The margin of choice

If eating disorders are brain diseases does that mean the patient is helpless and there is no hope?

I don't believe that at all. The idea that a biological origin means hopelessness is wrong.

You can't just decide not to be diabetic, but you can learn to accept the illness and take the right precautions and actions to live well despite it. Same with asthma, ADHD, heart disease, depression - all these illnesses have a biological origin and behavioral components.

I believe it is the same with eating disorders. If you have this illness you cannot, for example, diet. You must recover the health you lost before diagnosis, you must learn to protect yourself from restricting/dieting in the future. You must find, with the help of clinicians who understand the disease, a level of nutrition and the body composition your body's DNA and history have designed for you. You must find outside resources to monitor and give feedback on your health. You must learn about your illness and how it works uniquely in you, and learn what qualities in yourself make you vulnerable to the illness (anxiety, depression, unhealthy environments).

That is not helpless. That is not hopeless. That is recovery.


  1. I could not agree more with you Laura; I am Jewish and this weekend we are observing the Holiday of Yom Kippur that traditionally entails fasting for a 24 hour period. A close friend of mine asked me about what do I tell my Jewish clients that are suffering from an eating disorder in regards to fasting. I told him that I explain that for someone that has an ED it's considered to be a sin to observe the fast. Similiar to my father that is diabetic and unable to fast and also excused from fasting due to medical reasons so are individuals with illnesses such as ED. Fasting under to premise that it is for religious reasons is still fasting, it is observing the ED nothing else. I encourage people to talk about how it impacts them emotionally to not be able to engage in this and to also explore other ways that they are able to be mindful to G-d, their religious values & morals and to engage in prayer and repenting throughout the day; which is attainable without fasting. Bottom line when you suffer or have a history of suffering from a biological illness as severe as an ED you cannot afford to put your recovery or health at risk and therefore need to use protective factors. Similiar to one with a history of cancer now in remission, why after fighting so hard to attain remission would you seek to compromise your recovery. There is hope, recovery is possible however consistency is important and the best piece of advice that I can offer, Keep doing what works and what is effective, you are worth it! For those that observe, Best wishes for a happy, HEALTHY, and prospoerous New Year.

  2. I have battled Anorexia Nervosa and an Eating Disorder in general since I was 8 years old and I am now 35 (so yes 27 years all told). What you have written here Laura has given me more hope for recovery than I've had in a long long time. Thank you :)

  3. Thank YOU, anonymous. My best wishes for your full and glorious recovery - sending hope!


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