Understanding Eating Disorders: Treatment, functions, and the complexity of ambivalence

If you are interested in the definition and the signs of Eating Disorders check out our previous blog post: Eating Disorders: Understanding the Signs, Seeking Help, and Finding Recovery

Deciding to seek help for an eating disorder is a significant step. You might feel uncertain about what treatment involves and what to expect. The treatment of eating disorders usually follows a two-pronged approach:

1. On the one hand, the current symptoms and the factors that perpetuate the eating disorder are addressed, such as restrictive, selective and disordered eating behaviours, binge eating, and any type of compensatory behaviour (e.g. purging, overexercising). For this part of the treatment, it is recommended to work with a licensed, practicing dietitian in conjunction with psychological treatment.

   
   

2. On the other hand, the underlying causes of the development and persistence of eating disorders are explored. At their core, eating disorders are often coping mechanisms and serve specific functions. These functions may include regulating emotions, self-image, interpersonal relationships, and communication with others. Although eating disorders may serve such functions, they create further problems regarding wellbeing, relationships and health which need to be addressed in treatment.

Here are some examples of how eating disorders could serve a function: 

• Emotional regulation: Patterns of binge eating, purging, or restricting may offer temporary relief from emotional pain and overwhelming emotions. They can serve as a coping strategy and numb feelings such as anxiety, sadness, or loneliness. However, these strategies don't resolve the underlying emotions, they only provide short-term relief. Part of recovery involves developing healthier ways of emotional regulation.

  
  

• The illusion of control: Eating disorders can create a deceptive sense of control over one’s own body and life. The rules, rituals, and routines surrounding eating seem to offer structure and predictability in a world that often feels chaotic. Paradoxically, this illusion of control can often lead to a loss of control in the case of an eating disorder. Part of recovery involves letting go of this illusion and embracing uncertainty.

  
  

• Self-image and identity: An eating disorder can create a sense of self-worth and become deeply intertwined with one’s identity. It can feel like an essential part of who you are and may provide a sense of achievement, discipline, or uniqueness. In some cases, online communities around eating disorders can provide a sense of belonging that feels missing elsewhere. However, identification with controlling shape, weight, and eating can also dominate and likely shrink other parts of your identity. When you choose recovery, you’re choosing to redefine your identity without the eating disorder.

  
  

• Meeting societal expectations: Eating disorders may help individuals keep up with societal standards and body ideals, some of which was reinforced through positive feedback from others in their lives. However, trying to live up to these ideals can lead to acting against one's own body and its needs. Part of recovery involves letting go of these internalised standards, embracing the uniqueness of your own body and start listening to your body's signals.

  
  

• Escape of difficult experiences: Focusing intensely on food or your body can become all-consuming, leaving little mental space for other difficulties. Therefore, it can distract from painful memories, relationship challenges, or stressful life transitions. The eating disorder becomes a shield. However, this escape from reality does not help you cope with your circumstances and can lead to prolonged suffering. Part of recovery involves developing healthier ways of facing these experiences.

  
  

• Communication: Eating disorders can serve as an indirect way of communication and sometimes express what feels impossible to say directly: “I’m struggling” or “I need help”. It might communicate protest, or autonomy from others. In this way, the disorder becomes a form of communication, even if the person does not intend it. This form of implicit communication can also often lead to misunderstandings and misinterpretations by others. Part of recovery involves developing healthier ways of communicating your needs.

Therefore, despite its destructive consequences, the eating disorder may have served to meet certain needs, which can evoke fear and a sense of loss on the path to recovery.

For this reason, the treatment for eating disorders is often associated with ambivalence.

The definition of ambivalence is “the state of having mixed feelings or contradictory ideas about something.” 

While individuals suffer from the physical, psychological, and social symptoms and complications of the eating disorder, these conditions seem to fulfil certain needs, and deviating from this familiar path can lead to fear, distress and sometimes grief.

At Drummoyne Psychology, we understand that ambivalence about recovery is part of the process in eating disorder treatment, and we will explore it with curiosity instead of judgment. Ambivalence is not a barrier to treatment, it is part of the work. We provide compassionate, evidence-based treatment for adolescents and adults experiencing eating disorders, disordered eating, and body image concerns.

Working with a psychologist who understands eating disorders can help you:

• Understand the functions your eating disorder serves.

• Develop new coping strategies.

• Address underlying emotional or relational issues.

• Navigate the ambivalence and mixed feelings about change.

• Build a life where recovery feels possible and worthwhile.

At Drummoyne Psychology we will work with you every step of the way as you recover from your eating disorder. Because the most sustainable way to overcome your eating disorder is when you no longer need it.