Eating Disorders: “What Am I Eating?”

By Psychologist Cem Güner

Eating is one of our most fundamental needs. Yet our relationship with food is not shaped only by physical hunger and fullness. From the earliest stages of life, feeding is associated with being cared for, soothed, brought close to another person and having one’s needs met. In later years, family, culture, body image, social environment and the relationship a person has with themselves may give eating many different meanings.

For this reason, in eating disorders it is not enough to look only at how much or how often a person eats. What eating means to that person also matters. For some, food and the body become connected with control, anxiety, self-worth, shame, or ways of coping with difficult emotions.

Eating disorders include different clinical presentations. In anorexia nervosa, restriction of energy intake, fear of gaining weight and disturbances in the way body weight or shape is experienced are prominent. Bulimia nervosa involves recurrent episodes of binge eating and behaviours intended to compensate for them. In binge-eating disorder, recurrent episodes of eating are accompanied by a sense of loss of control, but without the regular compensatory behaviours seen in bulimia. Biological, psychological and social factors all contribute to the development of these conditions.

From a psychological perspective, eating behaviour may sometimes be connected with a sense of control. There are many things in life a person cannot control: how other people behave, how relationships unfold, what the future holds, or the uncertainties they encounter. By contrast, what to eat, how much to eat or how to shape the body may appear to be controllable.

Food may then cease to be only a means of nourishment and become one way of maintaining a sense of control. Especially in restrictive eating, how little a person eats or which foods they can avoid may become linked with their sense of willpower and achievement. Decisions about food can gradually become part of how the person evaluates themselves.

The boundary between “I ate well today” and “I was good today” may become blurred.

Rigidly classifying foods as “good,” “bad,” “clean,” “harmful” or “forbidden” may also become part of this relationship. A person may feel successful when they follow self-imposed rules and experience guilt or shame when they depart from them. A behaviour that belongs to nourishment can thus become an arena in which the person measures their own worth.

A similar process may occur with body image. The body comes to represent not only the physical form in which the person lives, but also an important measure of how they evaluate themselves. Weight, body shape or the image in the mirror may acquire far wider meanings connected with adequacy, attractiveness, acceptance and even success.

Eating may also serve to regulate emotions. Anxiety, loneliness, anger, boredom or sadness may trigger eating for some people. Food can provide short-term relief and help create distance from difficult feelings. When a sense of lost control is involved, however, this relief may be followed by guilt, shame or a wish to restrict again. Restriction, eating and guilt can thereby form a self-perpetuating cycle.

It is also insufficient to understand eating disorders only through the individual’s inner world. The culture in which we live continually shapes our relationship with food and the body. Social media in particular has made idealised bodies and lifestyles much more visible. People now compare themselves not only with those around them, but with hundreds of selected and edited images encountered every day.

At the same time, the language of “healthy living” may in some cases combine with rigid rules. What we eat, how much we exercise, how many calories we consume or how much protein we take in may cease to be simple health choices and become measures of discipline and self-worth. The boundary between eating healthily and becoming increasingly rigid and anxious about food is not always easy to recognise.

In trying to understand eating disorders, we therefore need questions beyond “Why does this person eat this way?” What does food mean to them? What is their relationship with their body? How much importance do they place on the body when evaluating themselves? Which emotions does eating help regulate? What does losing control mean to them?

It is important not to assume that the same psychological conflict lies behind every eating disorder. Eating disorders are serious clinical conditions in which biological predispositions, psychological processes, family and environment, cultural influences and social body ideals interact in different ways. Two people with the same diagnosis may have very different relationships with food and their bodies.

Recovery is therefore not limited to “eating more,” “eating less,” or reaching a particular weight. Alongside medical and nutritional recovery, it is important for the person to rebuild the relationship between food, the body and self-worth.

Perhaps this is why the question “What am I eating?” asks about more than the food on our plate. It also asks about the meanings we carry with it.

A relationship in which food can once again be simply food may be an important part of recovery.

Eating disorders—including anorexia nervosa, bulimia nervosa, binge-eating disorder and other feeding and eating disorders—are serious mental-health conditions involving biological, psychological and social factors.