Eating disorders are mental illnesses and are incredibly complex. There is no one “catch all” cause. Each disorder, and why it presents, varies greatly from person to person, and each disorder comes to be through many factors; be it biological, psychological, environmental, or a combination of all three.
The most common, known, and researched eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. However, there are many other examples of disordered eating which are not diagnosable…orthorexia (obsessive behavior in pursuit of a healthy diet), diabulimia (diabetics who restrict insulin for weight loss purposes), strict food philosophies for weight loss that live under the guise of “wellness”, rigid exercise routines and compensatory behavior, compulsive eating habits, harmful practices of heavy food restriction or cleansing when you “eat too much,” or “fall off the wagon” with your diet. Disordered eating habits are all around us.
The landscape of disordered eating is vast and complex as well. Our culture supports and encourages us to live in the uncertainty it has created, to live in fear of food, and to constantly question, if not completely ignore, what our body knows inherently. We are encouraged to wholeheartedly adopt the limited and biased understanding of nourishment our society has created, we are asked to change along with its every whim and new discovery (did you know in the 1970’s eating sugar was recommended for weight loss?), and we are told to blindly follow society’s ableist approach to “optimized health.”
It’s shameful that as a society we primarily learn about eating disorders through the stories of white, small, able-bodied, cis people who are frighteningly thin. These stories are real, and yes, these people deserve medical care, treatment, tenderness, understanding, and the chance to heal. What is unfortunate about this portrayal is that it is vastly misleading and affects the care of people who fall outside of that stereotype. Aka: eating disorders are rarely diagnosed to people in larger bodies…even less so if the patient is a person of color, disabled and/or transgendered. Eating disorders do not discriminate. They affect people of all ages, races, genders, and classes. Until we learn and acknowledge this fact, folks will continue to be misdiagnosed or ignored in our medical system when seeking informed and inclusive treatment.
Eating disorders and disordered eating disproportionately affect those with low socioeconomic status. This often means that LGBTQ+ and BIPOC (black, indigenous, people of color) communities are unfairly affected. Food scarcity can create abnormal eating behaviors, as can poor access to fresh food, fast food and affordability. These and many other byproducts of food deserts and low availability can create a host of health challenges. When we discuss eating disorders, we need to highlight the increased physical and emotional stress an individual who experiences oppression faces. This stress takes an incredible toll on the body, so the harm is NOT “just” the emotional relationship to food and one’s body, but also other health markers like blood pressure, digestive problems, depression, mood disorders, sleep problems, depressed immune systems, heart disease, and increased risk of diabetes. This is not exhaustive – the list of health implications when living in a stigmatized body is extensive.
When looking to treatment, not many people who have eating disorders or disordered eating can afford in-patient care, and if one can, understandably, there is a deep mistrust of our medical system. The experience a person has in medical settings differs greatly depending on the body that they show up in. This means that, more often than not, oppressed folks do not get the care or support that they need, let alone the proper diagnoses. Moreover, what happens when you have an eating disorder and are in fat body? *I use “fat” as a descriptive word* A fat person is much less likely to get the same care and concern in the treatment of an eating disorder that a thin bodied person *again I use thin as a descriptive word* is going to get in the treatment of an eating disorder.
It is appalling that what is diagnosed as an eating disorder or disordered eating behaviors for a thin person is often prescribed by a health professional to a fat person for a health concern that is not correlated to their weight, as most if not all are not. This is called the weight bias or weight-based discrimination.
It is important to say that for many folks an eating disorder can begin as a coping mechanism. On the onset, the behavior may invoke a sense of control and autonomy, or it can be an escape or a numbing from a life experience, be it past or current. It is common for there to be co-occurring mental health challenges at play like anxiety, depression, substance abuse, obsessive compulsive disorder, and PTSD, just to name a few.
Eating disorders are complex and multifaceted. It is worth noting that they cannot be “cured” by self-love reminders on social media alone, though curating your feed is one of my first lines of defense for those who are struggling.
According to NEDA, over 30 million people in the United States suffer from eating disorders, and those are just the folks who actively seek professional help and are properly diagnosed.
Our newfound “health optimization” obsession (aka wellness culture) is making this all much more complicated and much worse. The terrifying truth of wellness culture is that it is diet culture, rebranded. This makes it more palatable to the masses and more insidious in nature. I’m willing to bet that the new “wellness” lifestyle brand showing up in your feed is still pushing the agenda that thin = health and fat = lack of health, and that we are in complete control of how our bodies look. Eighty percent of our body’s size and shape is determined by genetics. Why do we allow for variety when it comes to nature, animals and other cultures, but in our white patriarchal system we continue to hold fast to a singular standard of beauty and health?
The thin white ideal is making the vast majority incredibly unwell.
There is no neat and tidy way to discuss eating disorders. They are terrifying, isolating, all-consuming, subliminally and not so subliminally encouraged. They are fueled by capitalism, white normativity and “beauty” as social currency. It’s a slippery slope from disordered eating behavior to full-blown eating disorder. I believe that the vast majority of people have experienced disordered eating at some point in their lives or know someone who is severely affected by this backwards, unethical health paradigm.
Eating disorders are complex.
If you are currently struggling with disordered eating or an eating disorder, or know someone who is, please reach out to a professional who can assist you. I suggest looking for therapists, counselors, dieticians and nutritionists who specialize or focus in eating disorders and disordered eating. Look for those who work with or are certified in Intuitive Eating, HAES, and Body Trust.
Please visit my website for more information on my approach www.innatenutritionist.com. I offer free consultations, 20% off appointments for be.come project folks, and a sliding scale if needed. I offer appointments online or in person in Portland, Or. I am also happy to help you find a practitioner in your area who might be a better fit depending on your needs etc.
You have the right to define health as it pertains to you, and you have the inherent right to love and live fully in the body you have, just as it is.
The Body Is Not An Apology – Sonya Renee Taylor
Hunger: A Memoir of (My) Body – Roxane Gay
A Hunger So Wide & So Deep: A Multiracial View of Women’s Eating Problems – Becky Thompson
Intuitive Eating 3rd Edition – Evelyn Tribole & Elyse Resch
You Have the Right to Remain Fat – Virgie Tovar
Pleasure Activism – Adrienne Maree Brown
The Gifts of Imperfection – Brené Brown
Beyond a Shadow of a Diet – Judith Matz & Ellen Frankel