And, it starts... the myths that kill

I taped the Starving Secrets second episode on Friday and watched it yesterday morning. You've heard my thoughts on the first episode on this blog and at Huffington Post.

There are times when I'm grateful for long commercial breaks - which I can just fast forward through - as it made the show itself blissfully short.

I had hoped it wouldn't happen, but the Big Myths are in full evidence in this episode. I'm doing this so you don't have to watch it, mind you. This episode's messages:

You have to want to get well
          This is a dangerous, dangerous myth. Not "wanting" to get well is what it seems like to those watching, and seems to be what the patient is saying, but let's reframe: patients have a mental illness where one of the symptoms is not really knowing one is ill, and another is the ENORMOUS physical and emotional difficulty of ending the behaviors. How much you "want" to "get better" is almost irrelevant. If what you see is a bathtub of cobras and not a normal meal, then I don't think you are likely to "want" it. If wanting to sit in that tub of snakes is a requirement of treatment, well, I wouldn't "want" it either. Truth: eating disorders cause both anosognosia and immense barriers to recovery. Your loved ones and your treatment providers need to "want" you to get well, and do so with confidence and practical help until you can.

The root of your eating disorder is your inability to be angry at your mom
          Oh, I've devoted years to dispelling this one, of course. What your mom did or didn't do, did or didn't see, did or didn't understand... is relevant, but not for the reason being implied here. If your family has been held at bay and lied to and frightened by behaviors and their concern has been hostilely rejected over and over then the parents are likely to be paralyzed, confused, and unhelpful. The antidote to that is helping parents understand that an eating disorder is a treatable mental illness and that the symptoms are remarkably similar between patients and remarkably improve with improved nutrition and symptom intervention. How would the parents learn this? Well, by shows about eating disorders, naturally. But not THIS one. Truth: The root of your eating disorder is a problem with your brain function exacerbated by and maintained by your eating behaviors. Your mom is trying to help you, and is even willing to be blamed and demonized on television if it will help you.

You are "dying to be thin"
          Eating disorder patients often believe they are losing weight and unable to eat normally and refrain from purging because they "want" so badly to be thin. I understand that: they are seriously mentally ill at the moment. What I don't understand is why treatment providers and responsible journalists would still believe that. This is a cruel, unforgivable, tragic myth that is, truly, killing people. The symptom of pursuing weight loss or "refusing" to gain weight or eat normally or stop purging is a SYMPTOM. The message that these young women have serious eating disorders because they want to be thin is dangerous and absurd and condescending to the patients. Truth: Your compulsions around eating do threaten your life, but you are not choosing these thoughts nor is it about weight loss. You are not vain, you are not weak, you are not failing. You will need to normalize your eating and regain your health so you can think more clearly and fight this mental illness. You need people around you who understand this has nothing to do with wanting to be thin.

But here's the greatest myth of all: that the eating disorder advocacy world has to put up with dangerously misleading coverage of the illness in order to get any coverage. The problem isn't that we can't get media coverage, it is that we have failed as a field to come together on some common principles. The myths above are believed by the public, and the media, because most of the eating disorders world believes them. Until that changes, we will get sensationalist media based on myths. We cannot pool our resources and have an effect on the media unless we come together.


  1. Laura, I haven't watched the program and still have not decided whether to, or not. On the myths issue, I recall at the F.E.A.S.T.Symposium that it's possible there may be a range or a spectrum of eating disorders as has now been identified re autism/asperger's. In addition, I think the first myth applies more to those with anorexia than it does to those with bulimia or even binge eating since a number of people who are in recovery from the latter diseases and even from anorexia who I've spoken to have indicated they brought themselves in one way or another back from the brink. They said they wanted to get quit doing what they were doing for a variety of reasons. There may be a difference between wanting to get well and wanting to stop since some want to hold on to their disease for "just a little while longer". Maybe the illness died away. Maybe their brain matured or something changed to erase the ED. Who knows. I also believe that the truth you concluded your first point with is spot on because those whose brains are totally messed up or whose brains are starved so they cannot make a decision or gather the energy to get well really do need every resource. So, just as there may be a range of ED's, there may be a range of recovery, too and the need for help. The person who posted and then removed the post said something to the effect that they wanted to get well but couldn't. That desire reflects the real person inside; not the ED. A poignant little book that reflects the idea of the person huddled inside was written by Nadia Shivack titled "Inside Out: Portrait of an Eating Disorder." It's written very simply and illustrated with drawings that she often did on a napkin. Many are very painful to look at and read; but they express the vacillation so often expressed. One breaks my heart when I look at it for the image is of a dragon kind of thing with a little person curled up in a ball inside of it. It's that person who's still in there who wants to survive. Some are strong enough to finally overcome the illness; others need that help.

  2. hi,
    i really do see and understand what you are saying and I never doubt your desire to help and not hurt, but where you always end up losing me is with your absolute assertion that was is/was true for your daughter and even many other anorexic girls is true for EVERY ANOREXIC girl. There are girls that have mothers than are huge factors in them developing an eating disorder. I have experience with mothers who restrict food, weight their daughters, call them fat, and have serious eating disorders themselves. I have clients who began restricting after the death of a parent, a robbery, an assault and after seeing all the thin girls at camp and making a decision to "get skinny no matter what". I think that often you can sound very invalidating of another's very personal and painful life experience. I know your intention is to protect parents, but I am not sure that is always needed. I am in private practice and see families all the time. I think if you poled EVERY single family i have seen in the last 5 years you could not find ONE that felt I was blaming, alienating or keeping them out. Your information seems very very outdated to me. Maybe I just work with very progressive people, but none of my colleagues sound like the horrible therapists you seem to have encountered. I don't think you are making it up either. I dont' know how to understand it, but I hope we all can get together and focus on helping people get well- in whatever way works best for each individual and stop getting stuck on proving we are right.... or pushing our own agenda. that feels like losing sight of the forest through the trees to me. We need to soften our hearts and be open to our patients and their experience and needs not close our hearts, divide and take sides. That is not good therapy..... just my humble opinion.

  3. I haven't yet brought myself to watch the second episode (on my DVR)... Even if you had true reasons to be angry at your parents (and some might argue that I do)... anger wouldn't get me any further in recovery. My parents didn't want me to develop an eating disorders. A LONG time ago I wrote about this theory of blaming parents and parents "getting it wrong" (and why it doesn't sit well with me):

  4. Anonymous,

    It is really important to distinguish eating disorders from the whole person's mental health, I think. Of course a parent's behaviors and beliefs affect the mental health of their child. A parent's actions have an impact on their eating disorder! There's a difference between causing an eating disorder and affecting the eating disorder and mental health. I know it may not seem like the distinction matters, but I believe it really does.

    One, because while the symptoms of an eating disorder often SEEM like they are coming from the environment I don't believe they very much are - and those symptoms happen at extreme degrees with or without environmental influences. So, judging the environment by the symptoms is a flawed idea.

    Two, because we need to promote healthy parenting and attitudes FOR THEIR OWN SAKE and for ALL children even if not at risk of an eating disorder. It is not healthy for anyone to be exposed to negativity and teasing and emphasis on appearance.

    On the topic of being outdated, oh, I wish this was true. And I don't doubt it about you - there are many, many, many providers who don't blame and shame. But most still do and ANY are too many - these are lives being ruined by that approach to treatment. Things are significantly better than they used to be even 9 years ago when we had our experience but I spend my time in the professional eating disorder world and find these parent-pathologizing attitudes quite common and these are the SPECIALISTS - not the 90% of professionals who treat eating disorders just as part of their practice without specialized training.

    Just as I should not generalize my experience to all families, it is important for good clinicians not to generalize to their professional colleagues. I recognize that there are some really dysfunctional and damaging parents out there, and it pains me deeply - I don't defend them or cut them any slack at all. But we also need professionals to do the same: hold colleagues and their professions to a higher standard.

  5. Kat, very thoughtful blog post - important reasoning!

  6. Laura,

    First, thank you. I was consumed by anorexia for over 10 years & this is the first time I've heard that my wanting to lose weight was a symptom. I always thought I'd done this to myself (and suffered terrible guilt/shame because of it). So thank you, truly.
    Second, I just feel I must thank you for spreading your message. For the worst part of my disorder, my mother was never once told to feed me & I was called controlling & selfish. The fewer patients & families that hear the lies, the better.

    I am now in full remission, even if the thoughts are still there, & living a full happy life. I hope access to the best treatment & full recovery for all is on the horizon.


  7. -e-

    I celebrate your remission and join you in that hope. I am so sorry that you and your family were not told this, it is wrong to fail to explain this to everyone, often. NOT YOUR FAULT!


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