National Eating Disorders Association

The Voice in Your Head

Lois Metzger

About ten years ago, I got intensely interested in the complex world of eating disorders after reading a newspaper article about a teenage boy with anorexia—which shocked me, because I’d had no idea boys or men could even get eating disorders.  Of course, this was only my first shock.

I dove into the subject and read everything I could get my hands on—novels, nonfiction books, articles; I watched personal accounts on YouTube, and met with doctors and their former patients.  What I found was something that kept coming up again and again:

The voice in your head.

This voice, shockingly, is a person’s inner bully—demeaning, scolding, nagging, dishonest, hateful, controlling.  Simply put, you do not want this person (or entity, consciousness, monster) in your life.  If you met this… thing, you wouldn’t want to spend five minutes with it.  Yet, for people with eating disorders, the voice is with them 24 hours a day (even in their dreams).

Sometimes called the “eating-disorder voice,” this voice was almost a constant, appearing in nearly all the personal accounts I came across.  In a New York Times article about binge eating, a man acknowledged, “There was this voice in my head that said, ‘You’re no good, worthless.’”  In Deborah Hautzig’s novel, Second Star to the Right, the narrator calls the voice in her head “the dictator”:  “He/she/it… had taken up residence inside me… Even thinking about eating forbidden foods brought punishment… it didn’t seem to be me doing the talking.  Not any part of me I’d ever encountered, anyway.”  In a YouTube video, a young girl told her family she couldn’t eat a donut because “She won’t let me.”  “She” was the voice in her head.

In one book, Eating Disorders:  A Parents’ Guide, by Rachel Bryant-Waugh and Bryan Lask, a girl imagined her anorexia as “a green scaly creature with a large beak that was always with her… and always scolded her after mealtimes for eating too much… It reminded her that to be fat and ugly was to be a useless, worthless, unlovable human being.”  The girl drew a picture of the creature, and her therapist put the drawing in a file cabinet.  That way, “They were then able to discuss the things it was most difficult for the creature to hear without interrupting.”

I came to realize that this distancing from the voice could be an essential part of recovery—a matter of finding a place to put the voice so it can’t keep hammering away at you.  In the book Treatment Manual for Anorexia Nervosa, by James Lock, Daniel le Grange, W. Stewart Agras and Christopher Dare, the authors talk about “externalizing the illness.”  It’s not you—they make this very clear to patients—it’s the eating disorder talking.  At the same time, the authors say that doctors and patients “all have to work very hard so that we can help diminish the power of this illness so [the] healthy part can flourish again.”

The voice and how to combat it have come to be central to my understanding of eating disorders, representing both how people can get trapped and how they can find their way out again.  Like any bully, the voice acts bigger and stronger than it really is.  It may seem all-powerful; it is not.  It may seem to drown out everything else, but the healthy part is always there and can be heard when someone listens for it.  The voice may seem to be “the enemy within” but it is in fact an outsider.  Seeing this can give patients power over it.  You can learn to ignore an outsider.  You can learn to silence it.

About the Author:

Lois Metzger is the author of  A Trick of the Light (HarperCollins), a novel about a 15-year-old boy with an eating-disorder voice in his head.  This voice is the narrator of the book.  She has published three previous novels for young adults, and has also written two non-fiction books about the Holocaust, and has edited five anthologies of original short stories.  Her own short stories have appeared in collections all over the world.