Content Notice: Please be aware this blog contains mentions of eating disorders, body image, suicide and sexism
I must first preface this blog with the fact that I have personally not had an eating disorder and I am writing this blog as an ally. It is written in collaboration with people with eating disorders.
This year, due to unfortunate timing, Eating Disorders Awareness Week clashed with our Mental Health Awareness Week and Spring Elections and I fear became a little lost in the mix. I’d like to provide the space eating disorders deserve and to share a few ideas about how our society needs to change, not just to better support people with eating disorders, but to change everyone’s way of thinking.
Eating disorders are still some of the most stigmatised mental illnesses in our society.They are also the most deadly. Eating disorders have the highest mortality rate of all mental illnesses, with disproportionately high rates of suicide and medical complications and despite being some of the most prevalent mental illnesses, there is still a lack of understanding amongst the general populace. This is dangerous; lack of understanding is perpetuating myths about eating disorders which further stigmatise the illness, oppresses people with eating disorders and endangers their lives. 10% of people with eating disorders have anorexia nervosa, and 40% have bulimia, yet the general narrative is disproportionately focused on anorexia and often with an incorrect representation. Both conditions are still incredibly poorly understood.
Here, I am hoping to provide ways we can be more mindful and supportive of people with eating disorders and facilitate a more inclusive community.
It is important to clarify that eating disorders are not the product of the modelling industry, nor do people choose to develop an eating disorder. The general narrative around eating disorders is that someone ‘just wants to be thin’ - this is dangerously and insultingly inaccurate and is similar to suggesting that an alcohol or drug addiction is just someone wanting to have fun. Eating disorders are actually incredibly difficult and pervasive coping mechanisms for someone dealing with extreme mental distress. These coping mechanisms manifest as a way to control at least one aspect of the person’s life.
This becomes an obsession with the person’s body and food, an obsession which ultimately will never be satisfied and will hurt the person in question. People with eating disorders often discuss the most prominent emotions they feel as being shame and guilt and these are exacerbated by the judgments they encounter from other people on a daily basis. Eating disorders can be interpreted similarly to an addiction, except the addiction is to food and/or the lack of it. Unlike an addiction to another substance, where you can abstain from using it, eventually, you cannot survive without food. Imagine trying to resist an addiction to and having a fear of something you need to survive. Now imagine no one affords you the same concern they would to someone with any other addiction or illness and that you are constantly bombarded by triggering conversations about food every day.
There are multiple intersections which we must consider when we analyse the prevalence of eating disorders. Approximately 725,000 people in the UK suffer from an eating disorder, with between 75-90% of those being women. So while the stigmatised depiction of eating disorders generally erases men, there is a clear influence of sexism on the development of eating disorders (likely the societal policing of women’s bodies and eating habits). There is also a high correlation between disability and eating disorders; for example, 60% of people with Type 1 Diabetes also develop an eating disorder (potentially due to monitoring of food and insulin control). Unfortunately, our health services, and specifically our mental health support services, are not equipped to support everyone or to enable their recovery. While we need to demand better therapies and services for people with eating disorders, we also need to challenge the discourse that mainly centres on the recovery of white women and continues to restrict non-white women’s access to a diagnosis and hopefully recovery. These intersections cannot be ignored; we need to analyse the impact of these broader systems to help inform intervention methods and therapies to support people with eating disorders and to prevent them developing.
What makes coping extremely difficult for people with eating disorders is the fact that our society, and so much of our emotional energy, is centred around food. Seemingly harmless everyday conversations around food can be triggering for people with eating disorders. But so much of the normalised rhetoric around food and discussion of people's bodies is terribly misinformed, problematic and insidiously oppressive.
Calorie counting is a prime example. This focus on tracking how many calories one consumes in a day and how many you can ‘burn’ through exercise is deeply problematic. Food should be about enjoyment, not an investment strategy that apparently will dictate weight gain or loss. Stop worrying about how many calories you are consuming and ‘burning’.
The calorie counting behaviour can feed into a punishment/reward relationship with food. We should not incentivise ourselves with ‘treat’-type foods and punish ourselves with exercise after eating treat food or eating supposedly ‘healthier’ food or smaller portions. We should exercise and eat for the sake of enjoying those activities.
This can also contribute to categorising certain foods as ‘good’ and ‘bad’ for us, when no food is inherently healthy or unhealthy. Forcing this dichotomy is not helpful and also contributes to the myth of clean eating. Clean eating is itself an unhealthy myth, the perpetuation of which only serves to embed the oppressive cycle of reward/punishment relationships with food, good versus bad categorisation of food and unnecessary guilt and shame.
Moreover, when we discuss ways to help and support our wellbeing, we need to assess our suggestions of engaging in exercise. The same way not every form of therapy can be applied to anyone with poor mental health, exercise isn't the answer for people with eating disorders. Particularly given the problematic reasoning behind encouraging people to engage in exercise (ie, seeing exercise as a way to lose weight, instead of just for fun) and the implications it has for people with eating disorders, we should be exploring other methods of intervention and wellbeing support. We also need to avoid glorifying exercise and those who take part in it - again, your inability to do exercise or lack of desire to do it is not a bad thing and certainly not a measure of your worth.
Diet culture is pervasive, fat-shaming and ultimately dangerous. Being fat does not make you unhealthy, fat in food is not unhealthy and the shape or size of your body should not determine your beauty or your self-worth. The diet industry and dieting culture makes a profit from people’s misery, making people believe they are not good enough unless they are ‘slim’ enough and seeks to take people’s money from this. The reward/punishment and good vs bad food false dichotomies heavily influence this and seek to shame and guilt people into losing weight. This needs to be resisted. You do not need to diet.
What we choose to comment on and praise about people can be also be incredibly triggering. For instance, commenting on or celebrating someone’s weight loss provides validation of the fattist rhetoric that guilts people into this behaviour in the first place. Of course, commenting on a person’s weight gain also serves to shame people for something that is not inherently bad. There are a few things you can do to stop this, starting with: don't comment on people’s weight. Compliment people on things other than their body, ideally things they choose to present about themselves, not things they can't. For example, someone’s hair or an item of clothing they are wearing.
The body positivity movement is a good example of resistance to dangerous, oppressive rhetoric around bodies and food, but this needs to avoid becoming problematic too. Focusing on certain types of ‘curvy’ figures sexualizes women further and perpetuates the myth of only certain shapes of bodies being attractive. Advocates of the body positivity movement also need to be aware of the thin privilege latent in this messaging, else fat women are still excluded from this movement and will continue to experience disproportionately more body shaming and policing of their bodies. Equally, we need to resist the typical capitalist takeover of body positivity as a modelling tool and just paying lip service to it purely for the uses of media campaigns that don’t actually challenge societal norms. Neoliberalism further embeds the competition that our misogynist society imposes on women and their existence. This needs to be challenged so existence can be about just that - existing, not comparing oneself to false, sexist standards and being accepted for who we are, not what someone wants us to be.
Finally, please know everyday discussions about food and events surrounding and involving food are difficult for people with eating disorders. You may not think twice about going to have your lunch and discussing in detail what you are eating, but for someone with an eating disorder, this is incredibly difficult, triggering and anxiety-inducing. We must also recognise that if someone with an eating disorder is eating, it does not mean they are ok. We need to be far more sensitive and stop making assumptions about people and their relationships with food.
It is easy, when discussing mental health, to question your own and to analyse yourself. What you MUST avoid, however, is diagnosing yourself with an eating disorder. The same way joking about them trivialises them, diagnosing yourself based on the experiences of others with eating disorders, or when someone is confiding in you, only serves to trivialise the struggles of those who are suffering and to impinge on their space to talk about it and be free from oppression. However, if you are concerned about your mental health and feel food is becoming the central aspect of your daily life and anxiety around it is time consuming, please speak to someone (there are links to related support groups below).
We need to facilitate a society free from food and body image taboo. These behaviours and assumptions that are deeply ingrained in our society are hurting people. They are fatist and ableist, often heavily gendered and all feed into a capitalist agenda which profits from oppression, from your self-loathing and directly impacts the suffering of people with eating disorders.
I'll tell you what makes food and body positivity ‘accessible’ - not shaming people for what they do or do not eat. It's time we called ourselves out and started resisting this oppression which is disempowering millions and deeply hurting people with eating disorders, people who are suffering enough and could really do without our problematic bullshit.
We need to be more inclusive of people with eating disorders NOW, because eating disorders kill. Let's give them the space they need and give people the respect they deserve.
If you would like some further insight on this topic, this article about Sarai Walker’s experiences of fat-shaming and sexism is incredibly insightful:
If you are affected by any of the contents of this blog, you can seek support from the SU Advice Centre or University Wellbeing Support and also from these external groups:
Diabetics With Eating Disorders: http://dwed.org.uk/
Overeaters Anonymous: http://www.oagb.org.uk/