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be prepared that it might not be as easy as you think. Once you start gaining weight, you might
feel differently.” Her tone expressed exasperation and frustration. Her comment reflected one
final attempt to undermine the participant’s insistence that her eating disorder was constituted
merely by an inability to gain weight, rather than a thought process that discouraged her from
gaining the necessary pounds. Insisting she knew better, the facilitator undermined the
participant’s authority and role in the group. In effect, the comment suggested that she was not
truly eating disordered.
Facilitators further reinforce participants’ construction of eating disorders in their framing
of meetings. In introducing me to her group, Emily commented that she prefers not to spend the
meetings discussing behaviors or the food, but rather “the emotions behind the food.” In her
words, “All the professionals will tell you it’s not about the food; it’s about the feelings below
the food.” In laying the ground rules for group, another facilitator commented that, “there are a
lot of different body sizes in here, but it is important to recognize that there are a lot of
commonalties on the inside.” An eating disorder is evident, not in someone’s appearance, but
rather in her mindset and though processes. Eileen commented that she did not think the label
really mattered. That is helped some clients because they felt validated but for others it was not
important. The DSM-IV is not really a good measure because it only brings into play the bio-
medical factors. There is nothing about the obsessive thought processes. “What really matters
isn’t if you meet 5 out of the 6 diagnostic criteria, but if this is impairing your ability to live.”
Disease Extension, Part 2: Constructing a Disordered Recovery Process
In addition to constructing the eating disorder as a mental phenomenon, participants also
construct the recovery process as disordered. Participants establish sharp distinctions between
what is “disordered,” “healthy,” and “normal.” Continued efforts to monitor and classify
behavior into these three categories, requires extensive energy, time, and dedication on the part
of participants, similar to the eating disorder itself. Constructing a disordered recovery process
further extends the bounds of the eating disorder, so as to enable participants to continue to
identify as eating disordered even after ceasing eating disorder behaviors.
In their recovery, participants strive to be “healthy” or “normal.” However, this is easier
said that done. Behaviors that are “normal,” when performed by those who do not have eating
disorders, may be “disordered” when performed by group participants. One participant, Alice,
Convention