Thread by @jamesldowns

I never counted calories until I was told that people with anorexia are fixated on calories

When I was last in #eatingdisorders treatment it was suggested to me to count calories even though I'd been a healthy weight & not calorie-counted for over 5 years

This is a problem 🧵->

At what stage to we stop and think about how treatment might actually introduce people to harmful behaviour/thoughts/beliefs by imposing pretty fixed understandings of what it is to have a particular condition? I think this happens in #eatingdisorders

When those in authority, with the power to define constructs, say "#anorexia is this" (for example) - to what extent do *some* patients then feel that this construct is something they have to fulfil, embody, talk the language of?
To what extent do patients get *given* identities?

If you have an insecure sense of self/identity, low self-esteem, poor self-image (all pretty normal teenage experiences, for example) then of course if a viable, clear, well-defined identity presents itself then it's natural to want to perhaps take that on -that's what I did.

I grew *into* the identity of having an *eatingdisorder* for many reasons, including that it was rewarded with attention. Attention for the behaviours, not for me as a person, but attention nonetheless. Something is better than nothing. I performed anorexia to a tee.

But I didn't know what anorexia was without reading about it, without being told about it, without being given literature on it. It wasn't something that "came out of me" from inherent characteristics. Nor was it something that came and "got me". It was offered to me.

Offered as a viable narrative, an accepted experience (just about, if conforming to set parameters and forgetting I was male, tho gay male meant it was explainable)
I was never offered other narratives. #Eatingdisorder behaviours were rewarded unlike anything else.

Reinforcing calorie-counting might seem a superficial problem, & will have varying utility for different people. But the relationship between the phenomena engaged with & the phenomena exhibited by people with #eatingdisorders is not coincidental. It needs to be examined.

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