During my first year of college I developed an eating disorder. Of course, I had no idea at the time that that was what was going on, but I would soon learn more about eating disorders than I ever wanted to know. I have since earned my Masters degree in marriage and family therapy and have become a counselor who specializes in working with eating disorders. I have also written a book about my experience with anorexia and I am a public speaker on the topic. As a result, I am often asked the question: how can I know if I or my loved one actually has an eating disorder?
Sometimes this question drives me crazy and other times I am so thankful that someone is mindful enough to address the issue. What bothers me about the question is our tendency to put labels on people. These labels become problematic when they are a catalyst for conclusions and assumptions about those people who have been put in a particular category. They often interfere with the important process of drawing individual stories out from the people who are struggling with their relationship with food. It is too easy to assume that you know what someone is thinking or feeling once they have been labeled with a particular disorder and not take the time to really understand what they are personally going through.
These same definitions are also helpful, however, to the extent that they offer general categories that can aid in better understanding behaviors, resulting in better care and understanding for people who struggle in similar ways. Through these definitions we are able to apply what we have learned from the past to what is going on in the present in hopes of preventing or limiting future struggles. There are many things that are common to people who struggle with eating disorders, so understanding what these struggles have looked like in other cases can be useful in helping someone recover from their own disorder.
The Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) is a tool that counselors use to help identify various disorders. This reference points to four factors that afflict those struggling with anorexia nervosa, the disorder that I was diagnosed with in college. These include: failure to maintain at least 85 percent of what would be considered a healthy weight for your body type, intense fear of gaining weight despite being underweight, distorted body image, and in females, failure to have normal menstrual cycles. During this period of my life, I was indeed struggling with all of these things, but identifying these warning signs is not what made me know that I had an eating disorder.
