Monday, February 21, 2011

Eating Disorders Are Not the End Point of Body Dissatisfaction

I don’t write that much about body image on here, for a variety of reasons. When I started this blog I wanted to talk about female personal beauty and appearance; body image is certainly a part of that, but there is already so much ink on women’s bodies that I didn’t feel like my time was best spent there. Also, because body image issues have high visibility, there’s a broader permission for women to be frank there than there is regarding overall appearance. (When was the last time a conventionally thin woman told you she was having a “fat day”? I’m guessing it was more recently than the last time any woman told you she was having an “ugly day.”) We’re fluent in the accoutrements of beauty—makeup, skin care, hair—but don’t frequently voice their essence, and that’s what I’m trying to do here. Body issues come up but I try not to make it my focus.

But the National Eating Disorders Association has declared it National Eating Disorder Awareness Week, and they’ve asked everyone who cares about eating disorders to do just one thing this week to raise awareness. I’m one of those people, and I have this forum, so I’m doing my part.

Here’s the thing, though: The connection between beauty and eating disorders is much more tenuous than it seems on first glance. I don't think that the end point of body dissatisfaction is an eating disorder; it’s not like she who is most dissatisfied wins the booby prize of an ED. Body dissatisfaction is one of many symptoms of an eating disorder; it is not a cause. Other symptoms of an eating disorder include what we usually think of as the disorder itself: restriction, bingeing, purging, weight loss, weight gain, compulsive exercising, chewing-and-spitting, and so on. 

So if those are the symptoms, what’s the cause? If you’re interested in that, you should be reading the excellent ED Bites; this entry gets to the heart of it. In short: It’s a complex mixture of biology and environment, like pretty much anything when you’re talking mental health. People had eating disorders before our culture’s thin-imperative struck so heavily; yes, they’re more common now, but I think that’s in part because dieting (which certainly is prompted by “thin is in”) can trigger a latent ED. We see—and love!—the neat story arc of a chubby girl who goes on a diet and everyone thinks she’s way purdy now but then it just goes! too! far! And then, of course, she gets help and is redeemed. But it’s not that the diet causes the eating disorder (plenty of people diet, healthily or not so, and don’t develop eating disorders; 8% of “normal dieters” do go on to develop one); it’s that restricting one’s diet can serve as a biological trigger for something that was there to begin with, whether that be further restriction or binge eating or whatever. When you’re not eating enough, or when your body’s resources are going toward digesting a compensatory high-calorie binge, your thinking is cloudy; if you’re biologically predisposed to having an ED, whatever safeguards you might have against it crumble a lot more easily.

Treatment professionals know this, and some laypeople do too; so why does awareness about eating disorders so frequently focus on body image? In part, it’s because everyone can relate to it—even people who are generally satisfied with their bodies have moments in which they bemoan something about it. So the 90ish% of people who don’t have an eating disorder read that compact little trajectory and are better able to sympathize. It turns an eating disorder from something stubborn and frightening and alienating into something that’s understandable; something that, for a healthy woman with body image concerns, has a ring of there-but-the-grace-of-God.

And also, it’s not like body image and eating disorders are unrelated. It would be disingenuous to say that people with eating disorders aren’t preoccupied with their bodies—some more than others, to be sure (there are plenty of ED patients who neither have body dysmorphia nor are fat-phobic, including not just binge eaters but anorexics too). But overall, the body is the focus for many, many women with eating disorders.

But that’s exactly why we need to be wary of making an exclusive link between body image and eating disorders. Because if we focus on the easy arithmetic of negative body image (severity x) = eating disorder, we do exactly what women with eating disorders do. We make the body the issue, when the body’s appearance is not the problem, nor the cause, nor the solution. We need to look at brain chemistry, family history, perfectionism, alienation from emotions, depression, anxiety, temperament, and more, in addition to the thin imperative, fat phobia, and even the mirror. And until we do, we’ll consider those root causes of eating disorders secondary to appearance. Do ED sufferers really need that message reinforced?

Of course I’m all for awareness of body image issues, for reasons that are so obvious that I’m not even going to list them here. I’m not arguing that we shouldn’t, say, be calling out messages that we find harmful, or that body dissatisfaction isn’t really a problem just because it doesn’t lead to eating disorders. It is a problem, and every woman has a right to a positive body image. I’m just wary of taking a mental illness and using it as a means of communicating a message that serves a different end, even if that message is essential to the well-being of all women. 

I especially don’t want to use ED sufferers to legitimize the way we watch like hawks over other women’s bodies, even if our intent is positive. One example of this: Emily Gordon's astute piece (not about eating disorders) about the (unfounded) rumors about Christina Hendricks dieting. “They’re Kate Winsletting her,” she writes of the fetishization of Hendricks’s body, seized upon all too often as a validation of how “real women have curves” (as if curveless women are impostors?); when Kate Winslet finally had enough of everyone gushing over her “real” body, she lost weight and became...unreal? Or something. But the point is, when we set up curvy women as somehow liberated and slim women as lucky, or sick, or beholden to a beauty standard—any of which may or may not be true—we keep the focus right where we don't want it: on their bodies. We stare at women's bodies and imbue them with all sorts of characteristics and qualities that may or may not be pertinent.

That is, we do exactly what women with eating disorders do to themselves. And I’m trying to opt out.


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