By Hannah Walsh
I. Definition:
Eating Disorder: the habitual misuse of food, characterized by severe disturbances in eating behaviors and related thoughts and emotions. Anorexia Nervosa: an eating disorder characterized by extreme weight loss.
Biblical Perspective
A person ought to bring glory to God in all that they do, including eating and drinking (1 Corinthians 10:31). Eating disorders are a misuse of God’s gift of food, and are contrary to God’s design for human beings. God created food to be enjoyable and nourishing. Unfortunately, sin affects the proper use and enjoyment of food. A person may misuse food by overeating, undereating, or having the wrong attitude about food. This is a result of being controlled or enslaved by wrong desires (1 Corinthians 6:12-13). Indwelling heart idols such as control, pride, or vanity may lead an individual to develop an eating disorder. Actions are sinful when one does them primarily to satisfy one’s own desires instead of to please God.[1] 1 Corinthians 6:19-20 says that one ought to honor God with one’s body. A person’s body does not belong to themselves, but to God (Romans 14:7–8). It is clear that someone with an eating disorder is not glorifying the Lord in the way that they are treating their body and the provisions that He has provided, nor with the desires that initially brought on the eating disorder.
Secular Perspective:
The National Eating Disorders Association states that there is a growing consensus that eating disorders are caused by a range of biological, psychological, and sociocultural factors.[2] More than merely a lifestyle choice, eating disorders are considered serious and often fatal illnesses.[3] Someone with an eating disorder is often described as having an abnormal eating pattern, stemming from mental or emotional issues. Signs of eating disorders may include an unhealthy obsession with food, body weight, and shape. The three general types of eating disorders are known as anorexia, bulimia, and binge-eating. [4] It is commonly accepted that eating disorders most often stem from incorrect thinking, and in particular an incorrect view of self.
Generally, people suffering from anorexia nervosa obsessively restrict calories and foods. Dorland’s Medical Dictionary for Health Consumers states that, most commonly occurring in young females, anorexia is characterized by a refusal to maintain normal body weight, a fear of gaining weight or becoming obese, a disturbance of body image, an unwarranted reliance on body weight or shape for self-evaluation, and amenorrhea.[5]
Secular treatments for eating disorders include nutritional rehabilitation, individual psychotherapy, reinforcement and cognition, inpatient and residential, group therapy, and family interventions, and medication.[6]
II. History
In the 19th century, a French psychiatrist named Charles Lasegue studied anorexia from a social and psychological standpoint.[7] In time physicians agreed that eating disorders were medical conditions and physical diseases, and later it was come to be accepted that they were not merely physical, but emotional and mental matters. In 1980, The Diagnostic and Statistical Manual of Mental Disorders (DSM-III) added an eating disorders section for the first time.[8] Since that time, eating disorders have come to be considered serious issues stemming from mental illnesses.[9]
III. Etiology
Eating disorders are both spiritual and physical matters. It is important to understand both the spiritual and physical aspects.
Physical evidences of eating disorders depends upon the particular disorder. A person with anorexia nervosa will exhibit certain distinguishable behaviors The DSM-IV outlines four major criteria for diagnosis of anorexia nervosa, which include a refusal to maintain body weight at or above a minimally normal weight for their age and height , an experience of intense fear of gaining weight or becoming obese even though they are underweight, a misunderstanding of the seriousness of their weight loss provide and a demonstration of disturbances in the way their body weight and shape is experienced.[10] Obvious symptoms may include abnormal blood count, fatigue, dizziness/fainting, anxiety and depression, insomnia, thinning hair, discoloration of skin, osteoporosis, or low blood pressure. A person with an eating disorders may isolate themselves from others or exhibit compulsive behavior.[11]
The spiritual side of the matter is of even more importance, as it is of eternal importance. Even secular psychologies state that eating disorders are not merely physical. The disorders stem from internal desires, and result in further spiritual issues. A person may, for example, desire to be in control of every aspect of their life, or desire to be beautiful or perfect. These desires, when desired above God, lead to sinful behavior. The eating disorder may lead to further sinful responses or attitudes, such as anger, depression, or anxiety.
IV. Examining the Heart
It is important that a believer thinks about the issues of eating disorders through the lens of Scripture. There are two emergency situations involved in eating disorders – the first is the physical life-threatening emergency, and the second is the spiritual eternal-soul threatening emergency.[12] Both must be dealt with in the proper way. The goal in counseling an individual who is dealing from an eating disorder is not merely to help restore them to a place where they are physically healthy and out of danger, but ultimately that the individual would experience true biblical change that can only come from the truth of God’s Word and the work of the Spirit impacting their heart and mind. Ultimately, as in all matters, the goal is that Jesus Christ would be glorified.
A counselee should be led towards a better understanding of who God is and why He made man. This will lead into a better understanding of how one ought to live in response, and how that affects even the way that one eats.
Once determined, the heart issues need to be addresses. Common heart themes in regards to eating disorders are control and vanity.
Control: A person who idolizes control is not trusting in God’s sovereignty. There desire is, essentially, to try to be God instead of trusting and living in submission to God. This idol can lead to eating disorders, such as anorexia, because the person desires to control every calorie they intake or every pound they weigh to the point where is becomes unhealthy and obsessive. They may pride themselves in having control over their feelings of hunger. The desire to be in control can lead to obsessive behavior in regards to food.
Vanity: Vanity is another common root of eating disorders. Many secular counselors will tell their counselees that they need to think more highly of themselves, that there self-esteem is too low. This is not the case. On the contrary, a person is thinking too highly of themselves when they so strongly desire to look a certain way that they are willing to hurt themselves to get there.
V. Biblical Solutions
When it comes to eating disorders, many biblical counselors use what is sometimes called the Three-Pronged Approach to care for their counselee in the best possible way.[13] This refers to the team approach that should be taken, as eating disorders are both a physical emergency as well as a heart issue. The three-prongs are: Medical doctor, Nutritionist, and Biblical Counselor. A biblical counselor needs to care for the counselee’s soul and mind, while encouraging her to be heeding the instructions of her doctor and nutritionist. Eating disorders are unique counseling issues as the spiritual and the physical aspects of eating disorders correlate. As in any counseling issue, the goal is that a counselee would move towards Christlikeness. The purpose is promoting genuine, lasting change in the life of a counselee, for the glory of God. Ephesians 4 demonstrates that sin needs to be put off, and righteousness needs to be put on. In some cases, the sin of control or vanity needs to be put off, and trust in God and humility need to be put on. Sinful behaviors and actions, such as the misuse of food, need to be put off, and godly behaviors need to replace them. This can only be done through a work of the Holy Spirit in one’s heart. A counselee needs to be led to heart-altering truth of God’s Word in order to experience change.
Recommended Sources:
“How to Help People Change” by Jay Adams
“Love to Eat, Hate to Eat” by Elyse Fitzpatrick
“Redeemed From the Pit: Biblical Repentance And Restoration From The Bondage of Eating Disorders” by Marie Notcheva
“Counseling as if Life Depended on It” by Martha Peace (audio)
“Eating Disorders: Hope for Hungering Souls” by Mark Shaw
“Eating Disorders: The Quest for Thinness” by Ed Welch
Recommended Homework Sources:
“A Homework Manual for Biblical Living” by Wayne Mack
“More Than Bread: A Workbook for Women Who Struggle with Eating” by Elyse Fitzpatrick
Discovering Wonderful Things Worksheets
- 1 Corinthians 10:13
- 1 Corinthians 6:19-20
- Matthew 6:33
Self-Talk Log Worksheet
Daily Prayer Journal
Works Cited
[1] Fitzpatrick, Elyse. More than Bread. 19.
[2] https://www.nationaleatingdisorders.org/what-are-eating-disorders
[3] https://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml
[4]National Institute for Mental Health, Eating Disorders: About More Than Food.
[5] Dorland, W. A. Newman. Dorland’s Medical Dictionary for Health Consumers. 91.
[6] Mental Health: American Addiction Centers, Inc: “Eating Disorder Professional Treatment
[7] https://www.mentalhelp.net/articles/historical-understandings/
[8] “DSM-IV-TR Classification.” Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
[9] https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591
[10]https://www.psycom.net/anorexia-and-depression/
[11]https://iocdf.org/expert-opinions/expert-opinion-eating-disorders-and-ocd/
[12]Peace, Martha. “Counseling as If a Life Depended on It (Anorexia).”IBCD Institute for Biblical
Counseling and Discipleship, 13 July 2017, ibcd.org/counseling-as-if-a-life-depended-on-
it-anorexia/.
[13]https://www.biblicalcounselingcoalition.org/2015/03/03/a-three-pronged-team-approach-when-caring-for-people-with-eating-disorders/
The Encyclopedia of Biblical Counseling 