“On a bad day, someone talking about a diet or how much weight they have lost, or someone saying you look well, can completely push you over the edge.” – Emma (Source: Beat UK)

“[Your eating disorder] is controlling you. It wants you to be scared of recovery, it wants you to maintain your behaviors, it wants you to fail at recovery.” – Adam (Source: MaleVoicED)

Emma’s and Adam’s experiences attest to the fact that eating disorders are about much more than food and weight. Patients with eating disorders have diverse physical and emotional experiences that lead them to struggle with their body image.

If you have an eating disorder, you might be curious about whether your experience is the norm — or, if someone you love has an eating disorder, you might be wondering how you can better relate to them. Understanding the sensations and emotions that often drive an eating disorder is a strong start.

So, what does an eating disorder feel like for someone in the midst of one? In this blog post, we will explain the most common physical and emotional experiences of people with eating disorders.

However, before we begin, we feel that it’s important to acknowledge that every patient’s experience with an eating disorder is different. You may not see your exact story on this list, but that does not make your eating disorder any less valid!

Physical Sensations in Eating Disorder Patients

Eating disorders take a toll on your body as well as your emotions.

It’s important to recognize that the physical experience of an eating disorder goes far beyond the measure of weight. You do not even need to be successful in losing weight to have an eating disorder. In fact, many people with eating disorders are normal weight or overweight.

Eating disorders can cause unpleasant physical symptoms, with or without weight loss. Many people suffer from gastrointestinal complaints, dizziness, menstrual irregularities, or problems sleeping. These symptoms occur because the body is deprived of fuel it needs to function optimally, not because the person has necessarily lost a lot of weight.

However, the physical experience of an eating disorder patient is more than just a list of symptoms. It is also a feeling of physical exhaustion. People with eating disorders constantly push their bodies to the extreme. Whether it is forcing themselves to exercise excessively or making themselves sick after meals, someone with an eating disorder puts their body through a lot on a regular basis. It’s no wonder, then, that eating disorder patients often feel fatigued.

Some people with eating disorders also struggle to feel physically connected to their bodies. Someone with an eating disorder may see their body unrealistically due to problems with body image or body dysmorphia. Because they do not feel satisfied with their appearance, they may not feel at home in their body.

As a result, dissociation — or an “out-of-body” experience — is common in patients with eating disorders. People with binge eating disorder may feel disconnected from their bodies during a binge, only recognizing how physically uncomfortable they feel once the binge is over. Others may lose track of their body’s normal hunger cues due to constant self-starvation and only get back in touch with their sense of hunger during treatment.

Thought Patterns in Eating Disorder Patients

Negative thoughts may also drive the eating disorder experience. These thoughts sometimes have to do with weight and food, but they often reveal deeper issues beyond the superficial eating disorder experience.

Many people feel that they have an “eating disorder voice” that is separate from their own. This critical inner voice is an intrusive presence in eating disorder patients’ minds. It is important to distinguish that this “voice” is not a hallucination or alter, but an extreme representation of the “inner critic” that many of us have.

Often, the voice does not cease its criticism until a person engages in an eating disorder behavior that helps them regain control over the voice. Even then, nothing is good enough for the eating disorder voice. Reaching a goal weight does not bring satisfaction, but only leads the eating disorder voice to tell the patient that it is not good enough and they should try to lose more weight. These patients’ inner critics are never satisfied, no matter how much havoc they wreak on their bodies.

Eating disorders often begin as an attempt to gain control over uncertainty in a person’s life. A teenager who lives at home may not be able to control the rules they must follow, for example, but they can exercise control over what or how much they eat.

Low self-esteem and perfectionism are also common in eating disorder patients. The core belief that we are not worthy unless we are perfect drives many people to engage in unhealthy behaviors in pursuit of perfectionism.

However, as the “eating disorder voice” proves, this attempt to assert control over their anxious or unwelcome thoughts often spirals out of control, until the person’s eating disorder voice sits in the driver’s seat.

Below, we discuss some of the core beliefs that drive eating disorders in greater detail, starting with disconnection.

Disconnection

Disconnection refers to a group of core beliefs based on our sense of being unlovable or unlikable. People with eating disorders tend to believe there is something fundamentally wrong with them and that they must hide their true selves from the rest of the world. Patients expect others to fail to meet their emotional needs once they realize that there is something wrong with the patient. They also score high on measures of abandonment, believing that all close relationships will end imminently, and emotional constriction, believing that they must conceal their distress in order to protect the feelings of others.

Impaired Autonomy

Impaired autonomy is a group of core beliefs that describe an expectation that we will fail, that we must defer to others, and that we lack the self-discipline needed to succeed. Ultimately, this represents a belief in our own vulnerability and incompetence. People with eating disorders often think that they are incapable of handling their responsibilities, that they cannot perform as well as their peers, and that they must submit to the control of others in order to avoid negative consequences. This sense of impending doom leads many patients to catastrophize, always feeling as if there is some danger looming around the corner.

Impaired Limits

Impaired limits refers to a group of core beliefs that drive our interactions with others. People with eating disorders may have difficulty getting along with others, making commitments, setting and meeting personal goals, or tolerating emotional distress. Patients who carry this core belief do not have faith in themselves. Because they feel that they lack self-discipline, they experience a need to inhibit their emotions and impulses. This inhibition is often driven by a strong fear of losing control, which ties into the next area of core beliefs associated with eating disorders.

Overcontrol

Overcontrol is a group of core beliefs that places an undue focus on controlling one’s feelings and actions. This group of beliefs goes hand-in-hand with perfectionism. People with eating disorders frequently over-emphasize the need for high achievement and performance. They may have a strong sense of duty and have a disproportionately high regard for rules. As a result, patients often subject themselves to unrealistic and unrelenting standards, and hypercriticize themselves when they fail to meet those impossible goals. They may also believe in the need for self-sacrifice in order to help others, which can lead to them ignoring their own feelings in favor of the feelings of others.

Emotional Experiences in Eating Disorder Patients

The physical and cognitive experiences of an eating disorder can quickly become distressing. Negative thoughts lead to eating disorder behaviors that make us feel physically unwell, which leads to more negative thoughts — and so on.

Psychologist Aaron Beck’s cognitive model shows how our thoughts fuel our emotions, and our emotions fuel our behaviors. When negative thoughts become automatic, they begin to drive our emotional responses to situations, even when those responses are not rational or healthy.

Take the example of low self-esteem. An eating disorder patient who believes that they are fundamentally unworthy may feel an overwhelming sense of guilt or disappointment. By forcing themselves to go hungry and exercise obsessively, they deliver a “punishment” to themselves that alleviates some of that guilt and disappointment.

Others say that eating disorder behaviors help them numb negative emotions like anxiety, sadness, or anger. Someone may binge eat to the point where they feel stuffed and physically unwell. The physical sensation of having binged may become so distracting that they forget why they were originally upset.

As their attention focuses more and more on their feelings of discomfort, they may become disgusted with themselves for being greedy or over-indulgent. These feelings supersede the previous emotional discomfort, allowing the person’s body and food behaviors to become the problem instead of what is really bothering them. They may then purge to relieve these feelings, only to find that they still feel dissatisfied because their original feelings of anxiety, sadness, or anger are still there.

These examples show how distress intolerance lies at the core of many eating disorders. Eating disorder behaviors become easy ways to distract ourselves from emotions we find unpleasant or intolerable. The physical sensations of discomfort that then arise from engaging in eating disorder behaviors serve as a further distraction from our negative emotions.

Conclusion

The physical, cognitive, and emotional experience of an eating disorder wreaks havoc on every area of a person’s life. Someone with an eating disorder may feel physically disconnected from their body, harbor negative and undeserved core beliefs about themselves, and/or experience extreme intolerance in the face of strong emotions.

Eating disorder behaviors often begin as coping mechanisms that patients have formed to deal with these problems in their lives. Hence, treatment for eating disorders requires patients to replace these maladaptive behaviors with more positive coping mechanisms, and to restructure their automatic negative thoughts in a way that no longer hinders their lives.

If you or someone you love is struggling with an eating disorder, our trained therapists can help jump-start the process of recovery. Our clinicians are experienced in therapeutic techniques like cognitive-behavioral therapy, dialectical behavior therapy, and mindfulness that can be used to replace limiting core beliefs, increase distress tolerance, and help the patient feel more in-tune with their bodies and in control of their future. Contact us today for more information on eating disorder treatment at The Meadowglade!