Introduction
As I browsed the internet on eating disorders and self-harm, the findings was rather depressing. It shows how little I have been aware of this dark and painful world. The statistics for ED in Singapore is alarming and it is on the rise, especially among youths. Social media plays a big role in fuelling the growing desire to be thin, providing the platform for body-praising and body-shaming. Celebrities and ‘influencers’ set harmful standards for the ideal of beauty. Sufferers share other initial motives such as pursuit of higher athletic performance, loneliness, pursuit of clean living and desire for control amidst chaos in life. While there are multiple online materials warning against ED, they are also sites where sufferers dangerously support and encourage one another towards ED.
The beginning of many ED’s journey seems so simple e.g. a suggestion from a peer, or a thoughtless comment from a friend at the pool party: ‘You have a flabby tummy’. Some even began with a healthy reason just to lose a couple of pounds. And yet the eventual spiral into full-blown ED seems inevitable. This perhaps means that in my support of ED sufferers I could look out for ‘first cause’ in order to understand what exactly is the sufferer going after. But at the same time I also need to recognize that the initial motivation may have evolved into an abyss. But this probing may still help the sufferer put together a coherent narrative of what happened.
It seems common that recovered sufferers share the satisfaction that comes from ‘taking control of life’. I wonder how this would make the counselling or any intervention very difficult. For we are essentially removing ‘control’ from the sufferer. Perhaps the eventual goal is to lead sufferer to find rest in God’s loving sovereignty over His people. He is in control while we are not in this chaotic world.
DSM-5, Anorexia & Bulimia Nervosa
I am surprised by how brief the section on anorexia and bulimia in DSM-5 is. In my ignorance, I simply assumed there is much that science have to say about them. And my surprise is also towards how little of the common sufferers’ psyche has been documented e.g. desire for control and independence.
The key markers for ED listed can seem common even among people I know who are not anorexic e.g. ‘undue influence of body weight on self-evaluation’ can be said of many of my friends. The broad and general nature of these markers can potentially make identification of anorexia difficult. And given how no one develops ED overnight but starts with a small desire to lose some weight, these markers may not pick up ED sufferer in their early stages. One can in fact easily hide bulimia based on these markers.
But I can see these markers being helpful to in counselling those with this condition. It points out the common emotion of fear among sufferers. There is a common fear of gaining weight and this fear is connected to their self-worth. This may give biblical counsellors a way into the sufferer’s world and eventually discerning the heart issues that drive and keep the sufferer to being anorexia. DSM-5 described sufferers as having a ‘persistent lack of seriousness on one’s low body weight’. While I agree there seems to be ‘lack of seriousness’, I also wonder if there is also a sense of an active desire to be thin disregarding risk involved. This emphasizes sufferers’ determination to remain thin.