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Abigail Shaw
Writer, communicator, etc.
In memory of my 2016 Tumblr era and in honor of the 2026 GLP-1 era, I’d like to discuss an extremely detrimental side effect of this cycling trend of absolute thinness we have seen in the media with the rise of the internet and constant access to others. I don’t think it’s far-fetched to say social media and movie star crushes have led to an increase in disordered eating and body dysmorphia. Not everyone who struggles with their image has an eating disorder, but it’s a slippery slope to crossing that line and plunging off the cliff into diagnosis and maybe even death. Wow. Wasn’t that a mouthful of cliches. Let’s get into it.
Eating disorders (EDs) are serious psychiatric illnesses. On top of that, people with EDs are often misjudged and misunderstood due to a lack of understanding surrounding the cause of an eating disorder. People minimize the issue because thinness is the standard.
"Just eat a hamburger." Like, okay Bob, that's not helpful.
Data shows that most people will encounter an ED in their lifetime, whether it be themselves, a friend, family member, significant other, coworker, etc. Which means if we educate ourselves on what causes an eating disorder and how it affects the person struggling, we can help those around us. So that's what I'm here to do: give you some info to break down those social barriers so people aren't quite as afraid to ask for help. The more we understand, the more we can empathize.
Eating disorders are not caused by one singular thing, as previously thought in the past. So, naturally, we're going biopsychosocial on these bishes. Okay in all seriousness and in case you don't yet know, the biopsychosocial approach is the best way to educate oneself on a psychiatric illness, because it explores the different effects of biology, psychology, society, and culture on a person’s health and well-being. It's well rounded, and doesn't chalk a struggle down to one oversimplified label.
Anorexia nervosa was the first ED to be recognized as a psychological disorder in 1694. Then in 1959, binge-eating. Then finally in 1979, bulimia nervosa was recognized. Now, these are all in the DSM-5 and recognized and treated by mental health professionals all over the place.
Disordered eating comes in many forms, but they all have the same gist. Cognitive features include body dissatisfaction; including size, shape, and/or weight. When we don't like our weight or appearance, it's only natural to want to change it. The problem comes in when the methods to do this become unhealth, obsessive, and begin controlling one's life. This is the behavioral aspect. These can include binge eating, food compensation, dieting, emotional eating, and a weight lower than healthy for their age group, gender, and physical health. It isn't a one size fits all situation, so keeping an eye out for all of these behaviors is important. Binge-eating is classified as eating excessive amounts of food in a short time. Individuals with EDs may compensate for their food intake by self-inflicted vomiting, laxatives, exercising too much, or fasting.
And then of course, there's emotional eating which is me on Saturday night watching Criminal Minds reruns with my hand in an endless bag of chips while I cry about the state of the world. It's like I forget I can change the channel to something happy. Okay, I'm kidding, that was insensitive. But emotional eating really is eating when emotionally upset to make oneself feel better.
While there are three main types of eating disorders someone can be diagnosed with: anorexia nervosa, bulimia nervosa, and binge eating disorder, behavioral symptoms can sometimes overlap. Again, it isn't a one-size fits all diagnosis. It all comes down to dissatisfaction with one's body or appearance and partaking in harmful behaviors to force change on tone's body. Less common, but no less important, eating disorders include avoidant/restrictive food intake disorder; pica, consumption of nonfood items; and rumination disorder, repeated regurgitation of already swallowed foods.
Okay here's where we get to the interesting stuff... the Biopsychosocial effect!
Four of the eight key factors leading to an ED are are biological. These include:
Interesting Fact: Twin and adoption studies give a good amount of evidence to support the claim that many psychiatric disorders are associated with genetic disposition. Identical twins are more likely to share an eating disorder than fraternal twins or other siblings. Similar genes beget similar psychiatric issues.
Part of this biological component is linked to biochemical abnormalities, like around the hypothalamic-pituitary-adrenal (HPA) axis (the boss of the endocrine system). This is the part of the body that regulates our body's response to stress. We want to be in a state of homeostasis (think balance, steadiness). If our endocrine system can't get us to homeostasis, things inside of us get all out of control... inflammation, depression, eating disorders, and so on. This lines up with evidence that anxiety and depression have comorbidity with EDs. It all comes down to irregularity of neurotransmitters in the brain. There is no homeostasis.
While genetic predisposition is a huge part of many diagnoses, temperament of parents and immediate family members can lead to dissatisfaction, low self-esteem, or insecure attachment. Here is where we get into nature versus nurture, genetics versus environment, but the truth is, it's most likely both.
Three of those eight key factors leading to an ED are are psychological. These include:
The 5th edition of Health Psychology presents the theory that EDs can also be found in certain psychological situations, “such as the competitive, semi-closed social environments of some families, athletic teams, and college sororities”. These competitive environments create a breeding ground for a lack of control over one’s own emotions.
Have you seen arrested development? If so, I'm looking at you Lucille. If not, Lucille Bluth is constantly belittling her daughter's looks. It's disgusting. Reminds me of my one grandmother.
I mean it only makes sense that if children or young adults are constantly ridiculed by or in competition with a parent, friend, or sibling that they're going to develop some self image problems! I can't blame them! Especially when those thoughts and behaviors become so habitualized, they struggle to stop.
When someone understands that their eating disorder is an issue they would like to address, a part of them wants to get rid of the illness, while a different part of them continues to partake in risk behaviors. When they begin to lose control over their eating habits, they start feeling all kinds of shame which leads to even lower self-image. It's so much deeper than just telling someone to love themselves as they are.
But sometimes there isn’t a conscious goal to lose weight when an ED begins to develop. There may be an unrelated issue that the person is trying to cope with. The problem is how they choose to cope. Negative coping mechanisms can turn into dangerous habits, eventually allowing the person to feel a sense of control. The person begins to not realize when they’re even performing these habits.
Emotional well-being becomes linked to physical appearance. When someone wants to look a certain way to feel more secure and confident, they can become obsessed with their appearance. For example, this obsession may cause them to start dieting. That diet may subconsciously become an obsession with not eating over a certain amount of calories a day. At first, a person may not even realize they are developing an illness.
Behavioral therapy is a common way to treat an eating disorder because it dives into many areas of one's life and how one behaves both consciously and unconsciously. Cognitive-behavior therapy can be a great option since it focuses on motivating the patient to want to change their conscious behaviors. There's also family therapy. These sessions educate the parents and family members on how to be a positive force in the patient’s life surrounding their eating disorder. After a while, the patient will be able to be their own positive force without their family members playing such an active role. Therapy that involves a life-long plan is more successful than force-feeding a patient. They have to gain new cognitive pathways and develop new, positive habits.
It's like that cheesy proverb that says, "Give a man a fish, feed him for a day. Teach a man to fish, feed him for life." Hmmm. It dawns on me as I write that, that using a proverb about eating is a little ironic in this particular essay. On that note let's move onto the final piece of the puzzle.
The remaining key factor leading to EDs is... culture, class, and abilities.
Do you guys recall the "Superwoman Complex"? I don't since it was introduce din the 80s and I was born in 99, but I did read about it. The Superwoman Complex described a woman who had it all and could do it all. Culturally, thinness and “being fit” has become an important depicter of success and happiness of the perfect man or woman. A lot of psychologists noticed a strong trend of said complex in women they were treating for EDs.
A more specialized group seen with high rates of EDs are dancers, or really anyone who has to be on stage. Dancers are supposed to appear perfect on stage for their audience. Social expectations say they should be graceful and strong. Those who already have a great deal of self-discipline and a focus on perfectionism are the ones who fall into negative coping behaviors to deal with the social pressure put on them. The problem is when the need for perfection becomes and obsession.
While others are critical of their bodies and the movements they make, the dancers become hypercritical of themselves as well. They cannot control the opinions of others, but they can control the way their bodies look. The ED becomes a tool of control. Dancers can control their weight in place of what others are thinking. It is important for anyone in sports or activities where they are constantly being watched and judged to remember that the social expectations of those around them are not as important as their health and well-being.
The way people are treated in society based on their appearance and how they portray who they are greatly affects the way one views themselves. As much as we tell each other to just "brush it off", it's not so easy-peasy. For a few years, being thick was in. It wasn't such a big deal to have some extra weight on your bones (as long as you were still attractive... AGH can we never be free?!), but now the increasing standard of thinness is back and it's looking to stick. This growing societal ideal of thinness breeds new ideas, such as the objectification theory, where men and women compare themselves to the "ideal", internalizing the negative thoughts they gain towards themselves.
Internal aspects of eating disorders (biopsycho-) are treated more frequently, external aspects (-social) are less focused on. Many treatment methods for eating disorders focus on the biology of the brain and the emotions of the patient, not society’s impact on them. Cognitive behavioral therapy and family therapy have no effect on the society we live in, only the way we react to it.
Psychologists used to believe that psychiatric illnesses, like those of eating disorders, were caused by one single traumatizing event or biological abnormality, such as 'women with eating disorders had been sexually abused as children'. I’ve read articles that say the sole cause of an eating disorder is simply a negative coping mechanism to deal with depression. This oversimplifies the issue and makes people with real issues think, "Oh, well that's not me. I'm just thin" when really they are battling against their own bodies without help.
Eating disorders and body dysphoria have played a hefty role in my life and in the lives of my family members. Growing up, my paternal grandmother struggled with an eating disorder. While she is currently fairly healthy, she still has the same mindset that no one in our family is ever skinny enough. Her daughter, my aunt, is currently struggling with anorexia nervosa. For as long as I could remember, my grandmother instilled that mindset in her. I’m not entirely sure if my father has an eating disorder, however, he insists on lifting weights and working out three to four times a day. In a way, he obsesses with never having his “gut stick out farther than his chest.” In 2013, I got caught up in the family trend. It started with a need to impress my grandmother by being thin and making my dad proud by working out all the time.
By 2015, I was eating as little as I could, counting my calories religiously, refusing to eat certain ingredients and foods, and going to the gym or for a run at least six times a week. The comments that I was “just so thin” or “so tiny” started and it made me feel accomplished. Eventually, my stepmother started noticing just how stressful I would get when we went out to eat or had to eat with the family. Eventually, I went to see a new therapist, was diagnosed, and went from there. Currently, I am in remission and at a healthy body weight with a realistic BMI. I still run, but in a much healthier way. I also eat, and make a conscious effort to eat well.
Being a teenager during the 2016 “pro-ana” “pro-mia” Tumblr era left a mark on me and many of my friends. I hope this next generation of teenagers is able to recognize the absurdity and danger of how thinness is being praised and portrayed in the media and Hollywood today. Every time I see another GLP-1 ad or catch clips from movie premier interviews, I catch myself shaking my head. It’s too easy to get caught up in today’s beauty standards, so educating ourselves on the consequences and different causes of those consequences is essential to building a physically, mentally, and socially healthy generation of children and adults.
Note to everyone: Temporal wasting is not normal. Please eat.
And don't just take my word for it. here's a list of sources that informed my writing.
American Psychiatric Association. (2016). Feeding and Eating Disorders : DSM-5® Selections. Arlington, VA: American Psychiatric Publishing. Retireved from https://dsm.psychiatryonline.org/pb-assets/dsm/update/DSM5Update2015.pdf
Culbert, K. M., Racine, S. E., & Klump, K. L. (2015). Research Review: What we have learned about the causes of eating disorders - a synthesis of sociocultural, psychological, and biological research. Journal Of Child Psychology & Psychiatry, 56(11), 1141-1164. doi:10.1111/jcpp.12441.
Harris, J., & Steele, A. M. (2014). Have we lost our minds? The siren song of reductionism in eating disorder research and theory. Eating Disorders: The Journal Of Treatment & Prevention, 22(1), 87-95. doi:10.1080/10640266.2014.857532.
Heiderscheit, A. (2016). Creative Arts Therapies and Clients with Eating Disorders. London, UK: Jessica Kingsley Publishers. Retrieved from http://web.a.ebscohost.com.hclproxy.hastings.edu/ehost/ebookviewer/ebook/bmxlYmtfX zEwNzcwNzdfX0FO0?sid.
Morton, N. (2016). Eating Disorders : Prevalence, Risk Factors and Treatment Options. Hauppauge, New York: Nova Science Publishers, Inc. Retrieved from Retrieved from http://web.a.ebscohost.com.hclproxy.hastings.edu/ehost/ebookviewer/ebook/bmxlYmtfX zE0MDYzMDFfX0FO0.
Munro, C., Randell, L., & Lawrie, S. M. (2017). An integrative bio-psycho-social theory of anorexia nervosa. Clinical Psychology & Psychotherapy, 24(1), 1-21. doi:10.1002/cpp.2047.
Smart, R. (2010). Counseling a biracial female college student with an eating disorder: A case study applying an integrative biopsychosocialcultural perspective. Journal Of College Counseling, 13(2), 182-192. doi:10.1002/j.2161-1882.2010.tb00058.x.
Smith-Theodore, D. (2018). The Perfect Storm. Pointe, 19(4), 41. Retrieved from https://www.dawntheodore.com/copy-of-calabasas-style.
Stiles-Shields, C., Hoste, R. R., Doyle, P. M., Le Grange, D. (2012). A review of family-based treatment for adolescents with eating disorders. Reviews on Recent Clinical Trials, 7, 133–140. doi: 10.2174/157488712800100242.
Straub, R. O. (2017). Health Psychology, 5th Edition. Chegg. Retrieved from https://ereader.chegg.com/#/books/9781319067410.
Walsh, B. T., Attia, E., Glasofer, D. R., & Sysko, R. (2016). Handbook of Assessment and Treatment of Eating Disorders (Vol. First edition). Arlington, Virginia: American Psychiatric Publishing. Retrieved from http://web.b.ebscohost.com.hclproxy.hastings.edu/ehost/ebookviewer/ebook.
I write a lil something like this usually once or twice a month. Drop your email, and I'll send it straight to you. No newsletter format, no extra spam emails. Just the essay. (Mom this is for you.)
