[acb-hsp] How I Learned About Mainstream Myths About Eating Disorders Are Wrong

[peter altschul]

How I Learned the Mainstream Myth About Eating Disorders Was 
Wrong
  Autumn Whitefield-Madrano, Salon February 29, 2012
  A longer version of this piece originally appeared on Autumn 
Whitefield-Madrano's Open Salon blog.
  For National Eating Disorders Awareness Weekbwhich starts 
today-the Renfrew Center, one of the best-known eating disorder 
treatment facilities in the United States-is sponsoring a new 
campaign.  Called "Barefaced and Beautiful," it's encouraging 
women to post photos of themselves on various social media 
without any makeup.  The point is to ...  well, they sort of lost 
me on that.  I think the idea is to display pride in one's 
natural, unadorned self, the idea being that ...  you don't need 
to ...  adorn yourself ...  with an eating disorder?
  I'm being intentionally dense here.  Obviously the idea was to 
touch on the role of appearance dissatisfaction in eating 
disorders, using something plenty of people wear -- makeup -- as 
an entry point for talking about the larger issue.  (Certainly 
it's more on target than cryptically posting the color of your 
bra on Facebook for breast cancer awareness.) And for something 
like a week designed to raise awareness about eating disorders, 
you need a campaign that's simple, accessible and 
attention-grabbing.  But not only does the no-makeup rally 
willfully ignore the myriad reasons women wear makeup in favor of 
a one-dimensional shame-based explanation, it treats bodily 
dissatisfaction as the cause, not a symptom, of eating disorders.  
And if we keep the focus of eating disorder conversations on 
women's bodies, we're doing exactly what women with eating 
disorders do to themselves.
  We should be wary of conflating body image and eating 
disorders, because they're not nearly as connected as they're 
made out to be.  It's not like she who has the worst body image 
develops the worst eating disorder, or that people whose body 
image is average are immune from eating disorders.  (I have yet 
to meet a woman with an active eating disorder who has a good 
body image, but then again, I don't know tons of women with a 
good body image to begin with.) I'm baffled that Renfrew chose 
the makeup hook for its NEDA campaign, unless the idea really was 
just to raise awareness of the existence of eating disorders.  
("Anorexic" has been a coverline of enough celebrity magazines 
that I don't think we need any more awareness of that elementary 
sort.) Yes, makeup is deeply tied to our ideas of 
self-presentation.  It's also a method of controlling the way 
you're seen, and eating disorders are rooted in control.  But 
none of that shows up in the Renfrew campaign; instead, it's all 
about appearance dissatisfaction, as though that alone can set 
off a disease that ravages onebs life.
  Eating disorders are complex beasts, with not-great recovery 
prospects and the highest mortality rate of any mental illness.  
We don't entirely know what causes eating disorders, but last 
year when I interviewed Sunny Sea Gold author of "Food, the Good 
Girl's Drug and a recovered binge eater herself, she broke it 
down nicely:
  Therapists pretty much agree that there are three main causes 
of eating disorders, and most of us who get them have a 
combination of the three.  One is your genetics.  Second is your 
physiology, like the biology of your actual brain -- your 
personality....  The third thing is environment.  Environment is 
broken into two parts: the environment of your home, what your 
mom and dad said to you, the behaviors they modeled.  The other 
part of environment is culture.  So about one-sixth of eating 
disorders can be blamed on cultural environment, like the 
pictures we're shown. ...  If we magically were able to suddenly 
change the images we see in order to be diverse in all ways, 
gradually that part of the pressure would relieve itself.  But it 
wouldnbt relieve that need of a girl to control her food intake 
because she can't control her life.
  It's that last part that continues to get short shrift in the 
popular media.  I get why the press might latch onto the thin 
imperative as the root cause of eating disorders: Media outlets 
love nothing more than to generically critique themselves (what 
women's magazine hasn't covered the problem of unrealistic body 
ideals formed byband the media?).  Less cynically, poor body 
image is something most of us have experienced at some point; 
using this as a hook for readers to empathize with eating 
disorder patients works beautifully.  Plenty of people have 
dieted to lose weight for aesthetic reasons, and the disordered 
thought loop that makes a satisfying eating disorder story -- I 
was obsessed with food! -- is mimicked in the dieting mind-set.  
So the average reader may think she's identifying with the 
subject, not realizing that what she's identifying with are the 
symptoms of an eating disorder: the restriction of food, or the 
overconsumption of it, the vigilant attention paid.  But the 
eating disorder doesn't lie within its symptoms.  It lies within 
its causes.
  Listen, I'm not saying that there's no connection between 
appearance and eating disorders.  Of course there is.  And body 
image is an essential topic to so many women's lives -- including 
women who have never exhibited a single eating disorder symptom 
in their life.  Do I even need to point out the ways in which 
having poor body image is a drain of our reserves? Of enormous 
intellectual and psychic energy? Of time, of money, of already 
precious resources? Of emotion? Do I need to ask how many times 
women have asked "Do I look fat in this?" because we lack the 
words to ask for support and tenderness? As long as we have poor 
body image, we walk through this world ashamed.  So, yes, we need 
body image work, and we've needed it for a long time.  And a week 
devoted to eating disorder education is a good time to 
reinvigorate that conversation.
  But eating disorders do not run parallel alongside a track of 
bodily dissatisfaction, and the more we conflate the two, the 
less we're tackling the true complexity of eating disorders, and 
the less we're looking at the threads that unite patients more 
deeply than hating their thighs.  We're not looking at 
perfectionism, or the twin sisters of compliance and rebellion, 
and how all of these play out in the lifetime of an eating 
disorder.  We're not looking at biology, or heredity, or giving 
proper diligence to plain old depression and anxiety.  Hell, 
we're not looking at stress.  We're not looking at choice, 
autonomy or modernity.  We're not looking at the role of trauma, 
or sex, or comorbidity with addiction.  And it is impossible to 
treat eating disorders without treating all of these as seriously 
-- no, more seriously than -- body image.
  It's one thing for the media to treat body image with greater 
weight than, say, family dynamics in eating disorders.  It's 
quite another for a treatment clinic to do the same.  The Renfrew 
Center certainly doesn't take this approach in treating its 
patients.  When I was treated at Renfrew for my own eating 
disorder a few years ago, I was repeatedly struck by how little 
body image came up as a topic, both from the counselors and my 
fellow patients.  That's not to say it wasn't important; it was 
more that we'd all thought about our bodies so much by the time 
we landed in treatment that we were chomping at the bit to give 
voice to the things that we truly needed to be able to talk 
about.  I could deconstruct body standards before treatment as 
fluently as I can now.  But before entering Renfrew I had no 
words to tell you about the factors that took me 25 years deep 
into an eating disorder before I committed to getting help.
  The link between appearance and eating disorders isn't that one 
causes the other; it's that they're both partly rooted in 
expectations of properly gendered behavior.  (It's worth noting 
here that while plenty of straight men develop eating disorders, 
gay men are at higher risk To untangle the social angle of eating 
disorders, we need to look beyond the mere existence of the thin 
imperative and look at what it says about the role of women: that 
we are to be perfect, controlled, managed and compliant -- themes 
that come up repeatedly with eating disorder patients, themes 
that get to the crux of the matter more directly, without taking 
the meandering detour through our bodies.
  Makeup, too, can say a lot about those issues.  It's not the 
worst motif Renfrew could have chosen for its campaign.  Nor is 
it the best.  I'm no P.R.  expert; I have no idea how the clinic 
could have better channeled its extraordinary work into a simple 
campaign for the public to engage with.  I just know that by the 
time I was discharged from Renfrew, I'd finally begun to learn 
that my dissatisfaction with my body wasn't causing my eating 
disorder; it was merely a symptom of my disease, like restricting 
my food intake or binge eating.  I'd begun to take the focus off 
my body and put it into understanding the roots of my 
perfectionism, my people-pleasing, my family history, my silent 
shrieks of rebellion.
  I'd begun to understand that loving my body wasn't the point.  
The point wasn't even to like it.  The point was to learn how to 
eat.
  Autumn Whitefield-Madrano examines beauty at The Beheld.  Her 
essays have appeared in Glamour, Marie Claire, and Jezebel, and 
she is a contributing editor at The New Inquiry.
  ininB plus Alterationet Mobile Edition