“Do the best you can until you know better. Then when you know better do better.” -Maya Angelou
I don’t know about you, but when there’s something really important to me that I want to talk about, I have a hard time doing it. I want it to be eloquent enough to be understood in the way that it feels in my heart and in my head. Sometimes I get a tiny bit perfectionistic and put off saying it because I worry it won’t sound right so I end up not saying it at all. This is exactly how what I’m about to write feels to me. I really want you to understand how important this is, and I want you to understand that it’s coming from a loving place and not a place of criticism. I just want a little help in making a change. Thank you for being here.
If you have lived in Utah, you are likely somewhat familiar with The Church of Jesus Christ of Latter Day Saints, and might be familiar with the young people that are sent out to do missionary service. If you aren’t, I’ll catch you up. LDS (abbreviated for writing purposes) missionaries voluntarily are sent out on their missions at the age of 18 for men and 19 for women. They serve for 18-24 months, and it is most often some distance away from home and from their families. Missionaries are assigned all over the world, and often are funded for their service by themselves, their families, and their local church congregation.
LDS missionaries might be vulnerable to developing eating disorders
Being a missionary is a significant sacrifice for those that choose to go. They are often putting off their education or careers to do something pretty hard with their lives. It takes a great deal of bravery to go somewhere different, to leave behind what is familiar and comfortable, and to have limited contact with family and friends. Many missionaries report this to be an important experience for their lives. They spend the 18 to 24 months focusing on service to others, developing grit, and strengthening their spirituality. Developmentally, 18-21-year-olds are at a vulnerable period of their lives. They are attempting to: have a better understanding of themselves, greater concern for others, work for more emotional stability, learn to develop more serious relationships, and become more comfortable with themselves. Missionary service has been a protective factor for some during this developmental period. However, for some, it’s not, and that’s ok but it’s something we need to talk about.
I want to talk to you about these missionaries and their development of eating disorders while they are serving their missions. I want to talk about it because it feels like we are being too quiet about it or maybe some of us don’t realize this is going on. That’s why I’m here. Working as a therapist and treating eating disorders, I see plenty of clients that developed an eating disorder during their missionary service. Is it missionary service that causes an eating disorder? I don’t think so. Eating disorders are complicated mental illnesses with multiple contributing factors. However, serving a mission can be a stressful experience, and it can be isolating, and it can be anxiety-provoking.
It’s important to understand the mental health of LDS missionaries
I want to help you understand some of their experiences and maybe what we could do better in serving them. They are some of my favorite people to work with because they really are so special. I’ve been inspired to be a better person because of my work with these clients. Here are some of my thoughts and suggestions.
Missionaries don’t need the fear of weight gain instilled in them. These young missionaries are sent to 140 different countries around the world. Even when they are serving in their native country, this is a stressful experience. There is a new culture and or language to learn on top of the stress of leaving home for the first time for many. Every place has a different culture around food and eating, and missionaries are trying to adapt. Missionaries are getting the message while in the Missionary Training Center (MTC) or from church leaders that weight gain is something to be avoided and to be aware of. People try with good intentions to give advice on how to avoid it. A. Is this really our biggest concern for missionaries? That they might change their body size? They’re sacrificing their time, education, money, and careers to take care of other people and we don’t need to be worrying about their weight. Another area that I want us all to please consider is that 18-21-year-olds are in the period of late adolescence. Puberty is not finished for this age group. Puberty = body changes and weight gain. They likely should be gaining some weight while they are away because their body is still maturing and changing. This is healthy and appropriate so let’s not give the message that if they come home weighing more, they did something wrong. They’ve got enough pressure on their shoulders to try and manage something that they don’t need to worry about. Please don’t make comments on missionaries changing body or their weight gain. Let’s also work on not commenting on anyone’s weight or body size.
Those with an eating disorder tend to have traits of perfectionism and are high achieving.
Those that are wanting to sacrifice and serve other people in missionary work, especially sister missionaries, tend to be high achievers naturally. These people are already probably doing pretty well in other areas of their lives. Good grades, success in sports, model employees, etc. are all qualities these missionaries already have. Their personality traits already tend to be perfectionistic and when combined with missionary service it can lead to troubles for some. Missionary work can be a rewarding experience but it can also be a significant stressor.
This is a perfect storm as the lifestyle of being a missionary is pretty strict. Again, I’m not saying this is a wrong approach but I’m merely outlining why this works out. Missionaries are expected to have every hour of their day outlined with something purposeful that they will do. Self-care is not something that is focused on during this stage of life as missionaries’ whole goal is to take care of others. Missionaries have their study time, exercise, wake up and bedtime outlined every day. They are never allowed to be alone during those 18-24 months unless they’re in the bathroom. Missionaries are assigned to a geographical area during periods of their mission that they aren’t allowed to leave and only have a set amount of miles they can drive during the month. Missionaries may feel that they can’t take breaks or they feel the need to skip meals so they can focus on teaching other people or finding people to teach. They can experience enormous amounts of guilt if they aren’t doing that all the time. This structure can trigger perfectionism part in these people, and they can become perfectionistic about what they eat and their weight or they may feel a lack of control with all the other areas of their life and turn to restriction, binging, purging, and overexercising to control what they can control.
We cannot determine an eating disorder based on outer appearance.
This is important for you to understand: eating disorders come in all shapes and sizes. People can be at deadly stages of their eating disorder and appear normal or “overweight”. Large or small-sized bodies can all be really struggling in their disorder. Some missionaries may be restricting and appear to be a normal weight or above weight. They can be binging and purging and be in a larger body, and you will not know it. It doesn’t matter because some serious health risks are associated with these behaviors, and weight is not the only factor. Missionaries may be complimented on weight loss that could result from disordered behavior, which sadly reinforces continued unhealthy behaviors.
Some returned missionaries I have worked with didn’t feel they needed help or could reach out for help because their bodies didn’t appear to fit the mold. I want you all to know that there is no mold. There are serious health risks associated with being underweight and serious health risks for being normal or “overweight” and using eating disorder behaviors. We need to be concerned about all of them.
Missionaries can hide their eating disorders/disordered eating well.
Eating disorders require some amount of secrecy to thrive. Eating disorders are also a shameful experience (we will get to that later), and behaviors can go unnoticed. It’s not just that way for missionaries but for anyone struggling with an eating disorder. I have worked with many parents that have been shocked that their child had been struggling for years with an eating disorder. Missionary work can be an isolating experience, and although missionaries all have a mission companion, they can hide the behaviors even from them.
“Fasting” can be disguised as restriction with a spiritual purpose when the intention is actually to restrict or compensation for food they felt out of control eating before. Throwing up secretly after meals can go unnoticed by their companions as well. Mission companions might feel like something weird is going on, but if you are unfamiliar with eating disorders, you may not notice. Please remember that these mission companions are young as well and inexperienced or may not have a lot of self-awareness themselves that this is going on. This is another frightening thing about eating disorders and missionaries. Missionaries can be well into their disorder, and nobody notices.
There is a significant amount of shame present.
Brene Brown, a well-known shame researcher, defines shame as “ The intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging – something we've experienced, done, or failed to do makes us unworthy of connection.” Shame is never useful or helpful. It’s a paralyzing emotion that targets who we are as a person and not our actions. Guilt: “I made a bad decision”. Shame: “I am bad”.
Missionaries struggling with eating disorders and disordered eating are experiencing some deep shame for things outside of their eating disorder but certainly for that as well. Missionaries that end up being sent home early for their eating disorders struggle even more with shame. The returned missionaries that I work with feel shame for the fact that they weren’t able to “keep it together” with food and eating while they serve their missions. They believe that there must be something wrong with them or that God must be so disappointed them. This is heartbreaking every time I hear it. These lovely people have sacrificed so much more than the average person for this experience and end up leaving feeling that they aren’t good enough and that even God couldn’t be proud of them.
Symptoms of Anxiety and Depression may show up in missionary service.
Anxiety and depression are common in those that I work with experiencing eating disorders. Nearly all of the clients I have worked with have some form of anxiety. Before missionaries leave for missionary services they may not think they have these struggles but anxiety and depression show up in the midst of service.
I would like to normalize this heavily. Missionaries spend 18-24 months every day talking to strangers and being open about something extremely personal. This is a vulnerable experience, and being vulnerable so often can make anyone anxious. Being away from family and friends is hard and when you aren’t vibing with your mission companion it feels really isolating and depressing. Missionaries start to feel shame for experiencing these emotions as well even though they are totally normal and appropriate for the situation.
However, just because it is normal I don’t want to minimize the significance of these mental illnesses. Missionaries don’t develop eating disorders because they are a little homesick and aren’t getting along with their companion. These things aren’t just going to go away with a little more faith and prayer. Onto that next….
Eating disorders don’t go away with just faith and prayer.
While research does suggest that spiritual beliefs do aid in the recovery of eating disorders, it is not the only factor in recovery. Missionaries have relied profoundly on their spiritual beliefs, prayer, and faith in God to succeed in their service. They have even tried to use these skills to stop their eating disorder behaviors and find it unsuccessful which further exacerbates the shame they are feeling.
Eating disorders are complex and complicated mental and physical illnesses. Recovery requires working with a team of highly trained professionals. Therapists and dietitians with specialized training in eating disorders are essential in recovery, along with medical providers.
Please don’t accuse missionaries or anyone else that if they just prayed harder, showed more faith, or read their scriptures that their anxiety, depression, and eating disorders will go away. They developed for a variety or reasons and, because of that, will need a little extra help in recovery.
How do I help a loved one with an eating disorder?
Eating disorders aren’t just happening among some missions around the world but are likely happening in every mission. Although I haven’t had the opportunity to get the stats on missionaries with eating disorders, the statistic in general state that 30 million people in just the USA experience an eating disorder, and even that is likely under-reported. Encountering a missionary with an eating disorder is not a rare occurrence, and we owe it to those suffering to do better at spotting it and getting them to help early on. Here are some of my suggestions:
Don’t comment on weight gain or weight loss in a missionary (or anyone). It’s incredibly unhelpful to comment on a missionary’s weight gain or weight loss. It places more emphasis on their bodies, which may increase pressure to be a certain size.
Don’t demonize weight gain in missionaries. Their bodies are still changing and are still in puberty. Please don’t forget that these people are still teenagers or young adults who have bodies that are still changing and growing. Of course, it’s possible and even healthy for them to gain weight. Their bodies are not done growing.
Don’t expect an eating disorder to be a result of a lack of faith or spirituality, and don’t reinforce that it will go away with having increased spirituality. Try and notice what messages you are portraying with what you are speaking about when it comes to eating disorders. Spirituality may be an important part of recovery for some people, but it’s not all of it. Eating disorders don’t develop because of a lack of faith.
Remember those with eating disorders are experiencing a lot of shame. Be gentle and loving when approaching this. It costs nothing to be gentle and kind to those struggling. You don’t have to understand what they are going through in order to be supportive. Be aware they are already feeling shame and like there is something wrong with them.
Eating disorders are complex and complicated mental illnesses so please seek help from a trained eating disorder professional early on. Waiting and trying to figure out how to manage an eating disorder on your own ends up prolonging recovery. Find a therapist and dietitian specializing in the treatment of eating disorders. Eating disorders require specific training and finding someone you connect with as soon as possible will make a difference.
Eating disorders are often kept secret for a long time. Provide an open and accepting approach if you notice signs of an eating disorder. Eating disorders are more common than we realize, and we may be tempted to make a joke or make light of them because we don’t understand how painful they are. If you see someone struggling, show you are open and safe to talk to.
If a missionary is sent home because of their eating disorder, they will feel an increased amount of shame. Remember to be sensitive. Eating disorders require therapeutic and medical intervention and take time to recover from. if a missionary is struggling with an eating disorder, it may be better for them to be is home where they can devote time and energy to getting better.
Be aware that anxiety and depression are commonly diagnosed with an eating disorder, and missionaries may be experiencing these for the first time during their missions. Depression and anxiety may be the first symptom to be noticed with an eating disorder as previously mentioned, eating disorders aren’t always apparent. Missions are stressful and may provoke anxiety and depression. This isn’t the result of not having enough faith or diligence; it’s a healthy reaction to stress.
Eating disorder treatment in utah can help.
The most important thing to know is that eating disorders require treatment. A missionary isn’t going to just grow out of it. They might become better at hiding it, but they don’t just snap out of it. Eating disorder treatment can be life-changing for missionaries experiencing an eating disorder. Effectively treating an eating disorder consistent with working with a therapist, dietitian, medical provider, and often a psychiatrist.
Eating disorders are a complex mental health issue and require specialized care and a team approach. Recovering from an eating disorder requires the support of family members and friends. This is one of the most important parts of healing, but really someone struggling with an eating disorder requires all of them to get better.
Begin eating disorder treatment in Utah
You don’t have to keep living stuck in the cycle of an eating disorder. There is hope that you can fully recover and ditch your eating disorder for good. This Provo Utah Area Counseling Clinic has an eating disorder therapist specializing in eating disorder treatment. To begin therapy, follow the steps below:
Meet with a mental health professional
Start eating disorder recovery
Online Therapy in Utah for Eating Disorder Treatment
I realize having access to a therapist specializing in eating disorder treatment is absolutely essential when trying to recover. This is why I provide online therapy in Utah. This allows you to securely and conveniently receive counseling without leaving home and traveling to a specialist.
Online counseling allows me to work with you wherever you are across the state, including Salt Lake City, Logan, St. George, Cedar City, Heber, and more.
Other mental health services at Maple Canyon Therapy
Eating disorder treatment isn’t the only mental health service provided at this Northern Utah Counseling Center. Other mental health services provided at Maple Canyon Therapy include body image therapy, binge eating disorder treatment, birth trauma therapy, EMDR Therapy, and anxiety therapy in Utah.
About the Author
Ashlee Hunt is a licensed clinical social worker and owner of Maple Canyon Therapy in Utah County. Ashlee has a bachelor’s degree in psychology and a bachelor’s degree in family life and human development from SUU. She has a master’s degree in social work from Utah State University. Ashlee is passionate about helping women recover from their eating disorders and uses a body-positive approach to helping women heal. She has worked in an eating disorder treatment center and has worked with all levels of care but has a specialty in working with binge eating disorder. When Ashlee is not doing therapy, she’s probably at the back of Barnes in Noble in Orem looking at interior design books.