Eating Disorders Thrive in Isolation: Why Support is Crucial in Recovery
How Diet Culture Fuels Shame and Secrecy
Eating disorders worsen in secrecy and are still hard to talk about today. The lack of knowledge around eating disorders in our society further leads to feelings of shame and isolation. Diet culture has been rebranded as “lifestyle” or “wellness,” allowing eating disorders to hide in plain sight. Wellness culture perpetuates the idea that we are not supposed to care about dieting. We’re just supposed to be effortlessly thin and healthy. It gets even more complicated when eating disorder behaviors are normalized through dieting and weight stigma. Conversations in the breakroom at work often center around food and dieting. Coworkers talk about “cheat days” or needing to be “good” by not eating a certain food. It can all feel overwhelming and hopeless if you’re struggling with an eating disorder. The lack of hope can make it hard to open up when you need support the most.
The Hidden Toll on Relationships
Eating disorders affect our relationships by taking up a lot of emotional and mental real estate. It’s hard to have the time and energy for anything else when you’re always tracking food and constantly hungry. You may have skipped dinner plans with a friend out of fear of going over your calorie limit or you might avoid take-out altogether. Your eating disorder makes you dread social outings because you can’t plan your meals ahead of time – which then makes it hard to feel present and engaged with your relationships.
Eating disorders can get tangled up in your identity, such as being the “healthy” friend or the “thin” friend. This can make recovery feel scary as it can feel like you’re losing a part of yourself.
Food issues create a lot of stress in relationships and loved ones can feel powerless in knowing how to help. If you’re struggling with an eating disorder, you might be sensitive to what your loved ones are feeling. You might then withdraw out of fear of being a burden. You may feel embarrassed of having an eating disorder and struggle to know how to bring it up. While eating disorders can negatively affect relationships, support and connection is crucial to finding peace with food.
Social Anxiety and People-Pleasing in ED Recovery
Anxiety is one of the most common mental health issues that show up with eating disorders. Social anxiety is the fear of being judged leading to avoiding social situations and feeling extreme discomfort in social outings. Eating disorders and social anxiety have some things in common such as perfectionism and fear of being judged. (1) Body image issues are often rooted in fear of judgement around appearance, a trait that is shared with social anxiety. This can lead to feeling consumed by thoughts around weight, body shape and food. It’s very common for someone to rely on an eating disorder to cope with social anxiety, especially those struggling with bulimia. If social anxiety is present, it can add another layer to the recovery process and make it hard to reach out for help.
Early childhood experiences can cause wounds that manifest in our current relationships. Your feelings may have been minimized, dismissed, or your needs were made to feel like you’re “too much”. Some sensitive kids are told to “suck it up”, leading to them to bury their emotions, only for them to come out in unhealthy ways.
Some folks develop people-pleasing tendencies to cope with emotional neglect from their families. People-pleasing behaviors are overextending yourself, struggling with saying ‘no’, and being overly concerned with other people’s happiness. “If other people are okay, then I can be okay”. If you’re a people-pleaser, you may seek approval from others and rely on external measures of self-worth, such as academic performance, sports and weight loss. Diet culture leads to being praised for losing weight even if that weight loss if from anorexia. People-pleasers often struggle with perfectionism; another trait that eating disorders have in common. Eating disorders become a way to gain approval and praise from others, making people-pleasing tendencies a risk factor.
People-pleasing also leads to avoiding conflict in relationships, which can lead to feelings of resentment that build up over time. If you’re someone with an eating disorder, you may struggle to resolve conflicts with friends out of fear of upsetting them or being abandoned.
Challenges in Seeking Support
Eating disorder thoughts can be so consuming that it’s hard to recognize when they are causing harm. If you’re in denial of your eating disorder, then it’s harder to seek help. A big part of recovery is being able to acknowledge that your eating disorder is no longer serving you. Anorexia, bulimia and binge-eating thrive in secrecy which may cause you to hide your eating disorder from others. This can look like starving yourself throughout the day and then “eating normally” with friends at night. A common sign of binge-eating disorder is eating large amounts of food in secret.
You might be feeling ashamed and embarrassed, making it hard for you to feel safe to tell a friend. You might be afraid of feeling judged by your friend or scared to face the fact that you have an eating disorder.
Why Support Is a Game-Changer
Support can provide accountability in recovery through your treatment team and your loved ones. Accountability can be as simple as someone asking about your experience, whether it’s a therapist or friend. Sometimes it’s hard to access that inner part that aligns with recovery, so a friend can be that voice of wisdom. If your eating disorder is getting louder, check-ins with your community can help you avoid relapses. Honesty with your people helps you be honest with yourself. While weekly therapy sessions with your dietician and therapist are helpful, you spend most of your time with your friends and family, making them important parts of your treatment team.
How Partners and Families Can Help
While this might be hard, your spouse or partner can be helpful in your recovery journey. Maybe you haven’t told your partner about your eating disorder yet out of fear of worrying them or feeling judged. Your people-pleasing tendencies might feel activated. What if I’m a burden and it’s too much for my spouse? Including your partner in your recovery journey might allow them to provide some accountability in a loving way. Sometimes just knowing that your partner is aware of your eating disorder can be enough to cope with those urges. If you’re struggling with restrictive disorders like anorexia, your partner can help you implement your recovery meal plan. If you’re working with a therapist, they can help guide your partner in the best ways to support you.
If your teenager is struggling with an eating disorder, you might feel powerless in how to help them. Eating disorders are incredibly stressful for parents, which is why family support can be so healing. Family Based Therapy is an evidenced based treatment that views parents as the experts of their kid and empowers them with tools to support them in recovery. It is considered the first line of treatment for adolescents with anorexia and bulimia. (2) In Family Based Therapy, you’re in charge of implementing your teen’s meal plan at home, often with the guidance of a registered dietician and a therapist. You’re fully in charge of what and when regarding mealtimes. As treatment progresses, your teen will gain more independence in decision making around food with the goal of returning full control back to them. Siblings also play an important role in family-based treatment by providing relaxation and stress relief outside of meal times.
Group therapy provides teens the opportunity to connect with their peers who are also working on recovery. Peer connections are an important part of your teen’s development, making group work a great option for eating disorder and body image issues. Group therapy helps build empathy, compassion and self-esteem in teens. It’s common for teens to make connections that last beyond the group.
Group Therapy and Community Connection
You might be feeling alone in your struggle with your eating disorder. Unfortunately eating disorders are becoming more common, meaning there’s a good chance you may know someone who is struggling. Support groups are a great resource if you want to hear from others who are having similar struggles. Groups can provide a safe space for you to share about your recovery with people who are not connected to your personal life. You’ll have the chance to interact with group members who are at different stages in their journey, which can offer hope that recovery is possible. Support groups can be in person and virtual. The National Eating Disorder Association has virtual support groups that are completely free.
Being in a community can affirm that you are more than your eating disorder. Messaging from diet culture emphasizes individualism: that you are responsible for your body size and your weight is something you should control. Despite the research that shows diets are not sustainable long term and are one of the biggest indicators of eating disorders. Learning to rely on your community can help you stay connected to the identities and values that are important to you. Surrounding yourself with those who have a shared identity can bring you a sense of belonging, purpose and safety. This is especially true if you hold a marginalized identity. Increased time with shared identities has been known to lower depression and anxiety. (3)
Final Thoughts: You’re Not Alone in This
Eating disorders are relational and often come with anxiety and attachment wounds. They continue to be exacerbated by diet culture, which makes eating disorders seem like a way to feel in control and safe. Eating disorders fly under the radar due to lack of public awareness and society’s obsession with being thin. This makes support and community even more crucial in eating disorder recovery. The more we talk about it with others, the less alone we feel in our experience.
Looking for therapeutic support? I’m a licensed therapist and board-certified art therapist offering in person and virtual therapy in Philadelphia. Is your teen looking for an eating disorder group? I’ll be running an in-person art therapy group for body image starting on June 2nd. The group will run for 8 weeks on Mondays from 5:30 pm to 7 pm. To register, just email at info@ruberticounseling.com to set up an intake.
References
1. Levinson CA, Rodebaugh TL. Social anxiety and eating disorder comorbidity: the role of negative social evaluation fears. Eat Behav. 2012 Jan;13(1):27-35. doi: 10.1016/j.eatbeh.2011.11.006. Epub 2011 Nov 11. PMID: 22177392; PMCID: PMC3244677.
2. Rienecke RD. Family-based treatment of eating disorders in adolescents: current insights. Adolesc Health Med Ther. 2017;8:69-79
3. Kristine Brance, Vasileios Chatzimpyros, Richard P. Bentall,
Increased social identification is linked with lower depressive and anxiety symptoms among ethnic minorities and migrants: A systematic review and meta-analysis, Clinical Psychology Review, Volume 99, 2023,102216, ISSN 0272-7358,
