Healing Eating Disorders Through Therapy in NYC
Healing an eating disorder can feel like embarking on an overseas journey before modern industrialization. You may even feel like you've tried many times or have exhausted many resources and efforts. That is okay. Give yourself some grace and compassion as healing from an eating disorder can sometimes be seen as lifelong work. That may seem discouraging, but actually I'm insisting that by having that outlook on the healing, one can heal even faster. It seems paradoxical, and much of it is.
Trigger Warning: content of specific disordered eating behaviors, diet culture, disordered eating thoughts and feelings
Here We Are Again Making Bodies Trendy
Sometimes I look at social media and think, “We’ve come so far.” Other times, “We’ve got so far to go.” Eating disorders feel as abundant as they did back when I was in my late teens and early twenties struggling with one myself. The pressure to remain “small,” “thin,” and therefore “beautiful,” sadly remain as cultural ideals in 2023. It’s no secret that celebrities are having their BBL’s removed and using the new diabetes medication, Ozempic, also known as Wegovy to lose unnatural amounts of weight. These ideals penetrate fashion and pop-culture trickling their way down to folks like you and me.
Is My Eating Disordered?
You might be wondering if your relationship with food and eating is considered “disordered.” Have you ever found yourself skipping meals or not eating for long periods of time, in spite of hunger, with the intention to lose weight? Have you ever found yourself working out excessively to burn extra calories? Do you obsessively think about food, losing weight, and being thin? What percentage of your thoughts revolve around food and your body image? Does your relationship with food and/or your body image disrupt daily activities or routines, like not going out with friends because you feel “too fat,” or avoiding a work dinner to avoid eating in front of others?
There are a lot of ways we take inventory of disordered eating. It can be confusing to discern if your eating is normal or not, when the culture we live in in western society actually suggests disordered eating as a solve for being in a larger body. Know that the size of your body does not solely qualify or disqualify you for having an eating disorder. Back when I was in the throes of mine, I used to think I couldn’t have an eating disorder if I was “fat” or if my BMI said I was overweight, or if doctors were telling me to lose weight. This isn’t true. Anyone of any size can have an eating disorder. What I care to know is: what is YOUR relationship to food, eating, and your body like? Usually that will provide the most clarity about the degree of the disordered eating, if any at all.
“But I Can’t Stop Trying to Lose Weight!”
I have heard this many times. I have also deeply felt this in my core myself. I will always validate that part of you wants to fit in in a society that happens to value thinness in our culture and lifetime. That is normal, and it is our society that has it backwards. Assuming your issues with food/body image do not fall into the extremely dangerous zone requiring immediate medical attention, it is okay to be exactly where you’re at with your ED. I say that with love and compassion. No one can force us to give up anything that we feel we need in order to belong.
But! And there’s always a “but,” I do imagine some part of you is curious about another way. To that part of you, I say, “stay curious.” Curiosity about better ways of doing things is a natural part of evolution. Is it possible that you could feel good in your body while not restricting your food to an unsustainable level that causes distress physically, mentally, and emotionally? Maybe. Maybe if restricting worked the way it’s often prescribed from medical offices all the way to pop culture articles, we’d all be Hollywood-approved thin by now. But clearly, it’s not so simple. And clearly the distress by millions is felt from attempting all of the various diets out there only for the diets to fail and the individual to take the blame on for themselves. There’s got to be another way.
The Other Way: How to Heal from Eating Disorders
I always wince internally a bit before sharing the other way with my clients in session. It’s never what we want to hear. We want to hear: There is a magic tool! You just do x,y and z, and Boom! Thin! Boom. Recovered. The tried and truest most evidenced based method to both healing eating disorders and finding your healthiest body lie within two movements: Intuitive Eating and Health at Every Size. You may have heard of these before. You may have not. And you may not be ready to hear them now. I ask that you stay curious and if anything, let a tiny seed be planted.
Intuitive Eating is a movement based in research that ultimately says: eating what you want, when you want, not only restores your unique and normal relationship to food, but it also allows for greater health over diets. Intutive Eating isn’t a diet, in fact, it’s anti-diet. I know, I know, your immediate thought is, “But I would never stop eating! I could eat ten boxes of Oreos every day!” You cannot. Not forever. Trust me. If you do, please write me and show me receipts and pics and I’d be happy to negotiate discounted services!
Health At Every Size (HAES) is a movement based in research that has found that focusing on ideals of healthy behaviors over intentional weight loss prove to be more effective at achieving health. It also disputes that folks in larger bodies cannot be healthy (they can!) and that body size is a direct indicator of health (it’s not!). In studies, research patients who focused on health over intentional weight loss, were more able to meet their health goals than those who focused on intentional weight loss.
How Can This Be?
I know, I know. Nearly every doctor in existence has touted “lose weight” at you since you were six. So then you should know more than anyone that that advise is utter BS and frankly medical negligence. You see, a paradox occurs, and it is a necessary paradox for eating disorder recovery. In the development of an eating disorder, often without consciously realizing it, we stop listening to our bodies physical cues and begin dictating our eating through the advice of diet culture. Maybe you’ve followed a Special K diet back in the day, or cabbage soup. Maybe you’ve done intermittent fasting, or tried forcing yourself to have 6 small meals a day. Whatever the timing, portions, or content of what you were eating, you listened to outside sources. This then caused conflict in your body, which is why you are reading this. If those things “worked” at as they promised you wouldn’t be here looking for the other way. The conflict can take many shapes and forms, usually it’s hunger, cravings, obsessive thoughts about particular foods, re-directing focus back to “thinspo” or other images of the thin ideal to keep your “will power” strong to override your body’s natural hunger needs and cues.
The issue is, and what research has found, is that when we restrict like this, we’re actually inducing a state of famine to our body. Our body doesn’t know we are living with an actual abundance of food. You’ve changed your eating and now it’s been hungry for a week or worse, several weeks or months, and it is determined now to keep you alive. So it works extremely hard to keep that weight on and make you feel the pain physically, emotionally, and mentally, that your dieting is a big “No-no.” You eventually binge and feel like a failure. You didn’t fail. Diets don’t work. Not long-term. And they leave more harm with us than good.
The paradox of all of this is that we’ve all taken dieting way too far. The very methods that doctors are prescribing, the ones that health gurus and fitness trainers swear by, are over-shooting the runway…by A LOT. Again, if this shit worked, you wouldn’t be here reading this. Nor would you know as many people as you do struggling with their body image and eating. The paradox is that, if we stop trying to override our body’s natural needs, we can actually learn to become aligned with them, and this in turn, can create the health that we seek.
“But Will I Be Thin?”
I could never say. I’m apt to say, “Take thinness off the table.” I know. You may not be ready for Intuitive Eating or Health at Every Size. You may need to try just one more diet to really see if that’s the one that will get you there, wherever there is. I remember it took me reading the book, “Women Food and God” FIVE times before I finally, truly, knew in my core that I had to give up restricting and dieting for good, and therefore the thin ideal. I will always have compassion for the desire to achieve the thin ideal in a society that is actively harming folks who do not fit into it. You are not crazy. Society is. And yet…
Your mental health matters. Your well being matters. Your life matters. Have you ever considered who you’d be if you weren’t spending so much time and energy on becoming thin? Maybe you’ve even gotten there once or twice, or you now look back on a version of you years ago with nostalgia for how thin you only now think you were then, but at the time you thought you were fat!
The Ugly Truth About the Thin Ideal
The truth about the thin ideal is that it’s a destination that you never arrive at. For those of us who ever did achieve some level of conventional thinness, we may recall that we never lost the feeling that we were still the “fat one,” or that if we just let up a little bit and enjoyed a meal with friends, that we’d lose all of the adoration and flattery. You see, the thin ideal isn’t about a specific size, it’s about a desire to feel loved, cherished, and adored. It’s the yearning to be desirable, to receive positive attention, to feel important and noticed, to be accepted. It’s the imagery of a fantastical “cool girl” who has the privilege to be carefree and confident because she’s never had to worry about her positioning in a social hierarchy of life. That sounds so nice doesn’t it? Undeniably beautiful, constantly confident, effortlessly carefree, ridiculously fawned after by all. Who wouldn’t want that?
I must repeat this again: the thin ideal is a fantasy destination you will never arrive at. Why? Because your ideal celebrity body belongs to a person who still feels insecure deep down and who is still chasing an even crazier ideal. Because you have arrived at levels of thinness and still felt like you weren’t enough. Because you will never please everyone and even at your ideal size, there will always be folks who don’t find you to be their flavor. Because size does not guarantee: love, adoration, confidence, and inner peace. Because it’s just one of the many “existential insets” on how to go through life: basing worth in beauty/approval of others with a constant pursuit of getting to a place we’ll never arrive at.
Some of us subconsciously fell into this pathway due to specific upbringing influences. Others have a “status/money ideal” where they will chase an undefinable level of success and wealth forever and ever, never feeling good enough, forever chasing the high of the next raise or purchase only to return quickly to the pursuit again. The point is, there are many fantasy ideals to pursue consciously or unconsciously in life. The trick is understanding in your core, that what you want instead are feelings of: approval, self love and external love, adoration, positive attention, confidence, and an inner ease with how you look. Because of culture consistently raising the bar on beauty standards as well as shifting the goal posts entirely (BBL’s in then out), you put yourself at the mercy of a moving target. Moreover, even if you magically had your ideal body tomorrow, there is no given that you would actually consistently feel those feelings listed above.
If you’re familiar with Emily Ratajkowski, I also recommend reading her book, “My Body.” She explores her own body insecurities and more importantly how as one of the most widely desirable models in the world, she could still feel like nothing more than an object for a sexist, classist, racist, patriarchal world that prefers women to exist as decorative objects for the male gaze and profit without any concern for the people that ideal harms.
Where to Begin
Maybe my tiny seed has been planted and you find yourself curious. You don’t have to be ready today to ditch dieting and begin Intuitive Eating. In fact, I’d argue against it without proper preparation first. I believe the first step is changing the lens of the culture we’re in as best as you can. What do I mean? Immerse yourself in body neutrality culture by following certain social media accounts. Maybe you’re even ready for body positivity. If so, follow body positive creators. Curate your social media feeds to cut out all triggering posts/images that perpetuate your thin ideal fantasy and that support a more healthy and sustainable relationship to yourself and food. Join Facebook Groups or other online or in person groups that support Intuitive Eating and Health at Every Size.
Read! Educate yourself! Become informed! Most folks I work with on eating disorders are very bright, type-A individuals who pride themselves on being informed on evidence-based research. I leverage that positively against you and say, check out these books for yourself and then formulate your own opinions AFTER reading and spending time reflecting on them.
Readings: Intuitive Eating, Health At Every Size, The F*ck It Diet, The Body is Not an Apology, The Intuitive Eating Workbook, Body Respect, Intuitive Eating for Every Day, My Body, and the one that resonated so deeply with me and ultimately convinced me I could never diet again (only after my fifth read) Women Food and God.
A Final Word
There are so many ways to dive into a new way of relating to your body, food and ultimately yourself. You just have to start. Dieting isn’t going anywhere and you can always return to it as the part of your brain that feels its more important needs to go back to it. But see what elements above you can begin to parse through and maybe even integrate.
Lastly, finding a therapist that is HAES informed and who utilizes intuitive eating as treatment for eating disorders can truly aid you on this journey for individualized care.