Eating disorder recovery is tough, right?! One of the main reasons I love my work as an eating disorder dietitian is my clients. I have the utmost respect for the way recovery requires folks to show up for themselves with such strength and tenacity. ED recovery is one of the toughest challenges I could imagine. In order to recover, you have to face your biggest trigger all day, every day in a way that is physically, mentally, and emotionally taxing. In my opinion, folks in ED recovery are superheroes!
But what if we add a chronic illness to the mix? Understandably, this can add another layer of complexity to a person’s recovery. However, managing chronic illness does not have to detract from a recovery journey! Read on to explore the ways in which chronic illness can impact recovery.
What is Chronic Illness?
Let’s define some terms before we go any further! A chronic illness is a disease enduring beyond 3 months. Often these diseases aren’t preventable or curable. Think IBS, celiac disease, epilepsy, POTS, dysautonomia, or gastroparesis. Treatment for this type of illness typically involves symptom management or remission rather than full recovery. Living with a chronic illness is heartbreaking and challenging. These diseases often redefine life goals and zap time, energy, and focus. Because of this, many folks with chronic illnesses also deal with mental illness(1).
3 Ways Chronic Illness and Eating Disorders Intersect
Challenging situations require coping skills. Sometimes depression, anxiety, or an eating disorder can be coping tools to get through challenges. Eating disorders may not be adaptive or healthy coping skills, however they can help us get through difficult situations. Read on to explore how ED’s and chronic illnesses intersect.
1. Setting Expectations of Symptom Management
Because chronic illnesses often don’t have cures, the focus typically rests on symptom management. When medical providers are out of options and symptoms seem unbearable, food is often suggested as a potential cure. Many of my clients with chronic illnesses work with providers who recommend elimination diets, weight loss, etc. When we need hope, we are vulnerable to grasp at any possible solution. However, trying to use food to fix a chronic (unfixable) condition sets us up for disillusionment and frustration. This frustration often gets directed back at our bodies or food.
The idea of food fixing or alleviating symptoms fills us with hope. The reality of food often not being able to do this snatches this hope away. Rather than sitting with the grief of a chronic illness, it can seem easier to avoid it by blaming food or our bodies.
Chronic illnesses often bring with them a sense of loss of control. Our bodies are doing something that we can’t control or fix. When we feel out of control, it’s normal to try to find ways to regain control. If this desire for control gets directed towards controlling food and weight, it can lead to the development of an eating disorder.
2. Separating Body Image and Chronic Illness
I have so much empathy for my clients with chronic illnesses. I learn from their determination and resilience every day. I’m relying on their expertise as I write this blog, as I don’t wrestle with the same chronic illnesses they face. One predominant experience my clients share with me is the sense of betrayal they feel in their bodies. “My body created or allowed this disease; my body is broken and cannot be fixed.” This complicates body image work. The reality of living with chronic illness is that our bodies don’t work as we think they ‘should’.
Body image work is rife with ableism. Often providers encourage clients to focus on what their bodies can do to help tolerate discomfort. We are encouraged to express appreciation to our bodies. But what if chronic illness severely limits our capacity? What if it means that physical ability can be lost at any moment? What if our bodies harbor a debilitating or deadly illness? What if we can’t appreciate what our bodies do because they have betrayed us?
Challenging ableism in body image work means accepting the truth that bodies are not valuable merely for their physical ability, health, or capacity. I believe our bodies are valuable because they house our personhood – which is not defined by our health status. Acknowledging this, however, brings grief. It requires those with chronic illness to acknowledge their reality of living in a body that feels like it betrayed them. Sitting with the reality that their lives look different than they hoped or dreamed. Realizing that their health may never improve or change. Knowing that the body they’re going through life in isn’t the body they wanted or used to have. Not simply because of size or weight, but because of health status.
3. Validating Chronic Illness During Recovery
Ouch…there’s not much we can do here besides grieve the loss of our health and the current ability of our body. We can also try to hold compassionate space for the body we do have and acknowledge that we are so much more than our bodies.
This complexity and intersectionality of ED’s and chronic illness is a tremendous challenge. The only tools I have as a provider are empathy, grief, holding space, and humility. I can explore food as a gentle tool to support ED recovery without using it as a punishment for being in a chronically ill body. I can advocate on behalf of my clients to help protect them from food blaming and fat phobia. But I can’t offer a magical cure.
Living with a chronic illness means there may not be hope for a fully healed body. Acknowledging that food or weight loss can’t fix us may feel like giving up. Yet there is hope for creating compassion for our bodies. What if we can acknowledge the sense of betrayal, grieve our health, and create room for tolerance, neutrality, and maybe acceptance? Our bodies may be battered by chronic illness, and yet they are our vehicles for this life. Can we allow them to be? Can we try our best to take care of them even in their broken state?
Closing Thoughts on Navigating Eating Disorder Recovery with a Chronic Illness
I acknowledge that compassion and care for a chronically ill body is a tremendous task. And I come back to the statement I started with. Although managing chronic illness in ED recovery may add complexity and challenge, it does not detract value from you and your recovery.
Resources
- Dealing With Chronic Illness and Depression, http://www.webmd.com/depression/guide/chronic-illnesses-depression#1
Contact Us
Courage to Nourish is a group of eating disorder specialized dietitians. We have in person locations in Alexandria, Virginia, Columbia, Maryland. and College Park, Maryland. We offer virtual services across the state of Virginia, Washington DC, Pennsylvania, and Colorado. We offer individual nutrition therapy. As well as support groups. We would love to guide you in building a better relationship with food.
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