Eating Disorder Maintaining Factors
While there are a variety of factors that can trigger an eating disorder, additional factors often help to maintain disordered behavior once it begins. Indeed, once a disorder develops, the resulting changes can cause additional factors that maintain a debilitating pattern. The elements that initiate a disorder are not always the same things that keep it going.
Eating Disorder Mindsets
Dysfunctional thinking and negative mindsets can perpetuate eating disorders. While these thinking patterns may seem illogical and unreasonable to healthy individuals, those with eating disorders fully believe the entrapments of their mind.
Some clinicians and researchers have suggested that eating disordered individuals have difficulty coping with and managing strong emotions, such as anger. The anger they experience can be a result of bitterness toward their family, the world and themselves. These feelings are often turned inward, instead of being expressed in healthy, manageable ways. This inward anger often cultivates self-hatred. Anorexics punish themselves for their perceived failures and self-hatred by restricting their food intake. They atone for the ever-increasing pile of mistakes by punishing themselves through not nourishing their own bodies. For bulimics, however, their strategy for atonement is through purging. Their attempt to make up for binging and the resulting sense of shame is manifested through vomiting, exercising, laxatives and an otherwise abusive response to the body. Regardless of the means, self-hatred and punishment are generally unbridled, difficult to escape, and feed depression, anxiety, and secretiveness. Ultimately, these feelings keep eating disordered behaviors alive.
Sometimes, self-punishment is related to dangerous, destructive behaviors, variously called self-mutilation, para-suicidal gestures, or self-harm. These behaviors can occur in individuals who are depressed or anxious, lack alternative coping skills, or need attention and nurturing. Also, those who experience great loneliness, emptiness, and perceived deprivation often engage in self-destructive behaviors. All of these factors are common for people suffering from an eating disorder, putting them at greater risk for engaging in self-injurious acts. In addition to starving themselves or purging, people with eating disorders may purposely try to harm themselves by cutting or burning themselves, picking at wounds, pulling their hair, banging their head, trying to break their bones, or engaging in high-risk "extreme" behaviors.
Binge Eating As Comfort
If food is the enemy, it is also very much the temptation. Unlike anorexia, binge eating disorder does not revolve around deprivation from food for not being perfect, and instead uses food as a source of solace during times of distress. In high contrast to most other disordered eating behaviors, binge eating is experienced as highly pleasurable and comforting. Foods consumed during binges are generally high in fat, starch, and calories; low on nutrition and high on taste. Binge eating then is less a self-punishment and more a dysfunctional means of coping via an escape into a pleasurable reverie of food.
Many individuals with eating disorders search for an escape from their misery and are desperate to find peace. Before, during, and after binging, bulimics and binge eaters may become emotionally numb and withdrawn. They may also dissociate. Dissociation is a complex neuropsychological process that involves a disconnection from full awareness of self, time, external circumstances, and sometimes memory. The essential feature of dissociation is an involuntary separation from conscious reality which is created when the mind stops acknowledging some or all sensory information or memories. For bingers, dissociation may be experienced as a trance state, or something similar to a drug high.
The comfort derived from a binge is generally short-lived. After a binge, most eating disordered individuals feel guilty for having lost control and for the many calories they have consumed. Due to this shame, bulimic or anorexic bingers will move on to purge behaviors, which meet the need for self-punishment and atonement. There are a large group of binge eaters, however, who do not self-punish by purging. Often, such bingers feel depressed but resolve to do better next time.