ED hurts

A personal story that appeared in The Independent yesterday, questioned claims that anorexia is caused by the fashion industry, although being surrounded by our society’s glamorizaton of thinness can lure some young girls to diet or make it harder to break out of disordered eating. Young writer, Naomi Hooke, explained that, for her, she grew up feeling her body wasn’t good enough, and the cruelty and fears that accompanied normal body changes and fat gain and with puberty led to her problems. Most importantly, she urged readers to remember that even if someone appears “normal” weight, they could still be suffering, and that she was engaging in the most unhealthy behaviors and was most mentally anguished when she had a “healthy” BMI.

Understanding anorexia: A thin excuse

It was two days before Christmas, and for the third time in my 20-year-long existence I found myself having my blood pressure monitored, my blood taken for biochemical analysis and my mental state being assessed for risk of self-harm and suicide. Once again, I'd been admitted to an eating disorder unit, rescued from my own little world of self-destruction....It hurt to sit up, and hurt to lie down, yet I refused to believe that this was due to starvation and muscle wastage....

I'd suffered from anorexia to varying degrees since I was 11, hiding food and concealing my body under layer upon layer of clothing, and once again it had caught up with me....Although any measure to protect models at risk of eating disorders is to be applauded, to believe that the fashion industry causes eating disorders is to completely misunderstand this most complex of illnesses....Seldom is anorexia acknowledged as the life-threatening medical condition that it is. Many anorexics detest their bodies, refusing even to pose for family holiday snaps....As far back as I can remember, my self-esteem was low and I lacked confidence. Children can be cruel, and although they weren't the “cause" of my eating problems, the bullying I endured throughout my schooldays only added to my feelings of self-hatred.

It is often assumed that the distress in anorexia revolves solely around food and weight. However, the vast majority of eating disorder patients have numerous other difficulties, including low self-esteem or confidence, lack of self-care, and social difficulties. Sufferers are often presumed to pour over the pages of glossy magazines and starve themselves in their aspiration to become glamorous, thinner-than-thin sex goddesses. From my own experiences and from those of numerous other eating disorder patients I have met, I can say unequivocally that nothing could be further from the truth. Beauty has very little to do with eating disorders, and the desire to be thin is merely one of many symptoms. Rarely can a single “cause" be identified....

Focusing on weight and downplaying the gravity of eating disorders can be deadly, she tried to explain. There are those who think it’s just a teen fad or girls just trying to look like models, or even “a lifestyle choice.” Instead, it can be serious and take on an increasingly severe, deadly mental and physical life of its own, and some of these victims need help escaping. As she said:

My fall into the dark world of anorexia was never influenced by fashion or waif-like celebrities, though I knew others whose recovery from life-threatening illness was indeed hindered by the Western world's culture of thinness. I believe that the British Fashion Council's guidelines will go some way to protect the models themselves (of whom 40 per cent are said to suffer from eating disorders). However, I see problems both with the approach taken in Madrid of banning models with a BMI under 18.5, and the recent health certification scheme proposed in Britain.

Although BMI can offer a crude measure of physical health, it can never quantify psychological distress. Despite popular belief, low weight is not the only danger of eating disorders. There have been times in my life in which my BMI has been in the healthy range and yet my eating behaviours and mental state were far from healthy....

The idea that in recent years as many as one in ten healthy young persons has suddenly become afflicted with a mental disorder defies logic. No doubt, there are multiple contributing factors and wide individual variations. There is also no doubt that our culture’s incessant drumbeat against body fat and promotion of thin, “fit and healthy” bodies can both trigger and perpetuate the negative body images and disordered eating that have become the all too common female condition, and growing among men, too. Yet, our culture turns a blind eye to the deadly side effects of it’s anti-fat messaging.

Saddest of all, many eating disorder sufferers don’t realize how significant the role that food restrictions play — whether it be from that first diet, “healthy eating,” an illness, grieving, stress, or food fears — in triggering eating disorders. Many of even the most dramatic physiological and psychological things that are experienced can be normal, natural responses of human bodies to having been starved or had food restricted, as Dr. David Garner, Ph.D., director of River Centre Clinic in Sylvania, Ohio, has explained and the Minnesota starvation studies from the 1950s illustrated. If those with disordered eating were “made truly aware of the scientific evidence” about many of the symptoms they are experiencing, they can be helped and be less likely to persist in blaming themselves, continue self-defeating dieting, and feeling diseased and defensive, he’s said.

With growing numbers of young people getting caught into sometimes lifetimes of dysfunctional relationships with food or decades of full-blown eating disorders, caring people are desperately trying anything and everything if they think it might help prevent them. At the end of last year, the Italian government and fashion industry had adopted an anti-anorexia campaign, calling for a return to a "healthy, sunny, generous and Mediterranean beauty."

One question: Where are those images in the media to help young people see more of what the diverse range of normal, nourished bodies look like?