What is Normal?

Eating disorders are difficult to identify because all of the characteristic behaviors occur within the normal range of eating patterns:

• When we’re feeling upset most of us will eat differently - we may crave a large portion of something sweet or salty, or we may lose our appetite and eat very little for a while.
• Sometimes when we’re just starting an exercise program we become caught up in doing it diligently, even to excess…for a while.
• If we are facing a major event at which we believe we are going to be scrutinized — a job interview, for example — we may become very dissatisfied with our appearance, believing that everything makes us 'look fat'. But once the event is over, we become less self-critical.
• We may overeat at a celebratory meal. (The number of calories consumed at an average Thanksgiving dinner is pretty amazing!) And we may even try to compensate the next day or two by eating significantly less than usual and/or making a point of getting some exercise.
• We may read about how food is being over-processed and made less nutritious with the addition of additives, as a result of which we might decide to try to include more fresh foods in our diet.

In all of the above examples, the same behaviors that are diagnostic for eating disorders occur as part of normal experience. What is different is that all of these behavioral changes are clearly temporary, or one of many influences directing our choices. Moreover, the behavior is not associated with a devastating blow to our self-esteem, it doesn’t define us and it doesn’t leave us ashamed of ourselves. We are able to recognize the behavior as a choice - one which we might or might not repeat or continue - which we will be able to put in perspective.

People who suffer from Eating Disorders do not feel as if they have a choice. Their behavior is a compulsion. Not to engage in it produces intolerable anxiety and overwhelming guilt. Self esteem is measured by 'success' with food but, ultimately, they find that they are trying to meet impossible standards - they can never be 'thin enough', or eat food that is 'pure enough'. On the other hand, they are likely to experience overwhelming disappointment, fear or anxiety and they have no other way to make themselves feel better other than turning to food. The resulting guilt from having eaten something 'bad' prompts a pattern that may include more intensive restricting or purging, followed by more shame which leads to another agonizing experience with food. "Not to engage in it produces intolerable anxiety and overwhelming guilt, sometimes leading to other self-punishing behaviors such as scratching or cutting." Self esteem is measured by 'success'...

These obsessions and compulsions create an unbearable cycle - one which can be broken only with professional help.