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"Why don’t you just stop?" This is the question with which people with eating disorders are confronted again and again by parents, spouses, friends, and themselves. Costly experiences with programs promising an end to the food behaviors once and for all frequently lead to brief abstinence followed by devastating resumption of old and familiar patterns. Regardless of whether the person starves, binges, binges and purges, abuses laxatives, compulsively overeats, gains weight, or loses weight, the story of a roller coaster experience with behavior changes is all too common. Until the behaviors in an eating disorder are viewed as the symptoms rather than the problem, the focus of recovery remains in the wrong place, and the person is likely to experience limited success in attempts to recover.

Most people have great difficulty understanding the function of the behaviors in an eating disorder. Why would someone starve herself to the point of death as often happens in anorexia nervosa? Why would someone binge and then induce vomiting or painful diarrhea, as happens in bulimia nervosa? Why would someone eat so much that her stomach hurts so badly that all she can do is lie down and fall asleep? Why would someone maintain a body weight that is so high that she is physically uncomfortable and potentially endangering her health, as often happens in obesity?

The following story is one way to explain the role these behaviors play in a person’s life. Its intention is to help both people who have never had an eating disorder and people who do to better understand what the person must recover from in order to maintain permanent behavior change. Because they did not develop an eating disorder by conscious choice but rather as an unconscious protection from emotional pain, most people with eating disorders who are just entering treatment do not know why they do what they do with food. All they know is that they have not been able to stop and they are scared that the food and weight related behaviors will never end.
 
THE STORY

Imagine that you are in an airplane and you do not know how to swim. Normally, when a person purchases a plane ticket the agent does not say, "Excuse me, do you know how to swim?" It is not even an issue. However, imagine that the plane crashes into water, you are the only survivor, and the only way you have to stay afloat is by holding onto a life preserver. Due to the change in circumstances, not being able to swim suddenly becomes a very important issue. You realize that if someone does not come to rescue you fairly quickly, you will either drown or die hypothermia. You scan the skies, hoping and praying someone will come by who can help you.

All of a sudden, you notice a helicopter flying overhead. You wave your hands, and the people from the helicopter indicate that they have seen you. You breathe a sigh of relief and eagerly await their arrival. The people come down from the helicopter and come to you and say, "We’re here to rescue you!" You say, "I’m so happy you are here. I was afraid I was going to die." The people then say, "The way we are going to rescue is by taking away your life preserver." You look at them with puzzled expression and say, "No, wait a minute, you don’t understand! I don’t know how to swim!" The reply is "Well, we’re sorry but the only way we know how to rescue people is by taking away their life preservers," which means you have a very difficult decision to make. So you say, "Please, wait a minute while I think about what I want to do." You are floating there in the freezing water thinking, "This feels like a lose-lose situation to me. If I give up my life preserver, I don’t know if these people will really help me or if they will leave me to drown. If I don’t give up my life preserver, I don’t know if someone else will come by before I die of the cold." The people in the helicopter become impatient and say, "Look we are tired of waiting for you to make up you mind, so we’re just going to take the life preserver away from you," and they grab onto it. You instinctively ensue. Surprised by your response, the people from the helicopter then say, "Okay, okay, There is one other possibility. If you look behind you, there is a lifeboat that can take you to safety." Given that most people are not trusting enough of strangers, even those who appear to be helpful strangers, to give up their life preserver right away, you think this through carefully, then reply, "That sounds like a good idea, but I’m going to take this life preserver with me. If the lifeboat sinks, I want to be sure I can still survive." (Reiff & Lampson Rieff, 1997, pp. 3-4)

Source:

Reiff, D. W. & Lampson Rieff, K. K. (1997). Eating Disorders: Nutrition Therapy in the Recovery Process (2nd ed.). Mercer Island, WA: Life Enterprises.

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Ron Vick, MA, LPC
Counselor / Academic Advisor
Int'l Student Advisor