The nature of an eating disorder

The show Intervention recently kicked off their new season at the end of May. I don't watch every episode, but I do catch one every now and then. Last night's episode featured identical twin sisters, Sonia and Julia, both in their early 20s. I found this episode quite interesting, as there were many different issues displayed: biological factors, IDENTITY, family dynamics, co-dependency, and competitiveness.

Most of us already know that genetics has an influence on eating disorders, so I'm not going to discuss that at length. However, since these two girls were identical, there was a higher likelihood that if one developed an eating disorder, the other would as well. (study here) The interesting thing was that their sister, the eldest of the three, did not develop an ED.

From the family standpoint, the biggest issue I saw was never treating the girls as separate individuals. Thus, they never truly were able to develop their own IDENTITY which can be a core issue of an eating disorder. As teenagers, the two physically developed differently, Sonia, the younger of the two, was thin and slim, while Julia was more curvy and considered the "chubby angel." This seemed to be when anorexia first reared its ugly head, starting with Julia who began to exercise and get into karate. Then, Sonia became interested in the sport, and everything escalated from there, having a snowball effect in illness and further competitiveness between the two. Each one wanted to be recognized for something of their own, especially Julia.

Then, they developed a major co-dependency issue, especially when both were attending the same college and living together. Eventually, they both left college and came home. This only further exacerbated their rituals and rules, leading to the two of them to "feed" off each other. I thought these scenes between the two of them really showed the effects of the nature of the illness. You saw how both were incredibly isolated, never leaving the house, declined visits to their older sister's house, saying harsh words to their sister and parents, their daily rituals, etc. It was incredibly sad for their older sister to hear the things they said to her, like that they were never close. But it truly did show the mark of the illness in how they were so void of emotion, feeling, and attachment from anything other than their disorder.

There was something else Julia said that I found startling. She said how she felt like Sonia was copying her in her anorexia and other behaviors, but at the same time, she was her nightmare too. Just imagine, being an identical twin, living together in the same environment, with an eating disorder. It's like waking up to see she shadow of your nightmare in living form as the anorexia. How that must be so difficult.

At the intervention which the girls had separately, you could see how clueless, helpless, and distraught their parents felt. They simply did not understand the disorder nor how raising of them as "one" versus separates impacted the girls' lives so much. Even down to the letter they were supposed to write for each individual girl, they wound up writing the same letter for each girl. By the end of the show, they did realize this mistake.

Sonia and Julia did agree to treatment, although they worried about being separated. But it seemed for Julia, there was almost a sense of relief actually, at least that is what I saw. Both girls were treated at Remuda Ranch in VA, though their treatment was separate except for dealing with their co-dependency issues. At the end of three months, they had reached a healthy weight and were maintaining it. They plan to go back to college in the fall and live in separate apartments.

I'd say my only real discrepancy was whether the "tough love" approach should have been taken. It's something Intervention is known for. In many cases, it works, since there is usually an "enabler" involved. The interventionist said how the parents were enabling this, because they allowed it to go on. Clearly, Sonia and Julia were not doing well in the home environment together, so something did need to change. Whether it was exactly their parents is questionable. I think the dynamics did need some revising, however.

Did anyone else see this episode? What were your thoughts?