Media tells us that eating disorders such as anorexia and bulimia are a simple obsession with how the body looks, being thin or having a perfect physique. It's not that the media are completely wrong, there is obsession alright but this is just the tip of the iceberg, the part that people see, the truth of an eating disorder goes so much deeper.
There is often so much focus on the eating disorder labels and the diagnostic criteria to fit the label...that the person under the label is forgotten about, much like the iceberg...if I don't see it, it's not relevant but this is the most important piece, in this case it's the part that matters most. There is a person under the label and they are trying to communicate with a language that is being misunderstood. Their language being translated poorly to vanity or simply wanting to look thin.
The need to be heard is one of the fundamental needs of human beings and when somebody struggling is trying to communicate, they will communicate in the only way they know how, they demonstrate rather than speak. There is such unbearable pain and suffering that it could only be described as nearly impossible trying to put that pain into words that could do it justice. I have never met anybody struggling with an eating disorder that wasn't full to the brim with self loathing, it can be difficult to describe how much self loathing there is with basic words, mere words almost do the self hatred a disservice, as the saying goes...actions speak louder than words.
It's important that the words are heard, even if they aren't always delivered verbally and we don't just keep focusing on the action or the behaviour. I once got asked by a psychiatrist how many packets of biscuits I ate in a typical binge, it would have been really helpful if he might of asked what emotion did eating each packet of biscuit stop me from feeling!
Often there is a desire to punish the body and when all of the focus is purely on the behaviour and ceasing this punishment we forget about why a person might feel that they have a need to be punished in the first place, this is the real issue that needs addressing. The behaviour itself is literally anger and pain and overwhelming emotions turned inwards. If they punish the body enough that maybe somehow they may be deserving of some kind of life.
The reality of having an eating disorder is absolutely not about vanity, in fact it's the most unglamorous, destructive, hate filled way of living. it's an assault on the physical body and the soul that the body houses. It's a hatred of the body, a hatred of the mind and an obsession with being better, feeling deserving, trying to somehow feel worthy of a place on earth, if they suffer enough maybe they can feel some sense of deserving.
So when you see someone struggle with an eating disorder, try looking below what they are showing you. The behaviour you see is abuse of food, you see the size and the strange rituals and abuse of the body but there is a person in there longing to be understood, longing to be heard, longing to communicate the hurt that they are experiencing. They are not attention seeking, far from it, they are hurting, so helping them to heal their hurt has a knock on effect of helping them to shelve the behaviour that they are using to help them to heal the hurt.
Eating disorders are simply a means of communicating what words alone cannot.