Having an eating disorder is far more complicated than having feelings about food.

Eating disorders can be difficult to understand. I say this as someone who had no idea what they really were, until I was diagnosed with one.

When I saw stories of people with anorexia on television, with measuring tapes around their waists and tears streaming down their faces, I didn’t see myself reflected back.

The media had led me to believe that eating disorders only happened to “petite,” pretty blonde women who spent every morning running eight miles on a treadmill, and every afternoon counting the number of almonds they were eating.

And that wasn’t me, at all.

I’ll admit: Years ago, I used to think of eating disorders as healthy diets gone awry. And I was the person who, puzzled at what I saw on TV, once or twice thought to myself, “She just needs to eat more.”

My oh my, how the tables have turned.

Now I’m the one in tears, slumped over in a restaurant booth in an oversized sweatshirt, watching as a friend cuts up the food in front of me — thinking if they made it seem smaller, maybe that would entice me into eating.

The truth is, eating disorders aren’t choices. If they were, we wouldn’t have chosen them to begin with.

But to understand why I — or anyone with an eating disorder — can’t “just eat,” there are some things you need to know first.

Once upon a time, my eating disorder was an important coping tool.

It gave me a sense of mastery when my life was out of control. It numbed me emotionally was I was enduring abuse. It gave me something to obsess about, like a mental fidget spinner, so that I didn’t have to face a troubling reality.

It helped me feel smaller when I was ashamed of the space I took up in the world. It even gave me a sense of accomplishment when my self-esteem was at its lowest.

In order to “just eat,” you’re asking me to give up a coping tool that helped me to survive for most of my life.

That’s an enormous thing to ask of anyone. Eating disorders aren’t just diets you can pick up and stop at any time — they’re deeply ingrained coping mechanisms that have turned against us.

After periods of prolonged restriction, the brains of people with eating disorders are neurologically altered, according to multiple recent research studies (2016, 2017, and 2018).

The brain circuits that are in charge of hunger and fullness become less and less activated, which erodes our ability to interpret, understand, and even experience normal hunger cues.

“Just eat” is a pretty simple directive to someone with normal hunger cues — if you’re hungry, you eat! If you’re full, you don’t.

But how do you decide to eat when you don’t feel hungry (or feel hungry at erratic or unpredictable intervals), you don’t feel full (or even remember how it feels to be full), and on top of that, you’re terrified of food?

Without those regular and consistent cues, and all the fear that can interfere with them, you’re left completely in the dark. “Just eat” is not helpful advice when you’re neurologically impaired.

Eating may feel natural for some people, but having had an eating disorder for most of my life, it doesn’t come naturally to me.

How do we define “a lot” of food? How much is “too little”? When do I start eating and when do I stop if my hunger cues aren’t working? What does it feel like to be “full”?

Still in the early stages of recovery, I find myself texting my dietitian every day, trying to understand what it means to eat “like normal people do.” When you’ve engaged in disordered eating for a long time, your barometer for what constitutes an acceptable meal is completely broken.

“Just eat” is simple if you know how to, but for many of us in recovery, we’re starting at square one.

Many people with restrictive eating disorders limit their food intake as a way of “numbing out.” It’s often an unconscious attempt to reduce feelings of depression, anxiety, fear, or even loneliness.

So when “refeeding” — the process of increasing food intake during eating disorder recovery — kicks off, it can be jarring and overwhelming to experience our emotions at their full intensity, especially if we haven’t in a while.

And for those of us with a trauma history, it can bring a lot to the surface that we weren’t necessarily prepared for.

Many people with eating disorders aren’t so great at feeling their feelings, so when you take away the coping mechanism that flattened our emotions, “just eating” again can be an incredibly triggering (and downright unpleasant) experience.

That’s what makes recovery such a brave but terrifying process. We’re relearning (or sometimes, just learning for the first time) how to be vulnerable again.

Beyond hunger cues, eating disorders can do damage to our brains in a number of ways. Our neurotransmitters, brain structures, reward circuitry, gray and white matter, emotional centers, and much more are all impacted by disordered eating.

In the depths of my restriction, I couldn’t speak in complete sentences, move my body without feeling faint, or make simple decisions because my body simply didn’t have the fuel it needed to do so.

And all those emotions that came rushing back when I started treatment? My brain wasn’t so equipped to handle them, because my capacity to handle that kind of stress was extremely limited.

“Just eat” sounds simple when you say it, but you’re assuming that our brains are functioning at the same rate. We’re not firing anywhere near capacity, and with limited functioning, even basic self-care is an enormous challenge physically, cognitively, and emotionally.

We live in a culture that applauds dieting and exercise, unapologetically loathes fat bodies, and only seems to view food in a very binary way: good or bad, healthy or junk food, low or high, light or dense.

When I first saw a doctor for my eating disorder, the nurse that weighed me (not knowing what I was visiting for) looked at my chart and, impressed by the weight that I’d lost, remarked, “Wow!” she said. “You’ve lost XX pounds! How’d you do it”

I was so shocked by this nurse’s remark. I didn’t know a nicer way of saying, “I starved myself.”

In our culture, disordered eating — at least on the surface — is lauded as an accomplishment. It’s an act of impressive restraint and misconstrued as being health-conscious. That’s part of what makes eating disorders so enticing.

That means if your eating disorder is looking for excuses to skip a meal, you’re guaranteed to find one in any magazine you read, billboard you come across, or on your favorite celebrity’s Instagram account.

If you’re terrified of food, and you live in a culture that gives you a thousand reasons every day why you should be, let’s be honest: Recovery is not going to be as simple as “just eating” something.

We humans have a tendency to stick to what feels safe. It’s a survival instinct that usually serves us pretty well — until it doesn’t, that is.

We might know, logically, that our eating disorders aren’t working for us. But to challenge an ingrained coping mechanism, there’s a lot of unconscious conditioning that we have to fight in order to be able to eat again.

Our eating disorder was a coping mechanism that worked at one point. That’s why our brains cling to them, with the misguided (and often unconscious) belief that we need them to be okay.

So when we begin our recoveries, we are wrestling with a brain that has primed us to experience food as, quite literally, dangerous.

That’s why avoiding food is experienced as being safer. It’s physiological. And that’s what makes recovery such a challenge — you’re asking us to go against what our (maladapted) brains are telling us to do.

You’re asking us to do the psychological equivalent of putting our hands on an open flame. It’s going to take time to get to a place where we can actually do that.

There’s a reason why acceptance is the first step and not the last of any recovery journey.

Simply accepting that something is a problem doesn’t magically resolve all the trauma that led you to that point, nor does it address the damage that was done — both psychologically and physiologically — by an eating disorder.

I hope one day that food is as simple as “just eating,” but I also know that it’s going to take a lot of time, support, and work to get there. It’s difficult and brave work that I’m willing to do; I just hope other people can begin to see it that way.

So the next time you see someone struggling with food? Remember the solution isn’t so obvious. Instead of giving advice, try validating our (very real) feelings, offering an encouraging word, or simply asking, “How can I support you?”

Because chances are, what we need most in those moments isn’t just food — we need to know that someone cares, especially when we’re struggling to care for ourselves.

Sam Dylan Finch is a leading advocate in LGBTQ+ mental health, having gained international recognition for his blog, Let’s Queer Things Up!, which first went viral in 2014. As a journalist and media strategist, Sam has published extensively on topics like mental health, transgender identity, disability, politics and law, and much more. Bringing his combined expertise in public health and digital media, Sam currently works as social editor at Healthline.