Print This Article

Identity, Passion, and Eating Disorders

By Ira M. Sacker, MD
Reprinted from Eating Disorders Today
Fall 2007 Volume 5, Number 4
©2007 Gürze Books

One of the most distressing things about an eating disorder is the way it cuts the person off from family, friends, and enjoyable activities. The person tends to isolate and hibernate, focusing only on their eating behavior to the exclusion of almost everything else. Their true identity and any other interests have all been merged into the eating disorder. As I get to know a new patient, however, I often discover that this person once had a strong identity with real interests—often passionate ones—beyond the disorder. Our job becomes to work together to rediscover those passions and use them to regain that authentic self.

The stories of Paula, Ben, and Alice all illustrate how a frustrated or abandoned passion, or the lack of any passion at all, can lead to a serious eating disorder. These stories all show how releasing, refocusing, or finally discovering that passion can be an important step toward recovery.

Paula’s Story
From childhood, Paula loved to sing. When she reached high school and her voice began to mature, Paula began to think about music as a career. Unfortunately, Paula’s parents had different ideas. They pushed her to concentrate more on schoolwork in preparation for a career in something more prestigious and certain, such as law or business. When Paula substituted studying for singing, the perfectionist streak in her personality started to get out of control— soon she was overstudying and cutting back on her social life.

Because Paula had been chubby as a child, her body image wasn’t great—she saw herself as overweight even though by her teens her weight was normal. Near the start of her senior year in high school, Paula came down with a nasty stomach virus. She was so sick for a couple of days that she couldn’t eat anything, and for several days after that she ate very little. At the end of a week, she was several pounds lighter. Her friends and parents told her how great she looked. For someone with a poor body image, a thwarted passion, and a perfectionist streak, that was all it took. Paula redirected all the passion and perfectionism that had once gone into her singing and focused it on not eating. She very quickly developed a classic case of anorexia nervosa.

Ben’s Story
One of my patients, a college wrestler named Ben, was an Olympic hopeful. The pressure to train hard and keep his weight down, combined with his strongly perfectionistic personality, led Ben into bulimia nervosa—a situation that is fairly common among high-level athletes, male and female. As his eating disorder got worse, Ben’s health deteriorated, to the point where he had to drop off the team for medical reasons. Without the focus of wrestling, his passion, Ben was adrift—and his bulimia became his passion.

Both Paula and Ben have what I call Category A eating disorder identities: Before they developed eating disorders, they had passionate interests in their lives. Their passions were thwarted or abandoned, sometimes because of outside pressure and sometimes because of their own perfectionist personalities. No matter what the reason, all the energy and talent they once put into their passion ended up being redirected into their eating disorder.

Alice’s Story
What if you never had any passionate interests in life? When I asked Alice, a 35-year-old with binge eating disorder, what she used to do for fun before her eating disorder, she just looked at me blankly. She honestly couldn’t remember. Alice had what I call a Category B eating disorder identity: She was blocked. She never developed any real interests, much less passions, in her life. When Alice was a young girl, at an age when her interests in life should have been developing, she was sexually abused. The severe trauma made her withdrawn and fearful. Instead of exploring her world, she turned inward and filled her emotional void with binge eating.

Discovery and Recovery
As I worked with Paula and Ben, they came to realize how their talents had been thwarted and how they had focused their perfectionism onto their eating disorder instead. In Paula’s case, it was clear that returning to singing would be a good thing for her. It would make use of her natural talent and passion in a positive way. It would take her away from the eating disorder identity and move her back toward the positive identity. We were able to convince her parents that she could sing in a chorus and still keep up her grades, and that she deserved to see how far her musical talent and passion could take her. Paula made a rapid recovery, soon followed by a fairly easy transition to a prestigious college.

Ben’s recovery wasn’t as quick or easy. His purging behavior had damaged his health and forced him off his team permanently— his career as a competitive wrestler was over. Wrestling had been at the heart of Ben’s life for years. Without it, his eating disorder identity was all he had left. I worked with Ben to channel his drive and physical abilities into a related area. He’s now taking courses to become a physical therapist. Ben still feels the desire to purge, is still preoccupied with his weight, and still sees me regularly, but I can see that his newfound career interest is helping him to move away from his eating disorder identity and toward his true self.

Alice is also slowly getting better. We’re working to find her passions by having her research areas that she thinks might be interesting. So far she hasn’t found something that she’s deeply passionate about, but just doing all that research opens up her world and takes her attention away from her eating disorder. That gives her some perspective and helps her see that she can be more than her illness.

For Paula, Ben, and Alice—and for many of my other patients—my treatment is very nontraditional. We don’t talk much about their eating disorders. I feel that focusing so much on the illness only reinforces the eating disorder identity. Instead, we talk about the things that interest them and find ways to get them back in touch with those passions or develop new ones. By rediscovering their passions, they rediscover and regain their true selves.

click here to order
Eating Disorders Today!

Discounts Available for AED and IAEDP Members
or
Call 1-800-756-7533 to order
We accept Visa, Mastercard, and American Express

Read More Articles From Eating Disorders Today

Additional Resources:
Far-Reaching Effects of Sexual Abuse
Fat is NOT JUST a Feminist Issue Anymore
Father Hunger
Fathers: A Potential Antidote to the "If Only I Were Skinny" Fantasy
Finding the Needle in the Haystack of Eating Disorders Care-Providers