The following article contains information information regarding disordered eating, body image, and mental health. If you or someone you know is symptomatic of an eating disorder, please contact a care provider or the National Eating Disorder Helpline at 800-931-2237.
It was a usual Thursday night at the pizza restaurant I work at in Burlington. A young woman came into the restaurant with her mother; their body shapes were not the kind you would see on television or in fashion magazines. When the young woman came up to the counter and added a cupcake to her order, she said, "You know, my mom says I shouldn't be eating this. She wishes I was skinny, like you."
I felt a weight drop from the back of my scarred throat down through my stomach and out through the tips of my toes. I bit my lip, looked down at the register for a second, and back up. I wish I could have emulated the level of discomfort I was feeling in that moment to the young woman in front of me. My voice quivered, "I'm recovering from an eating disorder."
Reminder like these, of my current condition and the personal hell I've had to face since my diagnosis last summer, are painful. They sting more than the feeling of stomach acid on the back of my throat and are more exhausting than the feeling after a particularly rough purging session. I don't know if I can speak on behalf of all individuals with eating disorders, but I think it's safe to say that the way people talk about eating disorders is often more painful than actually going through them. That, or the disgust people have when you tell them a little *too* much information about your behaviors.
Eating disorders are not diagnosable by body shape, rather they are a mirage of symptoms that often emerge with other co-morbid mental health disorders. Individuals in large bodies can have eating disorders as can men, queer folx, and people of color. However, the disparities in the diagnosis of eating disorders among individuals who do not fit the "eating disorder image" of femininity, whiteness, and small-bodiness is stark. Of the thirty million Americans with eating disorders, more than 10 million are estimated to be male-identifying, but we don't know the exact number because many fear the stigma of treatment. It also wasn't until 2013 that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) expanded the diagnosis criteria of anorexia nervosa to include overweight and obese teenagers who develop disordered eating habits to moderate weight gain. That was only SEVEN years ago!
In a world where 70% of symptomatic individuals do not seek treatment because of stigma, we can't afford to discount the experience of marginalized folx. Every sixty-two minutes, someone dies from an eating disorder, making it one of the most deadly mental illness classifications there is.
If my doctors, my family, or my friends would have helped me recognize my symptoms earlier on, I imagine I would have been in less of a predicament than I am now. If only someone had recognized my disordered eating as something that was anything but healthy, I might have had an easier recovery process. If the people around me expressed more concern than celebration regarding my nearly eighty pound weight loss, I might have seen the red flags earlier on. But, I don't blame them whatsoever. I blame a culture that lauds weight-loss as a cure for societal ills. I blame marketing and diet plans that try to sell people on the idea that skinniness is correlated with self-gratification. I blame an America where people would rather die skinny than live a day in a fat person's body.
So why are so many individuals marginalized based on their body type and/or identity? I suggest that it's a systemic devaluation of bodies deemed culturally unworthy. The media perpetuates the idea that fatness is correlated with a loss of control, so essentially losing that weight is naturally seen as someone exerting control over their biology. In reality, health-based weight loss (which can be beneficial in reducing the risk of chronic disease and alike) can precede more dangerous disordered eating behaviors.
In male bodies (especially those of athletes), there is a meticulous culture around bodily maintenance for peak attractiveness and performance. Over-exercising is a symptom of an eating disorder, but society hasn't recognized the link between the two just yet (even if modern medicine has). There's also a culture built around masculinity and the suppression of emotion; this extends beyond just eating disorders and into the realm of all mental health concerns. Folx who identify as queer may also face conflicting expectations around body image and weight, as well as a fear of seeking treatment from non-inclusive health professionals.
There is also an underlying racial component to eating disorders that isn't often recognized. Black women are statistically more likely to suffer from binge eating disorder (BED) than white women; it should be noted here that many individuals still don't acknowledge BED as an eating disorder, which further disempowers those with the disease to get help. And although it appears that white women are statistically more likely to suffer from anorexia and bulimia, the potential for unreported cases due to stigma around black bodies skews these numbers. In one study, Latinx and Native American individuals were less likely to receive referrals for eating disorder treatment regardless of severity. In cultures where the Western ideal of skinniness conflicts with traditional norms around body image and weight, individuals may feel an immense cultural conflict.
My eating disorder has taken away so much from me: my time, my happiness, [possibly] my ability to have children, and my relationship with my body. I hope to God that no one will ever have to go through what I have, but I know that there are millions of people out there who have felt marginalized by the traditional profile of the "eating disorder victim" and feel disempowered to seek treatment.
It's about time we recognize that eating disorders don't conform to the traditional archetype of a small, white, female individual. Not only is this shift paramount in the realm of healthcare professionals, but also in our modern culture. Whether we realize it or not, the way we talk about eating disorders to one another might alter the way someone sees themselves and their ability to recover. We need to be more cognizant of our approaches to eating disorders, especially when so many cases go "undetected" annually. For some, losing weight, purging, compulsive eating, and/or restriction are a matter of life and death- not a cause for celebration.
For more reading:
Amid COVID-19 and Black Lives Matter, providers push for equity in treating eating disorders
Why You Shouldn't Assume That Only Thin People Have Eating Disorders
When it Comes to Race, Eating Disorders Don't Discriminate
To Hell and Back: The Untold Stories of Male Eating Disorders