Eating disorders and nourishing the self

This Body Image and Eating Disorder Awareness week we chat with Sam who has lived with experiences of both anorexia and bulimia since her late teens. She explains how for her, recovery isn’t black and white, it’s about building up her wellbeing and her sense of self. 

What is most misunderstood about living with an eating disorder?  

A significant misconception about anorexia, bulimia and other body image issues is that it’s all about thin models and fashion shows.

It’s true that social media has played a role from my experience of body image issues. However, it’s important to emphasise there are underlying factors which also lead to the development of eating disorders. Low self-esteem, bullying, anxiety, depression and trauma can all contribute to the onset of an eating disorder.  

I’ve even come across this misconception in treatment settings. Whilst I was undergoing an eating disorder treatment program in my early twenties, one activity in a therapy group was to identify which fashion model we aspired to look like. 

The actual task surprised me. No, to be honest it frustrated me! For one I had no intention of looking like any model, and at the time was not familiar with any.

There was this assumption from the therapist that we had all developed body image issues as we had wanted to look like a fashion model. 

Has society’s focus on diet culture impacted you? 

The diet industry tends to give the impression that if you follow a particular diet you will lead a healthier, happier life.

Yet it is not advertised that in the long-term, fad diets that restrict or eliminate certain foods do not work - and actually contribute to emotional and physical health issues. This can lead to disordered eating. 

Over the years I have learnt to disengage from any aspect of the media focusing on diet culture. I am aware that my challenges are not about dieting and society’s expectations. I am seeking an identity and sense of purpose. I have learnt the void I often feel within may need to be filled with not just nourishment but things that are meaningful in life.  

What has finding support been like for you?  

When I was young my engagement with psychologists was not helpful, I often felt disempowered and felt I could not voice my needs. 

Then in my early twenties I was confronted with the option of engaging in an eating disorder treatment program in a hospital setting. Personally, I felt this clinical approach did not improve my situation. Treatment focused on meal plans and weight restoration with minimal therapy.

While weight gain was important for my physical and mental health, there was the assumption that once my weight increased I would no longer feel anxious or depressed, and thus be on my way to recovery. This was unfortunately not the case. 

Although nursing staff were caring, I did not improve and within several weeks discharged myself. No rapport was established between the psychiatrist and I, and the expectation was to follow a series of rules which were supposed to benefit my wellbeing. 

While this treatment didn’t work for me, I don’t want to write off hospital programs altogether.

There are holistic and person-centred programs offered. Currently many inpatient and outpatient settings do offer a collaborative based approach, with both medical professionals and peer workers offering support. 

Peer workers have a lived experience such as with an eating disorder and can offer support and valuable life skills to encourage wellbeing. I believe this approach is more beneficial than treatment that relies on restrictive and punitive methods, such as strict supervision. I found this did not meet my emotional needs, and created mistrust, anxiety and often avoidance to seek support. 

What treatment did you find most helpful? 

I strongly believe any form of treatment/therapy needs to be offered in a safe environment where a trusting relationship with a support person can be formed, and where a person can make choices about their treatment. 

Over the past two years, for the first time in many years of therapy, I established a significant positive rapport with a supportive psychologist. This made such a difference to my healing process. In sharing my experiences, I did not have to justify my existence, nor did I feel disempowered. I felt I was able to just be myself. 

Personally, I have also discovered learning to recognise and regulate my emotions has been more helpful than concentrating on issues relating to weight and food intake.  

Through cognitive behavioural therapy, acceptance commitment therapy, mindfulness, and psychodynamic therapy I have utilised certain skills that are helpful for me to practice in my daily life. 

Also, an essential part of my healing journey has been interacting with peers with a lived experience of various challenges with mental health issues. Connecting with others has enabled me to share my story, establish friendships, learn life skills and develop self-confidence, and has motivated me to support others. 

It has also encouraged me to become involved in advocacy work, such as becoming a Peer Ambassador with SANE. 

What does recovery mean to you when it comes to your eating disorder? 

I have spent many years adapting to the fact that healing is a gradual process and a frustrating one.

There was the assumption that I was doing well if I maintained a safe weight, and this came with positive encouragement from family, friends and health professionals. Yet this was a deception. I still felt empty and unhappy within myself. 

Recovery is not merely about losing or gaining weight, it is about learning to understand and manage emotions and develop a sense of self. This can be an isolating process no matter what eating disorder you have been diagnosed with, and one needs to accept healing is not a linear process  – there are ups and downs.

Confronting one’s emotions and behaviours is a gradual process. Admitting I wanted to change became the first step in my healing journey. 

I have spent years trying to find a solution to be rid of the complexity of these disorders. And I have often felt guilty that if I display symptoms, I have not ‘recovered’. 

However, I recognise I have developed many strategies to manage my daily challenges with both anorexia and bulimia. I may face obstacles, yet I choose to work on improving my wellbeing and ensuring I am able to function as best I am able. 

What improves your wellbeing? 

Recognising what is meaningful for me is a huge part of wellbeing. Having been a carer to a family member since a child I have always wanted to support others – soI involve myself in many voluntary caring roles.

I also find working as a teacher, supporting and mentoring students from various backgrounds, has been therapeutic. Engaging with others who have their own strengths and challenges has enabled me to learn valuable skills. It’s also helped me to be more conscious of others’ challenges which has taken the focus off my personal experience. 

For me walking in nature, gardening, reading, writing, spending time with my cat and the family dog all improve my daily routine. Also, connection with family and friends and practising random acts of kindness all enrich my life.

I am now even considering applying for a therapy assistance dog! Like most pets, they are loyal and provide unconditional love and what more could one ask for in life?  

Where to from here?

• For support, SANE’s free counselling service is available online or on 1800 187 263, Monday to Friday 10am-8pm AEST/AEDT. 
• The Butterfly National Helpline is also available on 1800 334 673 and online.  
• To learn more about eating disorders, read our helpful factsheet.  

• To connect with peers who can provide unique insight and support based on their own lived experience, check out SANE’s range of peer support services. Connect with someone who gets it.