The theories on eating disorders have evolved over time but we still are struggling with many of the same frustrations regarding why recovery rates remain low and recurrence rates remain high.

Why can’t we effectively treat people with disordered eating and distorted body images?

I believe it is because we are not looking in enough places for answers. We are on some of the right paths — predisposing factors and perhaps genetics (the nature aspects), but how a child is raised and regarded, the messages she receives from caregivers during childhood, the experiences she has in and outside of her family (the nurture aspects) play a role as well.

A breakdown in family connection and attachment can contribute to the development of anorexia, bulimia, and binge or compulsive eating. Of course, the complete causes of any eating disorder are complex and no single explanation is likely to be uncovered.

What we do know, for sure, is that eating disorders are not created by the desire to be thin, even though that is what the person with the disorder starts out believing. We also know that genetic predispositions toward anxiety and depression, and even personality may play a role.

But I believe that focusing on these aspects of how eating disorders evolve limits our ability to examine the relational underpinnings that may cause eating disorders to manifest themselves.

In short, we have been seduced by the push toward an overly simplistic view of how these difficulties evolve.

I have come to the view that, first and foremost, eating disorders occur because of disorders of relationship, with others and with oneself. By healing these critical relationships, we see long-term healing for the person with the disorder and their family.

I believe that, aside from our physical health, the strength of our relationships sustains us throughout our lives. When our ability to relate to others and ourselves is damaged, it casts a huge shadow that may eventually turn into an eating disorder or an assortment of other psychological problems.

If this is true — if a disruption in family relationships can set the stage or contribute to an eating disorder — then part of the foundation for recovery must revolve around bringing those relationships into greater harmony. If a lack of attachment has contributed to the eating disorder, then rebuilding the attachment is one of the essential steps on the road to recovery.

My goal in writing this book is to teach you how to do that in your own home. This book is a hands-on, working guide to eating disorder recovery that will help you understand some of the psychological and relational underpinnings of eating disorders and the impact they have on both the person with a disorder and the family. This book will teach you ways to work together to heal, repair, and rebuild positive relationships….

Whether you are in therapy now or using this book as a preliminary self-help treatment, keep in mind that the cornerstone of healing is the ability of the entire family to experience empathy and extend that sense of empathy to one another. True and lasting recovery has the opportunity to occur when forgiveness, respect, and the true nourishment of emotional intimacy replace denial, resistance, anger, and blame.

When Food is Family will show you that families can — and must — do more than understand and support a loved one with an eating disorder. It is only through the family working together that all family members can recover and heal. I welcome you on our journey together.

Judy Scheel, Ph.D., LCSW, has been treating eating disorders for more than 25 years. In her years of providing treatment she has found that mutual respect, empathy, and trust provide the foundation for familial and relational repair and recovery from an eating disorder. Helping patients live authentically is the cornerstone of her approach.

Dr. Scheel is the Founder and Executive Director of Cedar Associates, a private outpatient program specializing in treatment of eating disorders and other self-harm behaviors. She is a member of the National Eating Disorders Association (NEDA), Academy for Eating Disorders (AED), and the Eating Disorders Coalition, Inc.

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