How one approaches loss in its many forms is a major component in the goal of ending an eating disorder or eating problem. The emptiness one experiences is eventually filled through the courage to say goodbye to this negative coping mechanism.  My purpose is to call attention to the necessity of loss and grief in order to permanently change eating disorders and/or problems.

Although the relationship with food holds different meanings for people, it can become all encompassing for those suffering with anorexia nervosa, bulimia nervosa, binge eating, overeating or obesity. These are a few quotes from people I have worked with; perhaps you have heard similar remarks.

• "I don't eat that much." 
• "Why can't I be normal?" 
• "I am so ashamed of myself."
• "Will I be able to accept the insecurity I feel?" 
• "I accept my new found sanity; I want to hold onto it."

In order to grow out of an eating disorder or problem and grow into a life without it, one much give up dependencies, expectations, illusions and attachments to this negative connection.

Eating disorders or problems often represent an attachment representative of a parent or best friend.  Unfortunately this may segue into a dependency on them.  Some things that may have felt uncomfortable at times become comfortable.  One literally wears her/his eating disorder/problem.  The ultimate result of this is the loss of living a healthy life physically, psychologically, emotionally and spiritually.

For many people their relationship with food needs to change from the habitual dysfunctional one to a healthy functional one.  This is a process that needs to be addressed on a continuum in order to embrace a healthy relationship.  If this change is not adequately accepted, the return to the problem is likely to be imminent, thus leading to the original imprisonment, shame, anger and hopelessness.  Knowing this is the first step to resolving and dealing with this issue.  This reduces the likelihood of returning to the eating disorder or problem.  However, it necessitates living through bereavement, grief and change.  The grieving process is necessary to order to shift the energy from grieving to living.

Judith Voist (1998) states, "losing is the price we pay for living."  Loss is a fact of life that we experience from birth through death.  This begins at birth with the loss of the mother's protective womb and continues through childhood, adolescence, and the  multiple phases of adulthood, culminating in old age with the ultimate loss.  Those changing their relationship with food have unique losses to contend with.

A major theme of these losses is becoming comfortable with healthy changes in one's weight and appearance.  In addition, we need to understand if food and weight are connected to a sense of security.  Do unrealistic expectations of weight and body size exist?  These unrealistic beliefs need to be explored, worked through, and grieved.

As one journeys down this road to healthy eating, unexpected losses, such as death, divorce, work changes, etc. may also occur.  How do these losses impact one's relationship with food?  Learning how to grieve and cope with life's losses without returning to the dysfunctional eating relationship is paramount.

I use a template for stages of change emphasizing loss in the groups that I run.  Although these stages are a work in progress, at this point the template comprises seven stages:  the relationship with food, fear/anxiety, anger, shame, procrastination, alliance/integration and acceptance/adaptation.  Within the context of mindful eating, relevant questionnaires and exercises, journal writing and group support, working through these stages has proved to be a powerful stepping stone in the grief work necessary to say goodbye to an eating disorder or eating problem.

In each stage of this template for change, the grieving process continues and becomes clearer.  By laying out the template and referring to it during treatment, patients feel more in control.  It helps them to recognize and focus on the pitfalls and resistances that surface.  I also often encourage individual therapy for further exploration.  The awareness of each stage leads to the realization that life can exist without the eating disorder or eating problem.  This acceptance is necessary in order to recover from the loss of the old negative relationship with food.  This begins the healing process along with the belief in, and adaptation to, a new reality.

About Louise Parente, PhD:

Louise Parente, PhD is a certified eating disorder specialist and approved supervisor for iaedp with a private practice on Staten Island, NY.  She has been an adjunct lecturer for NYU School of Social Work, conducted workshops, and continues to speak on the subject of eating disorders, grief/loss and communication. Contact email: lparentephd@verizon.net