Can you separate your triggers from your eating disorder?

In my last post I skimmed over this point, but I think it is incredibly important for both active and long-term recovery. The day that I really understood that my eating disorder was a mental disease with a genetic base was the same day that I began to understand that “triggers,” as we call them, are separate from the illness.

Triggers often spark the eating disorder in the first place—hence trigger. 
Triggers contribute to the eating disorder’s longevity if left unaddressed. 
Triggers worsen the eating disorder. 
Triggers spark relapse. 

Triggers are not causes.

I think this is very important, but it’s somewhat difficult to understand. First you need to know that the environmental trigger(s) that provoked your eating disorder to activate in your brain is/are not the “cause” of your eating disorder. Without the genetic predisposition for your eating disorder, those triggers would not have made you develop your eating disorder.

If going on a diet because you wanted to lose weight caused your eating disorder everyone who has ever gone on a diet would have one. If childhood trauma caused your ED then everyone who has been through trauma would have an ED. Those things might have provoked you into go into a calorie deficit, which can trigger eating disorders to emerge if the person is genetically predisposed to having one, but they are not standalone causes.

This is so important for sufferers, parents of sufferers, clinicians and in fact the general public to understand because when we separate the triggers from the eating disorder we can:

a) Attempt to lessen common triggers in the environment. i.e. we know that a trigger which causes a calorie deficit will spark an eating disorder in a person who is genetically predisposed to having one. We can potentially reduce the number of people who are predisposed to having eating disorders from developing them by reducing society’s obsession with thinness. This is like telling people to wear sunscreen. This is like telling people not to smoke. This is preventative.

b) Treat the trigger and the eating disorder separately. If a person’s trigger was going on a diet because he or she had negative body image problems, then these body image problems must be addressed so that the sufferer is not re-triggered. Simultaneously, the eating disorder needs to be treated with evidence-based protocol. This is like using sunscreen to prevent further damage, and also having chemotherapy to treat the current medical condition.

So your treatment has to be two-fold. First and foremost it has to get weight back on you and treat the actual eating disorder. Second, it needs to address whatever your trigger was to make sure that it doesn’t happen again.

The state of eating disorder treatment as is places all the emphasis on treating the triggers. The problem with this, is that the eating disorder is left untreated. This is like treating skin cancer with suncream alone. 

As I explain in Love Fat, my own trigger was actually non-body image related, incidental weight loss. So for me, after I had taken steps to treat the ED and was putting on weight, I didn’t really have to take steps to address my trigger, as it was a one-time incident that would be highly unlikely to repeat itself.

Be very careful to separate your trigger-treatment from your ED treatment. If your trigger was a negative body image which pushed you into wanting to lose weight because you thought you would look better then of course it is important that you have treatment to address that. But this as alongside the evidence-based ED treatment that you need to re-establish a healthy weight.

If your trigger was some sort of trauma then of course it is important that his is treated so that you are under less risk of relapse. But this is not the same treatment as that you need to go through in order to address the eating disorder.

That’s my opinion folks, and I welcome yours too! Let me know if you disagree or agree, because we learn when we discuss.