How can I make him understand?

You can't.

And it doesn't matter right now.

Most of the history of eating disorder treatment, indeed of all psychological symptoms, is the search for insight. Turns out, insight is overrated.

And with eating disorders, expecting insight while a person is still undernourished or caught in a cycle of bingeing or purging is like asking for insight in the midst of a coma or under the influence of a six-pack.

It is also not necessary. Insight is an important part of avoiding relapse, but it isn't necessary or even important until the later stages of recovery. We've had this upside down for so long it seemed to be rational, but think about it: why would a brain that is inadequately or erratically fed be able to think and reason? Do we give swimming lessons to the drowning?

You can't make someone understand, care, be motivated, or be thankful. You can make sure their brain is repairing. You can try to make them feel safe, loved, and moving forward. Insight will come.


  1. "Why would a brain that is inadequately or erratically fed be able to think and reason?"

    Wow, that is incredibly cold and offensive. I hope you don't really mean that?

    - Anorexia survivor who went through hell but never lost my ability to think, thanks.

  2. I don't mean to be cold and certainly don't mean to be offensive. I actually mean to be sympathetic.

    To say the brain doesn't work as well when starved of nutrients is a fact. This is not to insult your thinking while ill, but to respect the unfair burden that malnutrition puts on you.

    Certain parts of the brain seem to remain intact - even be sharpened - during malnutrition but at what cost?


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