In our society, there’s a common belief that thin models and unrealistic images in ads and magazines cause eating disorders, specifically anorexia nervosa.
But the thin ideal (the desire for thinness) doesn’t cause anorexia. Instead, it plays a different but still damaging role, writes eating disorder specialist Sarah Ravin, Ph.D, in a recent post on her website.
This distinction is important because saying that eating disorders are the result of wanting to be thin trivializes these serious illnesses and makes it seem like EDs are a choice. It’s like Dr. Ravin says: You can’t choose to have anorexia any more than you can choose to have autism or schizophrenia or epilepsy.
Remember that genes play a pivotal role in contributing to ED vulnerability. If you don’t have the genetic susceptibility to anorexia, you won’t have the disorder, explains Dr. Ravin.
In her post, Dr. Ravin lists the significant ways the thin ideal does impact anorexia. I’ve featured several of these ways, because they’re critical to our understanding of anorexia and the impact of society’s disordered view of weight and food.
The thin ideal postpones diagnosis and treatment.
In our society, losing weight is like acing a test, getting a promotion or winning a competition. Sadly, it’s seen as one of the greatest things we can do in our lives, and people will praise you up and down for it.
How often have you decided to eat a salad and someone comments on your virtuous willpower? Or left a few bites on your plate and someone says how wise you are not to eat the whole thing? Or worse, how often have you been sick (with something just awful), and as a result lost weight and received several compliments on your “new” look? Or how often do people envy others who can’t go a day without hitting the gym or the pavement?
This kind of environment makes it that much harder to spot symptoms of anorexia and get the person in treatment. As Dr. Ravin writes:
Since the population is so consumed with dieting and losing weight, children and adolescents in the early stages of AN are usually praised for their willpower around food, for their strenuous exercise regimens, for their avoidance of “fatty foods.” Parents, friends, and even pediatricians will commend kids for losing weight and compliment them on their slim appearance. In their own zest for thinness, adults seem to have forgotten that it is neither normal nor healthy for a child or teenager to lose weight. In this “thin is in” culture, a patient’s AN is often not recognized until he or she is emaciated and visibly ill.
The thin ideal sabotages full recovery.
Even clinicians get caught up in our thin-crazed culture. According to Dr. Ravin, clinicians may set a weight range that’s simply too low for full recovery from anorexia. She writes:
Clinicians often set a target weight range that is much too low for full physical and mental recovery. Eating disorder thoughts and behaviors, as well as the associated anxiety and depression, begin to melt away only when a patient has reached and maintained his or her unique optimal weight range.
When patients reach the BMI that no longer classifies them as underweight (18.5), they’re complimented for their thinness. Not surprisingly, this just reinforces and perpetuates their disordered thinking and the idea that thinness is beautiful and desirable and fatness is anything but. We’re all built differently, so a BMI of 18.5 may be healthy for one person and incredibly unhealthy for another.
The thin ideal fosters fear, guilt and shame around food and fat.
It’s safe to say that our culture collectively fears food and feels guilty for eating “bad” foods like dessert, pasta and fries (anything that’s not a “diet food”). As Dr. Ravin writes, people view themselves and others as bad for eating them. (“I was so bad last night because I had a piece of cake.”) We also feel guilty for not exercising and fear gaining weight.
This is damaging for people with anorexia. According to Dr. Ravin: “This societal moralizing around food and weight validates the symptoms of AN in its early stages and triggers their recurrence when a patient is trying to recover.”
While Dr. Ravin doesn’t think that a more voluptuous ideal would eliminiate or reduce anorexia, she does think it’d make a significant difference in how patients are diagnosed and recover and in how we view anorexia. She writes:
But I believe that patients would be diagnosed sooner, treated earlier, restored to higher (and healthier) weights, and feel somewhat less triggered to restrict after remission. Perhaps the public would also be more apt to see AN for what it really is: an agonizing, life-threatening mental illness that destroys a person’s physical and emotional health.
And, please, remember that the weight-loss and diet industries are the ones that have mainly constructed and perpetuate the thin ideal. There’s nothing virtuous, more attractive or more desirable about being a certain shape or weight. The reason thin is in is because it pays these industries. They get paid when we don’t feel worthy.
Do you think our society is clueless about eating disorders and what causes them? Do you think the thin ideal complicates or delays treatment and recovery?