New Optimism for Parents on Causes and Treatment of Eating Disorders

I'm a pretty loud critic of old and discredited ideas about eating disorders; and there are many. I have to say, though, lately I have more-and-more optimism about the future.

"Old School" Ideas About Eating Disorders

If you are new to the eating disorder world, you may not have encountered what I call the Old School ideas. I could go on all day: that eating disorders indicate a hidden psychic wound, that anorexia is associated with sexual abuse, that eating disorders are lifelong conditions, and that all people are at risk. I still hear people casually remarking that this illness is about a fear of growing up, and that eating disorders are a modern illness. My favorite old idea, for obvious reasons, is the one about parents causing eating disorders. The saddest one and most infuriating is: patients make themselves ill.

Who am I to say that these ideas are old and outdated? Twice this week, I've had people question my authority to speak out on this as clearly as I do. What they don't know is that I'm considering it a real move forward that I've earned this critique. I'm saying the same things I have for years, but it takes awhile to get a high enough profile to have my beliefs questioned in public. I'm all for it: we should always question the authority of everyone with opinions on these topics - including professionals in the field. Expertise in this field, after all, is a self-designation. It is time for us to ask where we put our trust when there is no solid ground of consensus in the field at all. You'll hear similar assertions to mine in the field, and a range of others. You'll hear the opposite as well. The range of strong opinion should tell us something about the vigor of the debate.

Remaining Optimistic Despite Dissent

I'm optimistic, however. Not because I want everyone to agree with me, although that would be a lovely vindication. My optimism comes from the quality of the data and information and thinking that are taking a larger place in the field of eating disorders treatment. I'm optimistic because the results of older eating disorders treatment models didn't have the positive results of the newer ones. I'm seeing a more open conversation, more ideas, and a growing number of recovery stories rather than cautionary tales. I'm seeing more optimistic and collaborative clinicians and a resultant change in how families are responding to the treatment environment.

There isn't a set of stone tablets for us to follow here. What we all need to acknowledge is that the fixed beliefs of the past were not based on solid ground, though they were passionately held out as if they were. The burden of proof is not just on those with newer ideas but perhaps more for those who defend the old ones.