“The public has the impression that when you can eat, you don’t have anorexia nervosa,” says psychologist Minibergerová.

Is the media image of anorexia and bulimia different from the reality that therapy professionals face? Why is bulimia more stigmatized than anorexia? And how can this harm patients if the causes of these diseases are only related to diet? Psychologist Lenka Minibergerová, who works with clients with eating disorders, explains how stereotypes hurt.

Do you notice more references to eating disorders in movies, series or magazines?

I pay more attention to all psychological topics, including eating disorders. I remember a documentary and then magazines where actresses talk about their diagnoses. These are the conversations one normally encounters on the boulevard.

How does the boulevard talk about the troubles?

I usually don’t like it at all. It’s terribly simplified. Although I think the author of the article tried to act preventively, from my point of view he never succeeded. The disease is simplified, as if it were not a problem to deal with it. Just a little craving and then it passes. Which, of course, is not the case. I have not read the article I would say, but it is well done.

It wouldn’t hurt for the public to see an interview with parents whose twelve-year-old child had been going through these troubles for several years. Then people would understand how difficult it is.

What else but a great oversimplification is wrong?

Imagery often begins and ends with food. The whole problem shows little. The public is not aware that it is a complex mental illness that manifests itself in life, social relationships, human functioning. It’s not just about food.

How do you think eating disorders can be improved?

I would consider it reasonable to see that these are normal, good people who did not choose illness. It just happened to them and now they are fighting the disease.

It wouldn’t hurt for the public to see an interview with parents whose twelve-year-old child had been going through these troubles for several years. Then people would understand how difficult it is. And I would also recommend using a document that can show the situation comprehensively.

Aren’t they normal nice people on the boulevard?

They are models, actresses, they are not ordinary people. They can also be normal and fine, but they have specific occupations. It reinforces our prejudices, like starvation. Moreover, in the world of show business, interest is very important. Someone is making this content interesting, but it’s twisting the whole topic. And I don’t like that. That’s why I don’t think he belongs on the boulevard.

What images does the boulevard choose when it comes to anorexia nervosa?

Accentuates thinness, emaciation. Headlines often say “She used to be pretty and thin, now she’s very thin.” So thin is good, but thin is already bad? And it also emphasizes low calorie intake.

Similarly, when someone on the boulevard accuses a celebrity, model, actress, of having anorexia nervosa, she defends herself by saying how much she eats, including junk food. This is a completely irrelevant argument. The public then has the impression that if you can eat, you don’t have anorexia nervosa, which is not true.

Who is Lenka Minibergerova?

Photo: Lenka Minibergerova

She graduated from Masaryk University and received psychological training in a systematic approach. Since then, he has been actively involved in the profession. Working with patients with eating disorders brings her difficult situations and a sense of purpose. He approaches her with great respect.

Do you see the stereotype that anorexics don’t eat anything?

Yes of course!

What is the reality of real people sitting with you in therapy and suffering from anorexia?

Weight is one of the indicators of anorexia parameters. On a certain percentage of people with an eating disorder, it is due to extreme wasting to see them. But it’s certainly not that only underweight people come to see me. Moreover, the disease has a stage, it has a certain development. The fact that a person has a normal weight according to the tables, visually he seems to be well, does not mean that he is really well. For example, someone was underweight, no longer has it, but still struggles with difficult and demanding mental states. It’s still the same diagnosis.

For me, the client is the one who has problems with these disorders. I’m not in the health care field, I don’t put tampons, and I don’t have to decide if someone has a diagnosis or not.

How do parents and relatives react when they only see anorexia in the media in relation to lack of food and emaciation, when they have someone next to them who does not look like that ?

They often say for a long time that it will not be an eating disorder, but just a fad. Maybe nobody eats meat now and everyone is working out. Then they meet with experts and other parents and clarify everything. They tend to be troubled by the fact that something else is happening to them at home and they see something different in the media. He thinks it’s not so bad. Then they confront their knowledge of the media with real information and harsh reality.

What impact does this have on the patient himself, when the patients appear different from him in the media?

It prolongs the time before we admit we have a problem. You’re comparing yourself, he thought: I don’t look anorexic. She’s skinny and I’m not that bad, so I don’t have a problem.

Or people have the false feeling that if they can eat an apple, they have no problem. Which is not true. But it’s not just the media that can blame them, the symptoms of this disorder are upon them. The patient’s eyes sense that he is not thin enough and that he never will be.

And what about the early stages, when you still don’t see those sick eyes?

The early stages are problematic in that they carry little negative and much positive. A sick person receives positive feedback from the area “it suits you how you lost weight”, “you are fit because you are exercising”. This is the situation in our society. And the media reinforces the feeling that it’s really nice to have a size XS. It seeps through these media. The normal and standard size of 38, 40 is already considered a whale. It is made up of each other.

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So can we say that when a person enters this disorder, is there a phase that is socially desirable?

Unfortunately yes.

Bulimia is no longer understood by the public

Now that we’ve talked about anorexia, what about bulimia nervosa?

I think bulimia is even more complicated. We anorexia experts don’t understand much. But the public does not understand bulimia at all, it is completely lost. To put it simply, being anorexic is kind of anorexic in some circles. It’s misleading on the one hand, but at least we’re talking about it. But I have seen or heard few conversations with someone who suffers from bulimia. A person with this type of disorder should reveal that they vomit, that some part of their being is ashamed of it, and that they talk about it very little. It takes a long time to tell someone. Moreover, he suffers from a social prejudice according to which when the disorder is not visible, the patient is fine.

Do you think the shame is greater than in anorexia?

From my experience with clients, definitely yes. The terrible downside is that nothing happens to the weight. So these are much more long-lasting problems. At the same time, the longer a person stays there, the greater the shame. It grows over time. That’s why it’s so difficult.

So how does society react when you say they don’t know much about themselves?

For anorexic women, the public believes that the solution is “to eat like that”, for bulimia it is completely incomprehensible. There’s just “don’t do it” and “if you don’t want to, don’t eat”. People don’t understand the situation of overeating and subsequent compensation, like vomiting, exercise, laxatives, fasting… I think people don’t talk about their bulimia because they find very little understanding.

Won’t they even tell their loved ones?

It is not uncommon for a person with bulimia to live in a relationship with a partner they do not know.

Does your partner not notice it?

Maybe it’s the prejudice. I also thought at the start of working with these clients that someone had to notice. They will somehow save loved ones over time, but they will find there is nothing they can do about it. So it becomes tolerated.

This disorder has been going on for decades. Bulimic problems are sometimes lifelong. Not that I don’t know people with chronic anorexia, there is.

It doesn’t stop in adulthood

What about elderly patients? Does it make sense to show them in the media?

It would be nice to mention that it doesn’t end at the eighteenth grade. It’s not that a person is an adult and the problems end. It is also good to inform that it can happen to men.

It’s even more complicated when a person “only” has binge eating but doesn’t vomit or compensate.

Don’t you think there is even more shame there? Confessing bulimia at forty…

I am okay. The company is able to accept her even in the young years, saying that she is “young, stupid” and “it will be fine”. But you won’t make it at forty. To say that it is not anorexia, but bulimia, is extremely difficult.

But I haven’t personally met anyone who would have problems so late. For all my clients, this historically goes back to their youth, they realize it retrospectively. But this is not the rule, I have read that these problems can arise as a reaction to a change in life, a burnout syndrome, the loss of a loved one. It would also be good to mention this point of view, because I think it is not known at all.

What about the third clinically specified eating disorder – binge eating?

When a person “only” has binge eating but doesn’t vomit or otherwise compensate, it’s even more complicated. He also no longer perceives that he has an eating disorder. He feels that it is his problem that he cannot face, because he is massaged by the media and the entourage. Now that’s all we need to eat healthy, we all need to exercise. Which, in a way, isn’t a bad base. But, there is a but”.

What are the consequences?

I think it takes a long time for these people to ask for help and support. Even if they confide in the doctor that they have this problem, they don’t have a full understanding – “it’s not easy, don’t be alone”. They learn to diet.

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