TRIGGER WARNING: In this post we will be covering Eating Disorders (EDs), their symptoms, and common misconceptions.
In honor of National Eating Disorders Awareness Week which is February 22-28, 2015, Cheri, Sanjiv and I decided it was a good idea to address Eating Disorders in Literature.
A lot of media has improved in the way mental illnesses have been portrayed, but there are still overwhelming stigmas and stereotypes that are pervasive in everyday life. In this series, I consult our friend, a doctoral student who goes by Sanjiv, on her field of Psychology as it pertains to literature and character creation.
Sanjiv would like to mention that when creating characters with mental disorders, it is important to understand that no individual exists in isolation, and to consider the familial and social situations in which the characters exist and how that might influence their psychopathology. Particularly with children and adolescents, the familial environment plays a large role in the development and expression of psychopathology.
There are three main types of EDs: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.
A character might have:
Anorexia Nervosa (AN)
- Weight loss due to excessive dieting and exercise.
- Body Dysmorphia (image in the mirror does not match how the individual perceives the way their body looks in their head)
- Egosyntonic – Eating behaviors (compulsive and extreme exercising, extreme diet restriction, food rituals, purging, etc.) are not viewed by individual as problematic
Bulimia Nervosa (BN)
- Cycles of extreme overeating, known as bingeing, followed by purging (vomiting food, using laxatives or diet pills) or other behaviors to compensate for the over eating.
- Feelings of loss of control about eating.
- Body Dysmorphia
- Egodystonic – Eating behaviors are seen by the individual as problematic
- Regular episodes of extreme overeating, with no compensatory behaviors (ex. purging, use of laxatives or diet pills)
- Feelings of loss of control about eating.
Misconceptions about mental disorders can make those who have them feel as though their experiences are demeaned and trivialized and can be very harmful to those who need treatment. Some misconceptions people have are:
- “They just want to be skinny.”
EDs are much more complex than following a ‘fad diet.’ Although EDs often appear to be solely about weight and eating, they involve much more. EDs can be a reflection or expression of interpersonal stress, sexual or physical abuse history, or an overwhelming feeling of a lack of control in life. Societal pressures play a large role as well as individual characteristics i.e. perfectionism (for AN), negative self-image, biological and genetic predispositions.
- All people with EDs are underweight and have low BMI.
Many individuals with an ED are not drastically underweight. People can be underweight, normal weight, or overweight or obese and can often fluctuate.
- EDs are problems isolated within an individual
Especially with adolescents and children, you must consider eating behaviors and attitudes that were taught throughout childhood. With adolescents, who are still very much involved in family settings, the functioning of the family has great influence on their behaviors. You must try to understand him/her within the context of their family.
- EDs only affect girls
Women are most commonly affected, but there is a large number of men and boys that struggle with EDs as well. There is very little representation within literature or media for males that struggle with EDs. Generally speaking, boys are much less likely to seek help due to ideas of traditional masculinity and conflicting gender roles. The current state of media can be seen as reinforcing the idea that only females experience EDs.
With Anorexia Nervosa, I want to talk about an important aspect of the ED that relates directly to literature. One of the characteristic symptoms of AN is that it is ego-syntonic. In other words those experiencing this disorder do not see their behavior as problematic, so in books portraying characters with anorexia, there is the potential for the content to be triggering in real life.
Example – Letting Ana Go by Anonymous – a novel written in the form of the diary of a young girl who is experiencing anorexia. While the book is well written and provides a realistic portrayal of the mentality of someone with anorexia, there is a dangerous element to it that the author might not have foreseen.
Within their own mind, people who struggle with AN do not see their behaviors around eating/food as disordered – everything they do (extreme dieting, over-exercising, vomiting, etc) is rationally done. This ties in to the experience of body dysmorphia. When a person with AN sees his/herself, they see someone who needs to lose weight, who needs to be physically improved. For girls and boys reading this book who have struggled or are struggling with AN, the immersion into such a mind frame could contribute to a relapse into their problematic behavior.
If you don’t explore the negative side of anorexia – the physical, interpersonal, and social consequences, you can create the impression or expectation that there really isn’t a problem with engaging in these behaviors.
So taking an outside perspective, making it known to readers what is really happening to this person, despite what is going on in their own mind, is an important aspect that I encourage you to consider.
Let us know what books you’ve read with EDs and if it was done right in the comments below!