Thursday, August 20, 2020

"Experts" Don't Always Have The Answers

Recently, I listened to a podcast about eating disorders that was a few years old and realized how common it must be for audiences to consider the content of podcasts as well-researched fact, simply because ideas are presented with authority and conviction. The same happens with documentaries, as I have already pointed out here and here. I'm not going to link to the podcast I listened to because I think some of my readers might find it triggering. There's a lot of talk about weight, body composition, and running times, and some misinformation about eating disorders, recovery, and how to help those struggling is presented as well. It's the perfect example of probably well-meaning individuals covering a topic they're familiar with more on the surface than in depth. Unfortunately, those who get labeled as "experts" don't always have the answers. That said, some helpful advice was offered, especially toward the end of the podcast, even though it contradicted what was said earlier. 

I got the sense that the one of three individuals who did the least amount of talking in that particular episode was more qualified and knew more about eating disorders than those who monopolized the mics. At least she brought up some important points, like how men also struggle with eating disorders, how eating disorders are complex, and how there's often shame around coming forward. Is it any wonder there's so much shame associated with eating disorders when the myth still exists that they're a choice? 

One thing I want to point out before I jump into the main topic is that criticism of the content is not the same thing as tearing down the creator of that content. People often assume that disagreements are charged in feelings of animosity, but that's not necessarily the case. My main concern is that misinformation and certain topics presented the wrong way can potentially cause harm, so I will often address what I stumble upon, even if it's a few years late. Quite often, people present ideas that support a certain narrative as fact, even though they are simply opinions.  

I'll add that it's completely false that someone who's self-critical is incapable of supporting, appreciating, and finding beauty in someone else. To be frank, fuck that. People who are not fully healed are absolutely capable of love. Everyone, except maybe psychopaths, at some time will experience self-doubt and will be self-critical. If you're human, you are not and never will be perfect. That doesn't mean you can't contribute, love, share, and deeply appreciate others. There might be some truth in the idea that there's a potential to project dissatisfaction with the self onto others, but it doesn't mean a person can't move beyond that while in the process of healing. To say otherwise is to discount the very real experiences of others. 

When it comes to numbers, by or even before 2011, it had become widely known that discussing weight and size can be triggering to those in the eating disorder recovery community, and specific measurements are often seen as an invitation to criticize and compare. Because of this, I started putting trigger warnings (TW) on my blog posts and content that contained potential triggers. We don't always know what will upset someone, but it's generally a good idea to warn audiences if weight is mentioned when discussing eating disorders. It's a simple fix, really, and can be done on any platform when editing out the content entirely doesn't make sense. It's also a helpful label when conflicting advise or information is presented. For example, when podcasters spend time talking about how unhelpful and unhealthy it is to comment on looks and body but then announce specific racing weights and sizes, and then say after the fact that it's potentially triggering, it's too late. Anyone who might be affected has already heard it. Sometimes light scolding in one moment doesn't prevent an individual from continuing to post triggering content down the road. Either she doesn't get it or doesn't care, so the audience ends up having to be prepared at every turn. Pretty much any time you see an article, podcast, or blog post about eating disorders, it's just sound advice to assume that there might be triggering content, even if there are no warnings. 

I've said it before that posting images with captions that focus on weight or perceived "flaws" like cellulite, is extremely unhelpful because it's just another invitation for you and others to compare and contrast or even criticize. The focus is still on the body. Can we please, at some point, just move away from this altogether? I really don't know what it will take, but a lateral shift isn't moving forward. 

One trap many bloggers, podcasters, and people in general fall into is assuming personal observation is fact or close enough. On the surface, it might seem like the majority of runners who struggle with an eating disorder have anorexia, but that's not actually the case. Remember, eating disorders come in all shapes and sizes. Does it really make sense that there would be more runners diagnosed with anorexia when nearly every study and survey show a higher incidence of other disorders in athletes and in general? Think about the percentage of individuals who struggle with binge eating, bulimia, ARFID, atypical anorexia, orthorexia, OSFED, or are in a state of RED-S. The breakdown of percentages of athletes with eating disorders is along the lines of 11% anorexic, 36% bulimic, and close to 70% EDNOS. Suggesting runners who struggle are mostly anorexic is misleading, and when myths like that are spread, you discount huge groups of individuals. By tossing out incorrect information, you're actually reinforcing stereotypes and potentially making it more difficult for those in the throes of an eating disorder to feel comfortable coming forward. 

One of the worst myths relating to eating disorders is that they are a choice. A person can say they're not but still reinforce the falsehood by suggesting a person "gets" a disorder in order to run faster or look prettier. When you focus on one symptom or imply a contributing factor is the cause, you're not giving people an accurate portrayal of what it's like to struggle with an eating disorder, and you fully discount individualistic experience. To suggest eating disorders are about looks and/or performance is missing the point entirely, and anyone who believes this should not be in a position of authority when it comes to speaking publicly about these kinds of illnesses. As stated above, eating disorders are complex and almost never come down to one simple cause. There are many contributing factors that can include peer and other types of external and internal pressures, media influence and set beauty standards, genetics, environment, brain chemistry, nutrition, nurture, self-esteem, coping skills, etc. In general, there's far more internal conflict than most people realize when it comes to the development of an eating disorder. 

I can not stress this enough that developing an eating disorder is not about a lack of willpower. I've addressed this previously, but avoiding an eating disorder has little to do with mental toughness. When you have a better understanding of the causes and contributing factors of an eating disorder, methods of recovery also become more clear, and those usually entail addressing the underlying issues like depression, anxiety, unhealthy coping strategies, and poor self-esteem, to name just a few.

I've also explained that an eating disorder is NOT a separate entity here. It is not something to fight against. It's not about self-control. It is quite often a coping mechanism. The illness can occur long before someone starts running, and, as a friend pointed out, running can be part of recovery. I suppose "Ed" can be used to compartmentalize certain thoughts, but it's important not to treat an illness as anything separate from the self. Doing so won't lead to a deeper understanding of the core issues. 

If you are addressing eating disorders and say, "eating disorders, disordered eating, whatever," you clearly don't see that there is a distinction. It's like saying, alcoholism, problem drinker, whatever." Labeling an illness or disorder correctly is important because the proper diagnosis helps with finding the appropriate treatment. Someone who's engaging in disordered eating might do well with counseling or journaling, whereas someone with an actual eating disorder might need more intensive treatment. I'm not suggesting disordered eating patterns aren't as dangerous; they can be, and they can evolve into a full-blown eating disorder depending on the individual and the root issues.  What I'm saying is that they are two very different problems and shouldn't be nonchalantly lumped together as one.  

Speaking of recovery, perhaps the most damaging bit in the podcast was the suggestion that those who want to help someone they suspect of having an eating disorder confront the individual by saying, "I noticed you..." To my horror, the blank at the end of that sentence was filled with suggestions such as "have marks on your hands from throwing up," or "go to the bathroom for long periods of time after meals," or "don't eat very much." I will absolutely put my foot down here and say that this is NEVER a good way to address someone you suspect might have an eating disorder, ever, unless you really want to push her over the edge, humiliate her, and cause undue stress in her life. My God. 

I'm all for removing the shame around eating disorders, but you never know where someone else is in that process. Denial is often a form of self-protection. If you hastily burst someone's coping bubble and humiliate her in the process, you will potentially cause tremendous stress and possibly make the situation worse. What if that person is suicidal, and she wasn't ready to be confronted? How do you think that scenario would go? Besides, you don't even know for sure if the behaviors are related to an eating disorder, and it's not your business to force someone to share what she's going through if she isn't ready. This is just a bad idea on all levels. 

What I would suggest, instead, if you believe someone is suffering from an eating disorder is ask if she is OK and then offer in general terms to be there for her. Let her know that you are there if she ever wants to talk about anything. Above all, listen. Don't take a finger-wagging stance and accusatory tone, and then expose her behaviors. That is not supportive and could be dangerous. If the situation is so severe that she needs medical attention, then the best approach is to get professionals involved. This is a must. 

As I already addressed here, spreading fears around going through puberty or menopause is not helpful. The best way for athletes to address either situation is to learn how to adapt and try a different way of training. Telling people they will gain weight or they will slow down is not productive. Jeez. Why do people do this? You don't know what someone else will experience through transitions in her life, so don't speculate, period. 

Regarding recovery, one of the biggest reasons long-term sufferers don't seek help after years of struggling is because they are told it's unlikely they will get well. To that I say bullshit. As long as you are breathing, you have the potential to recover. I find it horrifying that "experts" tell an audience that the longer you have an illness, the less likely it is that you will recover. See, the reason why people do this is to try to encourage those suffering to get treatment early, which seems like a great strategy on the surface. You know what they say about good intentions, though. What they fail to realize is that they are giving the finger to those who have struggled for years. If you spend any time at all in recovery forums, you will see how hopeless the many people who have been struggling for years feel. Don't make it worse for them. There is no rule about who gets to recover. It's all about finding the right kind or kinds of treatment at the right time. 

Rant over, for now. 

1 comment:

  1. Most of the podcasts I have listened to in this genre are hampered by one or more participants -- usually those self-styled "experts" whose running credentials far exceed their knowledge in areas they like to opine about publicly -- being in some stage of denial about their own relationship to food and weight.

    You will virtually never get blunt honesty from anyone involved when the conversation get steered toward shoulds and imperatives by people who care chiefly about leveraging their perceived influence and don't fundamentally care about positive changes in athletics unless they get to be credited with being among the architects of that change. They're as bad as the blowhards Fox News and MSNBC bring in to keep the hottest source of controversy in the minds of the audience going. And like you note, the podcast hosts don't always know what they're in for.

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