Bodily autonomy & the search for independence through eating disorders

Some eating disorders can be linked to a pursuit of bodily autonomy. Whether their bodily autonomy is/was threatened by trauma or parents, these people struggle to find both independence and love. Their method of managing their distress is bodily modification and control.

For example, many people who have an eating disorder also alter their body with tattoos, unusual clothing, hairstyles, piercings, etc. When this happens, we must consider whether there is a deeper need to assert bodily autonomy. Of course body modification is not always linked to a disorder. But when people appear to be compulsively acting against their own bodies, it’s worth considering bodily autonomy as a factor.

Bodily autonomy is the sense of ownership over one’s own body without other people’s influence or coercion.

A person’s bodily autonomy is often at risk if they have experienced sexual trauma, medical trauma, or any other situation in which they felt they were unable to control their own bodies.

Parents can also threaten a child’s bodily autonomy. While few parents intentionally threaten their child’s bodily autonomy, their behavior may create a threat nonetheless.

When we see a child who is using their body to assert independence, including with an eating disorder, it makes sense to look at bodily autonomy as a root cause.

How parents threaten a child’s bodily autonomy

Many parents inadvertently threaten their children’s autonomy. They usually have the best of intentions or are behaving unconsciously. However, the results can devastate the child if not addressed. Here are the most common situations that parents are involved in:

Life-saving threats

Sometimes threats to bodily autonomy are medically necessary. For example, some parents must approve medical surgeries and interventions for their children. Whether it’s a feeding tube for eating disorder recovery or surgery for a congenital defect, these medical interventions take away the child’s power to control their own bodies. They are literally life saving. And they still amount to a loss of bodily autonomy and thus can create trauma for the child.

Physical safety

Some parents threaten their child’s bodily autonomy for the sake of physical safety. For example, parents may not allow children to sleepover at friends’ houses or play with certain friends. Parents may use smartphones to monitor their child’s physical location. Still others will install monitors and cameras to protect the home that also impede a child’s sense of autonomy. And there are many parents who insist their children follow certain eating patterns. They require “healthy” foods, withholding favorite foods, and using food as a method of controlling a child’s behavior. In this way, our role as people who nourish a child can alter the child’s perception of food entirely and turn the dining table into a battleground.

Emotional safety

Parents may feel insecure about themselves, their own relationships, and their relationship with their child. This insecurity may affect a child. For example, a mother who is insecure about her ability to keep her child safe may ask the child for reassurance that the child is safe. This puts the child in the uncomfortable situation of reassuring (parenting) the parent. A parent who relies too much on a child for the parent’s own emotional safety impedes the child’s sense of self and independence. A child will provide the parent with whatever emotional security they can. But they will also feel resentful and insecure because of this unhealthy parent-child dynamic.

Eating disorders and bodily autonomy

It’s very common for a child to show their need for bodily autonomy through their eating disorders as well as clothing, hair, skin, or body modifications. For example, a child who feels smothered by their parent may refuse to eat with the family and will insist upon wearing clothing that shows they are different. These are physical manifestations of a deep desire for bodily autonomy and independence.

We define eating disorders as a symptom of psychological distress rather than a problem that exists in isolation. The eating disorder is often communication. It is a way that a person expresses psychological distress.

The eating disorder is a symptom masking a discomfort, a trauma, an emotional deprivation, an emotional disorder, an identity disorder, an emotional shock or an internal social conflict.[1] When a person perceives they don’t have bodily autonomy, a basic human right, they may respond with an eating disorder.

Eating disorder treatment denies bodily autonomy

It is thus strange that eating disorder treatment often denies people basic bodily autonomy. In the worst cases, people are physically restrained and a feeding tube force-feeds the body against the person’s wishes. Inpatient treatment centers dictate what a person wears, what it allows them to do, whom they can see and with whom they can communicate, and what, when, and where they must eat. Outpatient treatment often focuses on food choices, requires weigh-ins, and dictates a meal plan. These treatment methods all assert dominance over the person in treatment.

These methods may help some individuals recover. But the overall rates of eating disorder recovery are low. Treatment centers do not release long-term successful treatment data, but we know that most people who have an eating disorder either never recover or have an incomplete recovery. In one study, less than a third of participants with anorexia were recovered nine years after entering the study. [2]

One problem may be that eating disorder treatment often denies bodily autonomy. Eating disorder treatment is often focused on the person’s eating behavior and weight gain or loss. This focus on behavior and weight leaves the underlying issues unresolved while exacerbating loss of bodily autonomy. This sets the person in treatment up for a power struggle for bodily autonomy. Since bodily autonomy may be at the root of the problem, this is counterproductive.

One review of treatment methods stated that anorexia treatment is “unacceptable, inappropriate and laden with labelling ways, and thus exacerbate these patients’ struggles, leaving them dishonored, disabled, powerless and even more distressed.”[1]

What parents can do to help

Parents can help their kids recover from an eating disorder by understanding the role of bodily autonomy in emotional health. Our ability to feel independent, strong, and in control of our circumstances is important. While we cannot control everything, parents who empower their children to claim their bodily autonomy will see positive results.

First, ask these questions:

  1. Did my child experience sexual trauma, medical trauma, or any situation in which they were physically dominated?
  2. Have I been emotionally controlling or demanding as a parent in order to protect them from real or perceived dangers?
  3. Have I given my child ways to assert control over their own life and body?
  4. Is my child showing signs of a need for greater bodily autonomy (e.g. eating disorder, unusual hair and clothes, body modification such as tattoos and piercings, etc.)?

If any of the above is true, then it makes sense to consider the role bodily autonomy is playing in your child’s recovery.

Improving bodily autonomy

Here are some things that parents can do to increase their child’s sense of bodily autonomy:

  1. Work on your own fears and worries with capable adults who are not your children. Your child will sense your fear, even if it is well-founded. Work it out with people who can help you self-soothe and not bring your anxiety into your interactions with your child.
  2. Seek ways to increase your child’s bodily autonomy. What choices can you allow them to make for themselves? In what ways can they be responsible for their own life choices?
  3. Avoid dominating and demanding. Instead gain consent and seek agreement before imposing rules, systems, and structures on your child.
  4. Encourage your child to express themselves through their body without a sense of shame or rebellion. This takes practice, but parents need to accept and trust that their child is in charge of their own body.
  5. Consider how your child’s eating disorder treatment may contribute to a lack of bodily autonomy. Seek treatment providers who maximize personal responsibility and agency rather than those who seek to dominate your child.
  6. Look for ways to improve your empathy, unconditional positive regard, and attunement to your child’s emotional needs. Seek support and guidance from a counselor, therapist, or coach to learn these skills.

If your child is in immediate medical danger, you may need to take control of their physical health. But you can still gain consent to improve your child’s bodily autonomy through the process. If you have imposed medically necessary domination of their body, work through the trauma of the experience with your child with the help of a trained trauma therapist.


References

[1] A Search of the Origins of Anorexia Nervosa in Adolescence. A New Treatment Approach, Lacoste, Journal of Psychology & Clinical Psychiatry, 2016 [2] Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up, Kamryn T. Eddy et al, The Journal of Clinical Psychiatry, 2016

Ginny Jones is the editor of More-Love.org. She writes about parenting, body image, disordered eating, and eating disorders. Ginny is also a Parent Coach who helps parents handle their kids’ food and body issues.