Prevention or protection?

When it comes to the idea of “eating disorder prevention,” differing (and seemingly passionate) views arise. Some I have heard or read about include opinions such as: Why spend precious and limited funds on something that we don’t know works? Is it even possible to prevent eating disorders (Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder) when they are considered biologically-driven illnesses? Etc. Etc. Etc.
 

So I’d like to offer a reframe on the idea. I’m remembering that Mazzeo and Bulik (2009) refer to potentially protective environments when discussing risk factors and genetic influences possibly involved in eating disorders. I like that word. Protective. For some of us, maybe a shift from prevention to protection might serve our clients, friends, and family who might be vulnerable.
 

Let’s step away from focusing on what is considered scientifically proven at the moment. (With so little funding devoted to eating disorders, I believe it is also important to collect observational data, which may form hypotheses someday anyway.)
 

If we look at the subjective reports from sufferers and the clinical data about what seems to align with the eating disorder values and thoughts, isn’t it logical that we could seek to potentially protect?

Here is what I mean. First, body talk and an appearance-focus lines up with the way the eating disorder part of the person thinks. Plus sufferers commonly link professional/vocational (e.g., certain sports), and home environments that strongly value weight or shape standards with supporting eating disorder beliefs. Additionally, spoken and unspoken messages communicating you’re “not good enough until you look good enough or perform well enough” also tend to collude with the eating disorder’s values. If just these three aspects changed towards more potentially protective atmospheres and/or attitudes, can you imagine how different we might ALL feel about ourselves (even those without eating disorder biological vulnerabilities)?
 

I think if we really listen to our sufferers and get familiar with the existing data, we have great hints at what might help buffer the onsets or intensities of eating disorders.
 

For example, imagine if in society we could stop (or do less) commenting on weight, looks, diet, etc. (No more, “You look…” or “So-and-so gained weight”). Imagine if we could shift to commenting on internal qualities and worth instead—what we do and don’t appreciate about others and self (e.g., “What a kind thing you did!” or “I appreciate how dedicated you are”). Imagine if we could change or at least add an equal focus on other values to body-focused environments (e.g., a dancer’s strengths and talents vs. thinness or body qualities). Imagine if we could learn feeling-languages of expression and non-food/diet focused coping skills (using words and not food to sooth, reward, etc.). Imagine if we could challenge the messages we individually and as a whole send and receive about what is good enough/not good enough.
 

If we could do what we can to potentially protect those vulnerable to eating disorders, who knows? We may even find ourselves lifting our own spirits out of the oppressiveness of our societies’ seemingly “here’s what’s wrong with you—buy my product or this weight loss supplement to fix it”-focus.
 

I’m not saying eating disorders could ever go completely away all together because for example, anorexia has been documented as having been in existence for hundreds of years. During that spread of time, societal messages have obviously varied.  

Though eating disorders are seen as mostly biologically-driven that get triggered, it does not excuse any of us from doing our parts to positively contribute to environments that help protect from influences that can strengthen the eating disorder part of a sufferer.
 

In the end, even if a person who is vulnerable to eating disorders gets the disorder, with an environment of these mindful shifts having been made, maybe—just maybe—someone’s disorder won’t be as severe or long as it would have been. Or… Dare I say it? Maybe—just maybe—if we learned about and got really good (or at least better) at potentially protective factors (not limited to the three mentioned in this blog), maybe someday eating disorders could get more prevented from getting activated?
 

Only time would tell, but it would be one heck of an experiment, huh?
 

As a field, we seem to be working towards discovering and implementing both protection and prevention factors. As a society, awareness is the start of potential change.
 

 

Resources:
 

Levine, M. P. (2015, March 2). Does Prevention Work (and is this even a fair question)? Retrieved from http://www.edcatalogue.com/does-prevention-work/
 
 

Levine, M. P. (2015, March 31). Exciting Recent Developments in the Field of Prevention. Retrieved from http://www.edcatalogue.com/exciting-recent-developments-in-the-field-of-prevention/
 
 

Mazzeo, S., & Bulik, C. M. (2009). Environmental and genetic risk factors for eating disorders: What the clinician needs to know. Child and Adolescent Psychiatric Clinics of North America, 18(1), 67-82. doi: 10.1016/j.chc.2008.07.003.
 

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