Diets don’t work. Instead, they are very often responsible for starting or perpetuating an eating disorder, including binge eating disorder, anorexia, bulimia, or other disordered eating behaviors such as emotional eating. And for people who already have an eating disorder, diets can be lethal.
Changing what you’re doing with food is not about applying willpower or self-discipline, and sometimes there are complex biological issues underlying someone’s food behaviors. The National Eating Disorders Association identifies three factors that may contribute to eating disorders: psychological, social, and biological.
There is fascinating research being done in the area of biological factors. We already know that there are brain chemicals that affect hunger and digestion, and that these may be out of balance in people who have eating disorders.
While of course we leave these research pursuits to our colleagues in the medical and scientific fields, as therapists we follow it closely, especially when working in a collaborative team approach with these other professionals.
At our center, we always rule out the physiological issues first. Often our clients will need to go to their primary care physician or psychiatrist to find the right balance of medications and/or supplements that will restore them to homeostasis.
For example, a client with depression could have a thyroid issue, low blood sugar, or a vitamin deficiency. We would want that treated before—or while—we addressed the depression in therapy.
And then there is the nature versus nurture debate. When eating disorders run in families, as they often do, is that because everyone in the family is genetically predisposed to have an eating disorder, or because family members have learned potentially harmful behaviors from each other?
It’s important to point out that just because an eating disorder is genetic or physiological, it doesn’t mean it can’t be changed, but it sometimes requires a more intensive therapeutic process, or a higher level of care.