How Anorexia Can Affect Social Life and Skills

Anorexia is an eating disorder that usually involves an intense fear of weight gain, a distorted body image, and the restriction of food or energy intake. A person’s struggles with anorexia can come with a broad set of challenges. These may include difficulties with self-esteem, debilitating physical symptoms, and social isolation.

The impacts of anorexia on a person’s social life can be devastating. If you an individual is working toward long-term recovery from anorexia, beginning to rebuild human connections — both with themselves and others — can be a vital part of the journey to better well-being.

How Anorexia Can Affect Social Skills

Enjoying a healthy social life may require many things, including a sense of physical well-being, a belief in one’s value and worth, a feeling of connection with those around you, and an ability to be spontaneous and present. Unfortunately, many of these qualities and attributes may be dulled or absent when someone is suffering from anorexia.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), common features of anorexia can include [1]:

• Fears or worries about eating in public
• Being preoccupied with thoughts of food
• Struggling with feelings of ineffectiveness
• Lack of social spontaneity
• A strong wish to control one’s environment
• Impulsive behavior and substance use

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Moreover, when someone who has anorexia suffers from poor nutrition, they can experience severe symptoms of depression as well as irritable mood, sleep disturbances, and social withdrawal [1]. Other impacts of anorexia may include cognitive symptoms, such as dizziness, problems concentrating, and impaired memory.

Any of the above symptoms may make it difficult for someone to enjoy a healthy and fulfilling social life. However, these are not the only ways anorexia might affect someone’s social abilities. Behavioral challenges can also loom large, making it feel almost impossible to engage in regular social activities. Behavioral symptoms of anorexia that may impact someone’s social functioning include:

• Having strict food rituals
• Engaging in intense and rigid exercise routines
• Feeling uncomfortable eating around other people
• Feeling anxiety about participating in holidays and other celebrations

Many people who struggle with eating disorders like anorexia also grapple with low self-esteem. In some cases, low self-esteem may get worse because of social isolation [2]. Furthermore, difficult feelings like shame, guilt, and worthlessness may create additional barriers between people who have anorexia and their friends and loved ones.

How Anorexia Can Create Disconnection

Eating disorders, including anorexia, are often referred to as illnesses of disconnection. In general, this is because living with an eating disorder can be a deeply isolating experience.

Living with anorexia can lead to disconnection from the body’s needs, long-term goals, and social networks. It may perpetuate feelings of low self-worth, make one feel separate from others who do not understand the illness,, or keep them feeling trapped and limited by the routines, behaviors, and emotions that have come to dominate their life.

One study sought to understand the social experiences of 17 adolescents ages 12-17 from the United Kingdom who had anorexia and were receiving treatment in an inpatient program. The study, which collected data using focus groups and interviews, found the following [3]:

• Participants reported experiencing reduced social capital, meaning that they lacked friendships prior to admission to the hospital, or they lost friends, in part, due to struggling with anorexia. Participants also mentioned finding it hard to relate to others and feeling detached from the outside world due to being in an inpatient setting.
• Participants struggled with a fear of missing out on important social relationships and experiences and attributed this fear to factors like having an eating disorder, receiving inpatient treatment, lost connections, self-isolation, and social exclusion.
• Participants also feared negative judgments from others and felt that being shy or introverted made this fear worse. They also worried about what to say and how to act around others.
• Participants struggled to come up with social coping strategies that might help them.
• Participants felt that the negative impact of hospitalization on social opportunities was significant, although they also noted positive aspects like finding a safe source of social support among fellow patients.

Working Toward Recovery & Reconnection

Everyone’s struggles with anorexia and social functioning are unique. And for some, their social struggles may precede the onset of anorexia symptoms. In one study conducted in England, around two-thirds of participants recalled having early social difficulties before the onset of anorexia [4]. Additionally, two-thirds of participants said that social difficulties had contributed to the development of the eating disorder (anorexia) they struggled with [4].

Additionally, people who have anorexia frequently suffer from co-occurring mental health disorders like anxiety, depression, and posttraumatic stress disorder (PTSD), which can affect their social well-being. Research has found that social anxiety co-occurs at high rates with all eating disorder diagnoses, including anorexia [5].

Anorexia symptoms and social skills can interact in many unique ways. So it can be vitally important for people who are working toward recovery to give strong and loving attention to their social well-being needs. Throughout a person’s recovery journey, they may reap benefits from building social support, strengthening connections with the self and others, and adding to their social toolkit. This is often a gradual process, but it can be very worthwhile.

References

[1] American Psychiatric Association. (2013). Feeding and eating disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).

[2] healthtalk.org. (2018, October). Eating disorders (young people): Social life and public places. https://healthtalk.org/eating-disorders/social-life-and-public-places

[3] Patel, K., Tchanturia, K., & Harrison, A. (2016). An exploration of social functioning in young people with eating disorders: A qualitative study. PLOS ONE, 11(7), Article e0159910. https://doi.org/10.1371/journal.pone.0159910

[4] Cardi, V., Mallorqui-Bague, N., Albano, G., Monteleone, A.M., Fernandez-Aranda, F., & Treasure, J. (2018). Social difficulties as risk and maintaining factors in anorexia nervosa: A mixed-method investigation. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00012

[5] Hambleton, A., Pepin, G., Le, A., Maloney, D., National Eating Disorder Research Consortium, Touyz, S., & Maguire, S. (2022). Psychiatric and medical comorbidities of eating disorders: Findings from a rapid review of the literature. Journal of Eating Disorders, 10, Article 132. https://doi.org/10.1186/s40337-022-00654-2

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About Timberline Knolls

Timberline Knolls is a residential treatment center located on 43 beautiful acres just outside Chicago, offering a nurturing recovery environment for women and girls age 12 and older who are struggling with eating disorders, addiction, trauma, and co-occurring mental health conditions. An adult partial hospitalization program (PHP) is available for step-down and for women to directly admit. By serving with uncompromising care, relentless compassion, and an unconditional joyful spirit, we help our residents and clients help themselves in their recovery. For more information, please visit www.timberlineknolls.com.

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The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on April 6, 2023. Published on EatingDisorderHope.com