-- about eating disorders treatment

William C. Shearer, Ph.D., M.B.A., M.P.H.

When it comes to eating disorder treatment philosophy, I have become known for strong opinions. Then again, we all know the value of weak opinions -- so I will not water down or hold back on what I believe. I cannot do that.

So, what do I believe? First, I believe many people can recover. I also believe that destroying hope by telling people they have a disease for life is unconscionable. I believe there are far too many people treating eating disorders who mindlessly parrot what others have said without regard to scientific evidence.

I believe many weight loss programs victimize people and perpetuate the problem. I strongly oppose any program that creates an external dependency, or that emphasizes special foods or a special diet. Programs that promise quick and easy weight loss without regard to long-term consequences are run by conscienceless predators who greedily take advantage of prevailing societal prejudices and fears.

Diets do not work. Far too many people are telling other people how to eat with little regard to current thinking and research from exercise physiology, clinical nutrition, and scientifically respectful weight-loss research. Americans are spending billions on schemes that only make their problems worse.

Women, in particular, are victimized by the diet, cosmetic, and fashion industries. And let's not forget the destructive role of the media in glamorizing artificially thin shapes, including the shapes of anorexic celebrities.

This is a time of unbridled quackery, greed, and misinformation when it comes to food and weight issues. People need to speak up. Viewpoints need airing. Controversy is to be encouraged. Dialogue is essential for clarification of issues and a new direction based upon sound information.

Strong opinions usually have dramatic origins. Much of what I believe is based on my own pilgrimage. Struggles with food and weight were a central focus for me along with many concerns shared by other adult children of alcoholics.

Like many growing up in a contentious and unstable alcoholic home, I learned the value of keeping cool, keeping my anger under tight control. I took pride in the belief that nothing could get to me. And I was never, ever going to drink. I knew the odds. No one warned me of other dangers, other ways of avoiding anger and other unpleasant emotions.

Imagine my surprise and consternation when a skinny kid became an obese adult. I told myself that my metabolism must have changed. Of all the luck! I was only vaguely aware that I had traded open expression of anger for random grazing -- a constant involvement with food as a distraction from other issues.

Being fat was a drag -- and everything I did seemed to backfire. I would diet and miss meals, valuing my hunger pains and feeling strong and determined. Later, ravenous eating of huge amounts of food would leave me with a deep sense of shame and failure, stressed to the point of wanting to eat again.

Then I discovered running. A runner in high school, I knew that running was a sure-fire way to lose weight. I was soon compulsively running 8-10 miles a day, rain or shine, sickness or health. A wonderful discovery! I could run and not worry about eating. My life became an endless round of running, eating, guilt, fasting, bingeing, guilt, and more running. Missing my run was unthinkable and experienced as total failure with the terrifying conviction that I would soon weigh 400 pounds.

Weight went up and down. Running worked (or so I thought), but eating got worse. Self-esteem suffered. Food and weight issues took center stage and crowded everything else out.

Fortunately, I was involved in graduate school and psychology classes. I became involved in a lot of introspective thinking and discussing. I discovered assertiveness. I grew in confidence. I began to reexamine beliefs about myself and relationships. I learned how to take care of myself in real and effective ways. I renounced guilt and thoughts of failure. I became empowered. I wholeheartedly embraced the notion that my number one mission on this planet was simply to take good care of me -- both in thought and in action.

I began to think in terms of life-style changes and self-nurturance. I began to congratulate myself on each little step toward better self-care because I now was worth it inside my own head. Weight loss was simply a by-product of believing in me and being good to me -- without fear or guilt. My harsh internal critical parent was destroyed. I became calm and mindful about food and weight. I made friends with food. I stopped stressing. I lost weight.

For over 30 years, I have kept my weight off. I do not work at it. Exercise is moderate, enjoyable, and non-compulsive. It has been years since I felt any guilt or anxiety over food. I enjoy food. I think about food when I am hungry. I eat sensibly because I value me. I eat imperfectly, but that is okay. The emotion-food connection has been broken. I can express anger and not eat over it. I have learned to care for myself in a wide variety of ways.

Several years after losing my weight, I found myself running a very successful weight management program. So successful, that I was besieged by thin, stressed out, young women desperate for help in controlling their food and weight. This intrigued me and prompted my interest in treating anorexia nervosa and bulimia, an interest that has continued for the past 25 years.

Today I spend half of my professional life working with eating disorders. We de-emphasize food and weight and work intensively on issues of self-esteem and identity. We help people move away from preoccupation with food and all those who load them down with advice on how to eat. Mythology and guilt are exchanged for sound information and self-appreciation. Despair is exchanged for hope. Our clients have excellent recovery.

My own experience and the experience of many hundreds of clients have strengthened my conviction that dieting, food rules, fasting, and excessive focus on food and weight are inherently self-defeating. A full commitment to a nurturing involvement with one’s inner self is more to the point.

Nothing ever becomes real till it is experienced. Even a proverb is no proverb to you till your Life has illustrated it.

-John Keats

© 2005 William Carey Shearer Ph.D., M.B.A., M.P.H

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