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What You “Know” About Eating Disorders Is Wrong

I didn’t choose to have thyroid problems. Neither did my mom, nor either of my brothers.

I didn’t also choose to have an eating disorder. This, like other conditions, also runs in my family.

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eating disorder

Even though research suggests that 50-80 percent of eating disorder risk is genetic and heritable, many people still believe that those who struggle are at fault in some way. But eating disorders are not a choice.

An invisible illness

Regarding hypothyroidism, no one ever said to me, “Why don’t you just make your thyroid levels go back to normal?” But, in my eating disorder recovery, I often heard, “Why don’t you just eat?”

With physical conditions, we don’t usually blame the person for being sick.
– Jenni Schaefer

Even after I broke my foot because I was walking too fast down the stairs while carrying heavy luggage on a moving train, no one asked, “Why did you break your own foot?” And certainly no one said, “Why don’t you just walk?” as I hobbled with three broken metatarsals.

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My mom and dad didn’t choose to have the cancers that put them in two different hospitals at the same time. In regard to their lengthy treatments, people never asked, “Aren’t they over that yet?”

But, with mental illness, friends and family can lose patience. Mental illnesses, including eating disorders, can be excruciatingly painful for all whose lives are touched. When I finally sought help at age 22, yet was still struggling in my late 20s, friends questioned my mom, “Isn’t she better yet?”

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My brain was hijacked

I wasn’t better, because my brain was hijacked. If you’ve never had the experience of being taken over by a mental illness, then it’s impossible to understand. Before I realized that I was prone to mental illness, I used to wonder why a certain friend didn’t just quit drinking. Then, I entered my own recovery.

Eating disorders are brain disorders, and once the illness is locked in place, someone who suffers can’t just stop — not any more than I could make my bones snap back together, not any more than my parents could just rid their body of cancer cells.

One day, we’ll have the technology to see how mental health disorders really work, just as how we now know that cancer cells take over healthy ones. We already know so much about the mechanism behind hypothyroidism and how bones heal, too.

With eating disorders, groundbreaking research is under way, revealing that the serotonin system and possibly even gut flora may be involved. Someday, how we understand eating disorders will be one of those “the Earth is flat” conversations.
– Jenni Schaefer

Genetics loads the gun, environment pulls the trigger

An eating disorder is a biopsychosocial illness. That’s a big word for a large puzzle that no one could possibly put together even if they tried. What I mean is that I can’t cause myself to have an eating disorder, and a parent doesn’t just create the illness in their child.

An eating disorder is the perfect storm of genes and biology, and, yes, the environment. As part of the environment, we live in a society that is conducive to eating disorders, as made clear by Dr. Anne E. Becker’s classic Fiji Islands study.

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When Dr. Becker’s research team went to Fiji in 1995, just as American television was introduced, eating disorders were virtually unheard of. In fact, robust figures were valued and being skinny was looked at negatively. But, after three years of watching American actresses in “Melrose Place” and “Beverly Hills, 90210,” 11 percent of Fijian girls were vomiting in an effort to lose weight. Now, young girls wanted to look like the slender women on television, not like their moms.

Importantly, not everyone in Fiji developed eating disorders. This is the biology part of the conversation. Again, people don’t choose eating disorders. It’s not about simply rejecting societal pressures.

What we know about eating disorders is this: Genetics loads the gun. Environment pulls the trigger.
– Jenni Schaefer

What triggers recovery?

With hypothyroidism, I take a small white pill twice a day. For my broken foot, I wore a pink cast to help it heal. To treat cancer, my parents underwent chemotherapy and radiation, among other arduous cancer treatments.

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After witnessing the horror of cancer, I remember feeling awful that I had once, struggling in early recovery, wished that I had cancer instead of anorexia.
– Jenni Schaefer

I assumed that if I had cancer, I could just lie in bed and let the doctors do their thing. I wouldn’t have to do so much on my own. The fact that I even had this thought speaks to how exhausted and hopeless my eating disorder had led me to become.

Years later, watching my parents lie there seemingly helpless, I thought how horrifying that must be: to know that one of the biggest actions you can take in saving your own life is to just lie there and let a doctor pump you up with chemicals.

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My parents desperately wanted to live. Even though they kept their minds strong with prayers and positivity, there was never an actual time when they could simply make a solid choice to get better. They were, in many ways, left helpless to the latest research and knowledge of specialists.

But, in my eating disorder recovery, there did come a point when I wasn’t helpless anymore. After awareness and years of gaining tools and knowledge, there came a time when I had to make a decision to get better. And then I had to make it over and over again. There was nothing easy about that. To heal, I had to become accountable for my own recovery.

A choice to get better

In the early years, when my brain was hijacked and my biology was off, I could not make this choice. It’s only with awareness, time, patience, professional help, and lots of support that I can finally wake up each day and realize that food is like the chemo that helped cure my parents. Therapy is like my pink cast. Doctor appointments are like my little white pills.

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No one chooses to have an eating disorder, but people can choose to get better.


Jenni Schaefer is a bestselling author and a National Recovery Advocate with Eating Recovery Center’s Family Institute. On May 2, Eating Recovery Center celebrates Eating Recovery Day with the #DontMissIt campaign. Don’t miss the signs of an eating disorder, don’t miss out on the gifts of recovery, and don't miss the chance to save a life.

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