Eating Disorders 101: Removing The Shame & Stigma To

Move Toward Recovery

Jennifer Lombardi, MFT, CEDS, FBT Certified Certified Daring Way™ Facilitator-Candidate

Eating Recovery Center, National Recovery Advocate

Underlying Etiology of Disordered Eating

• Biology

• Temperament

• Culture

• Relationship Dynamics

• Trauma and/or Loss

Biology

• Dopamine – Low levels

• Harm avoidance • Insensitivity to normal rewards • New research

• Serotonin – Low levels

• Emotional highs & lows • bulimia/binge eating

– High levels – • Heightened anxiety • Anorexia

Temperament

0

10

20

30

40

50

60

70

80

90

100

Novelty Seeking Harm Avoidance RewardDependence

Persistance Self-Directedness Cooperativeness Self-Trancendence

AN-R, N=374

AN-B/P, N=295

EDNOS, N=115

BN, N=208

All Dx, N=992

Culture

• Surrounded by toxic messages – Viewed as failures if we struggle with weight

• Social media • The chronic critic

• Studies Show: – 42% of 1st-3rd grade girls want to be thinner*

– 81% of 10 year olds are afraid of being fat*

– The #1 wish for girls 11-17 years old is to lose weight

• And yet…. – Most overweight/disordered we’ve ever been in our

culture

Relationship Dynamics

• No longer blame families

• Complex “web” between relationships, modeling and temperament

Trauma &/Or Loss

• 30% of patients with eating disorders have experience with trauma and/or loss and exhibit PTSD symptoms

• Heightened sensitivity to traumatic experiences – Food is a way to numb

Treatment

1. Education about underlying etiology

2. Exploring role of food in “numbing”

– Shame

Shame The intensely painful feeling or experience of believing

that we are flawed and therefore unworthy of love and belonging*

• Typical reactions:

– I don’t know what you’re talking about.

– I know exactly what that is, and I don’t want to talk about it.

All quotes credited to Brenè Brown, Ph.D., LMSW, author & research professor at the University of Houston Graduate College of Social Work

More On Shame

• Where Does It Come From?

– Life experiences

• What’s It’s Role in My Struggle?

– It’s Fueled By Stories and Self-Talk

• I’m Not _____ Enough.

• If people really got to know me, they’d figure out _____ about me – and reject/judge/leave me.

Armor

• But when we believe we cannot be vulnerable, and we carry shame, the only way to survive is to armor up.

Vulnerability is the birthplace of love, joy, faith, trust, creativity and innovation. It also allows us the

opportunity to experience empathy.*

Types of Armor

• Perfectionism • Not the same as striving for excellence.

Perfectionism is all about “what will people think?”

• Foreboding Joy • When we lose our tolerance for

vulnerability, joy becomes foreboding.

• Numbing* • Vulnerability and shame are full-contact

emotions. When we cannot tolerate or address them, we numb.

What Role Does My Struggle Play in Armoring Up?

• We are the most medicated, addicted, in-debt society in human history.

• We numb in many ways, including with substances, food and exercise.

Questions?

Jennifer Lombardi, MFT, CEDS, FBT Certified Certified Daring Way™ Facilitator-Candidate

Eating Recovery Center, National Recovery Advocate

info@EatingRecovery.com | EatingRecovery.com