We are now in the peak season to promote wellness, dieting and fitness plans as moves further into January. It is crucial to keep a critical eye on the “diet culture” in this media frenzy. Many trendy diets are not sustainable or healthy and can lead to unhealthy obsessions that lead to dangerous eating disorders.
A quick search on social media for terms such as “body positivity suggests that we are moving toward greater body diversity acceptance. We have made great strides since the nonfat, heroine-chic, scary thin media rages. Or have we?
We have come a long distance as a society since the days of scary skinny, nonfat, heroin-chic media. We haven’t.
While there are more sizes-inclusive clothing options available for people with higher body weight, and we are less skeptical about the dangers of extreme diets, a quick look at 2022 shows us that we may not be as educated about body acceptance. The reality is that most people who have eating disorders are not the stereotype.
Ye’s comments about Lizzo’s obesity bringing in ” demonic ” promotions of obesity, to the recent controversy over Ashley Graham’s “fat positivitytoo far”, it is evident that there are still many steps to be taken before all bodies can be treated with kindness, inclusion, and respect. Many speculate that the slimming-down body ideals from the 1990s may be returning in fashion. These trends, which support a slimmer body, are becoming more popular, such as buccal fat reduction and off label use of weight suppressing drugs. This has led to a shortage in diabetes medications.
Cultural shifts in beauty standards are normative. There is a lot of art history that shows the link between historical events, cultural attitudes, and beauty norms. These changing beauty standards show how society embraces stigmatization. This system of valuing certain bodies as “good”, “beautiful,” or “healthy,” leads to other bodies being labeled “bad”, “dangerous”, “unhealthy”, or “burdensome.”
These regressive tendencies toward ultra-skinny bodies of the 1990s are extremely worrying for me as a researcher, mental healthcare clinician, and a survivor of eating disorders. They have been shown to contribute to eating disorders and body image concerns . Studies have shown that eating disorders are still a common problem among American teenagers. Some studies have suggested that 10% of U.S. male teens and 20% of U.S. girls have been involved in poor dieting habits (e.g., fasting, purging or laxative abuse) during the entire study period. These trends aren’t limited to young people. The most notable increases in eating disorder incidences among adults have been seen in people older than 45, those with lower incomes, and men.
However, not all people with an eating disorder are young white teenagers.
Studies show that people with a higher body mass are more at risk of developing an eating disorder. They also have to deal with the social stigma. A higher weight may make it less likely that an person is screened for an eating disorder, or referred for treatment. My doctoral research at Washington University revealed that people who are heavier than were more likely to wait for treatment. This is a significant finding considering that early intervention is crucial to good outcomes.
There is no single “look” that will help someone with an eating disorder. It is crucial to be aware of eating disorders and to get treatment.
Many parts of my life fit the stereotypes of an eating disorder survivor. As a child, my personality was spunky, athletic, and perfectionist. Growing up in the 1990s fat-free, I learned from media and adults early on that it was important to control my weight and diet. I was thin as a child, but not too much. No one noticed that I began choosing nonfat foods and Diet Coke over the food I loved before. In seventh grade, I began to read food labels and avoided foods that had higher calories. To supplement my basketball, cross-country, and volleyball practice, I skipped breakfast and packed low-calorie instant potato lunches.
Although I believed I wasn’t thin enough or sick enough for an eating disorder to exist, I realized that I was suffering from a serious illness.
My food rules grew exponentially over the next few years. I started purging and lost almost all my life due to this eating disorder. My pediatrician diagnosed me with anorexia at the age of 15 years. My family was confused. To the outside world, I was a straight-A student athlete, polite, driven, and cheerful. My inner world was dominated and manipulated by a cruel, relentless voice. Although I believed I wasn’t thin enough or sick enough for an eating disorder at the time, professionals and adults in my life soon realized that I was suffering from a serious illness. My struggle to get treatment for my eating disorder was difficult. I had no access to treatment and there were not many programs available. I struggled for years and was in and out treatment.
My eating disorder finally reached its breaking point in my junior year of college. I lost my athletic clearance after I was diagnosed as having a heart condition due to my starvation. Shortly thereafter, I was placed on mandatory medical leave. Although it was very difficult financially to get treatment, my providers were willing to help me. My diagnosis was confirmed by no one. My doctor explained to me the damage done to my heart, kidneys and fertility. She also told me how my body had stopped absorbing “unnecessary functions” to sustain itself, and that it had started metabolizing its own bodies. My eating disorder was a constant reminder to me that it would kill me if not I dealt with it. Slowly, I began to accept that my eating disorder would kill me if I didn’t fight it.
It took many years to restore my body’s health. Slowly, my body began to heal. My heart and kidneys started to function better, and I was able to regulate my blood pressure, have my periods and finally, return to athletics. My body eventually stabilized, despite my fears of “gaining weight non-stop”, but at a much higher weight than I expected. Although I was physically healthier than I’d been for over a decade, my body was considered “obese.” I felt like had “recovered” from the “wrong”.
Despite my fears that I would gain weight, I kept this weight and my health for many years. I listened to the tired voice in my head telling me that recovery had made me fat. Yes, my body did recover from my eating disorder. But my fat body was still recovering. My larger body made me feel different and I was a struggle to overcome. My thin privilege began to fade and I started to feel stigmatized for my larger body. Instead of encouraging me to eat more because I was so thin, concerned individuals started giving me diet advice
My discomfort with my body and the weight stigma that I felt eventually took its toll. I fell back into my old ways. This time I wasn’t the stereotypical woman. People weren’t as concerned about me not being painfully thin because I wasn’t. People congratulated my weight loss and continued to congratulate me as I became sicker. Unfortunately, many people with eating disorders claim that they get the most compliments when they are struggling with their eating disorder.
Within months, I was unable to drink water. Although I didn’t become emaciated, and was still considered “overweight”, my body suffered the consequences of starvation. My heart problems returned. My body was a different story. It was obvious that I didn’t “look sick” but my body believed otherwise. This time I was not diagnosed with “anorexianervosa”. Instead, I was diagnosed with “atypical anorexia”. A condition that delineates those who exhibit all the symptoms of anorexia, but aren’t (yet!) underweight.
My treatment team recognized that I was a larger patient and became my advocate for my eating disorder.
After I was discharged, my experience with treatment was very different. My therapist didn’t tell me how serious my eating disorder was. She questioned if I had one. After three weeks of treatment, my inpatient insurance coverage was terminated. She also compared me to other patients. Despite my significant weight loss and cardiac complications, I was placed on a low-calorie diet and not nutritionally rehab. My treatment team recognized that I was a larger patient and became the voice for my eating disorder.
Although my overall health is much better than when I was starving, I still get daily reminders from society about how my body is unacceptable and that I need to return to my eating disorder. Every January, I (like many other eating disorder survivors), prepare for the new year’s messages about weight loss and extreme makeovers.
My healing journey began with making peace and learning to accept my body. Although it was a slow process, this gave me hope that my eating disorder would not be my dominating issue in the future. I began to look for role models, athletes and artists who were open to celebrating body diversity, rather than focusing on thin, idealized bodies. I started to learn about the links between weight stigma and other forms of body oppression like racism, ableism and transphobia.
My recovery has not been perfect, but it was a reality. Recovery is messy and difficult. Americans will be bombarded with messages this year about self-improvement, change, and other topics. These messages are rooted in diet culture and often stigmatize larger bodies, like mine. I need to be vigilant about my recovery. Today, I don’t need a “New Year, New Me.” I am grateful for the “now” me who has survived so much, my “now body,” that is nourished and thriving, and all the people in my life who reminds me that my body needs nourishment, rest, and care, no matter how large.
