, Marcella. I have just been invited onto the communications committee of the Academy of Eating Disorders for just this reason--to help get the information across to the media and to the public. We have to just keep telling it like it is.

And now I'm off to our Thanksgiving feast! Happy eating--and I mean that in the truest sense--to all.

Carrie Arnold said...

Amen, Harriet!

I'm thankful for my first Thanksgiving since I wrote that article where I'm not phobic of what's being served.


Anonymous said...

I think its fair to say that there IS a biological AND psychological component to eating disorders -- they are not purely a brain disorder, just as they are not purely psychological.

Harriet said...

I guess it depends what you mean by "psychological." I've never really understood the distinctions people make between psychology and biology, since your brain is part of your body.

I believe that eating disorders are rooted in biology, meaning they are illnesses that strike. I don't believe you think your way into an eating disorder. Having certain kinds of thoughts is part of having an eating disorder, so in that sense, anonymous, I agree that there's a psychological component. But I think psychology is a byproduct of physiology when it comes to anorexia and bulimia.

Anonymous said...

True,genetics plays a large part (some sources say 60%. . .) so someone who is not predisposed cannot "think" themselves into an eating disorder, but I think certain environmental triggers can bring out an ED as opposed to depression or other mental illnesses.

True that many traits seen in an ED personality are also genetically predisposed (etc. perfectionism) but some issues are purely psychological and are important to address.

Regarding psychological issues, I am referring to issues which perpetuate the eating disorder currently -- in my case, social isolation, attachment issues, low self-confidence, poor people skills, etc.

For these issues, therapy is useful to explore and develop ways to cope/understand these inherent feelings or environmental triggers

mary said...

I know there are people who may be good to talk to when one is in your situation. (wish there were more T's like a friend of mine has (Carrie) ) I hope you have someone who helps you even if it's not always comfortable. Life can be darn hard at times for all of us.
More important than having someone to share with is having someone who challenges us. If we can challenge ourselves then even better.
You probably know that there are many books out there to help address your isolation. It's more common than you might think, often being the person who's the life of the party who's suffering the most.
I'd like to suggest you see the "What The Bleep Do We Know" movie. It's science/psychological and a bit of wonder combined. It offers some powerful evidence that we do have the ability to use thought for our own betterment. My oldest son has words that affirm written on his water bottle because of this movie.I believe strongly in the use of affirmations to either walk your way into a change or fool your way. What "I" believe makes a difference in my life just as your beliefs may lead you.
My daughter's mantra was "fake it till I make it". She's fully recovered but she's still one of my 2 shyer kids. She'll soon be entering a situation where all this may change but I don't think she knows it yet.:O I was once quite shy myself and so I know how just getting out there and taking the steps is crucial. Confidence is built on solid experience. If you like children, seniors, or animals begin with them. Get out there and GIVE yourself away. Stop thinking about how something makes you feel and allow yourself a place in the world.(Harriet didn't invite me and she could delete me for using up all her I am anyway)Please don't Harriet!
While I very much believe that ED's are genetic I also think we may have more than one type of ED sprouting up. (just to confuse the issue) Intention seems to be what differs the different types,IMO.
If only with written words you've connected yourself to others.
You aren't alone! Know that. Never were, never will be.

thebigman1432 said...
This comment has been removed by a blog administrator.
Anonymous said...


n : excess bodily weight; "she found fatness disgusting in
herself as well as in others" [syn: fat, avoirdupois]
[ant: leanness]

Harriet said...


Anyone who has to get a definition from an online dictionary has my pity.

You've got to play by my rules on my blog, anonymous. Honest dialogue is encouraged. Trolling is not allowed. Your comment adds nothing to the discussion--hence it's considered trolling.

If you've got the courage of your convictions, speak up--and don't hide behind the anonymous tag. By the way, it might interest you to know that I've got my blog set up so that I can see the ISP you're writing from, how you got to my page, and what city and state you're writing from. Beware.

Your comment is lazy and clearly speaks to your own self-loathing. I'm sorry for you, and I hope you find a way to accept yourself and others. Meanwhile, please play by the rules or I'll ban you.

Carrie Arnold said...

I do think eating disorders have a biological basis. The profiles of sufferers are quite uniform. The underlying personalities are too similar for there NOT to be something biological at work.

(I know there will be exceptions. There always are. I have a master's degree in epidemiology, which is basically applied statistics. I know all about outliers)


That doesn't mean that there aren't psychological issues. It means several things.
1) For any psychological work to be done, you MUST be re-nourished. Even if you binge eat, with no purging, I'm going to hedge a bet that you are not properly nourished.
2) Therapy can help you learn to live with your unique psychology.

I'm a perfectionist. I used to practice my handwriting when I was 6 because I thought it was messy. I enjoyed making sure my books were in perfectly uniform stacks. I never had a library overdue fine until I was 19. This isn't something that is going to just go away. It pre-dates the eating disorder. Ditto for my depression.

Just some more of my two cents.

Anonymous said...

Umm. . .Just to clear up things, the anonymous comment above with the defintion was NOT mine -- I enjoy reading your blog Harriet and Carrie's and Laura's -- and I think I am respectful, even if my opinion differs. . .

I will sign my "posts" as A if that is OK, in hopes that I will not be confused by other people who post as "anonymous"

A :)

Harriet said...

Hi A, and welcome (or welcome back?). Respectful debate is what I'm after! It wouldn't be very useful to talk just to people who agree with me, or whom I agree with. I've learned a lot from comments on my blog and hope to continue to. So I'm glad you're here!

Thanks for the comment. As I think I ranted on about earlier, I'm very interested in the nexus between physiology and psychology. When does something become psychological? I think I'm going to post on this soon so I'll save the rest of my wanderings for then.

Anonymous said...

Its welcome back :). . .I was the first anonymous -- but not the rude one.

A :)

Harriet said...

Well, then, welcome back. :-)