When you or your child is struggling with food, whether that looks like purging, restricting, binge eating, and/or rigid exercise, it can be terrifying and confusing for parents. It can also feel deeply isolating for the person living inside the experience.
What we see on the outside is food behavior: increased rigidity around food, eating in isolation, eating large amounts of food, or purging. The behaviors can look or feel so baffling that it may be hard to get curious about what is happening on the inside. But having this understanding is key to long-standing eating disorder recovery.
Most eating disorders serve some function, which means that they are “helpful” or serve a purpose for the person living with them. This may sound counterintuitive, because the behaviors can feel distressing and can be physically harmful. While the outcome is harmful, there is often a root need that it feels like the disorder is addressing.
Eating disorders are rarely about stubbornness or vanity
Eating disorder behaviors are the tip of the iceberg. These behaviors can look willful, defiant, obsessive, or confusing. But they are rarely about stubbornness or vanity. They are usually nervous system strategies.
When a child (or adult) cannot eat, eats beyond fullness, purges, or restricts, their body is often trying to regulate something overwhelming inside.
The nervous system is the hidden driver. Our nervous system is constantly scanning for safety or danger. This process happens automatically and below our conscious awareness.
Eating disorders are a survival response
When our nervous system is well regulated and feels safe, we can eat with flexibility, have awareness of hunger and fullness, digest food well, tolerate a wide range of emotions, and have the capacity for problem-solving.
In contrast, when our nervous system is in fight, flight, or freeze in reaction to distress, our brains and bodies do quite the opposite. Eating disorder behaviors often map directly onto these survival responses.
Not eating enough calories can subdue emotions
Dietary restriction, or not being able to eat enough, functions to dampen the nervous system over time, which reduces the intensity of our feelings. When the world feels chaotic, overwhelming or unpredictable, malnutrition can create a sense of safety and stability.
This is one of the reasons we think that anorexia nervosa often begins in early adolescence. During this time, lots of change is happening, including the onset of puberty. Additionally, the transition between high school and college represents another vulnerable period during which anorexia may emerge.
Binge eating and purging can function to help reduce distress
Binge eating is thought to be soothing when intense emotions crop up. In other words, food is used as an attempt to self-soothe or regulate distress. For someone who feels anxious, overwhelmed, depleted or lonely, eating can temporarily bring short-term relief. However, longer-term it makes one’s distress grow.
Purging behaviors often follow intense nervous system activation, including overwhelm, shame, panic, or sensory overload. Purging can create a rapid physiological shift. It may temporarily reduce anxiety or provide a feeling of release. The body learns: This brings relief. And so the cycle repeats.
Similar to purging, rigid, compulsive or overexercising can create quick physiological changes. These changes include a release of endorphins and changes in dopamine and serotonin, which can improve mood. Exercise can create short-term relief from emotions such as anxiety, guilt, shame, stress or sadness. Because of this relief, the brain learns to repeat it, which leads to increased amounts of exercise.
Understanding eating disorders is a key step in recovery
You or your child may be experiencing one or any combination of these eating disorder behaviors. The thing to remember is that eating disorder behaviors are serving some function. So, it makes sense that attempts to “have more willpower” or trying to abstain from the behaviors are often short-lived and ineffective. In fact, approaching eating disorders this way often causes an increase in shame, isolation and feelings of failure.
Treating eating disorders usually utilizes a combination of insight-oriented & behavioral therapies. The goal of insight-oriented therapy is to develop a deeper awareness of unconscious patterns, past experiences, and internal conflicts that influence current problems. The goal of behavioral therapies is to identify, modify, and replace maladaptive behaviors with healthier ones by changing the learning and reinforcement patterns that maintain them. Both are needed to recover.
Eating disorders are not just about food. They are about regulation, safety, and survival. If you or your teen are living inside this experience, your behaviors make sense in the context of your nervous system. They are not proof that you are broken or weak or that you failed as a parent.
Remember: recovery is possible.