Emilee: The Story of a Girl and Her Family Hijacked by Anorexia reveals the cracks in our health care system, the institutions we are taught to trust, as well as our own prejudices and misinformation about eating disorders, mental illness, and addiction.
Informed by the personal body stories of the hundreds of people they have worked with, Reclaiming Body Trust delineates an intersectional, social justice?orientated path to healing in three phases: The Rupture, The Reckoning, and The Reclamation. Throughout, readers will be anchored by the authors innovative and revolutionary Body Trust framework to discover a pathway out of a rigid, mechanistic way of thinking about the body and into a more authentic, sustainable way to occupy and nurture our bodies.
Fat Talk is a stirring, deeply researched, and groundbreaking book that will help parents learn to reckon with their own body biases, identify diet culture, and empower their kids to navigate this challenging landscape. Sole-Smith draws on her extensive reporting and interviews with dozens of parents and kids to offer a provocative new approach for thinking about food and bodies, and a way for us all to work toward a more weight-inclusive world.
The co-host of the Maintenance Phase podcast and creator of Your Fat Friend equips you with the facts to debunk common anti-fat myths and with tools to take action for fat justice
Aubrey Gordon (she/her) is an author, columnist, and cohost of Maintenance Phase. Her work has been published in The New York Times, Vox, Literary Hub, SELF, Health, Glamour and more. Her first book, What We Dont Talk About When We Talk About Fat was released in November 2020. Her second book, You Just Need to Lose Weight and 19 Other Myths About Fat People, is a New York Times and Indie bestseller.
Amanda Martinez Beck (she/her) is a fat activist, body image coach, & author of More of You: The Fat Girl’s Field Guide to the Modern World
Sharon Maxwell (she/her) is a speaker; weight inclusive consultant; and fat activist
Melissa Toler (she/her) is a former wellness coach turned writer, speaker, and educator
Non-conventional eating disorder awareness organization run by Gloria Lucas (she/her). Her work focuses on eating disorder harm reduction.
Nic McDermid (she/her) is a fierce activist, feminist, advocate and content creator whose work focuses on disrupting the dominant discourse around weight and bodies, and challenging the ways in which certain types of bodies are both idolised and idealised.
Schuyler Bailar (he/him) is the first trans D1 NCAA men’s athlete. He is also in recovery from an eating disorder and self-harm.
Wednesdae Reim Ifrach (They/Them) REAT, ATR-BC, ATCS, LPC, NCC, CLAT, LCMHC, LPCC is Fat, Trans/Non-Binary, Queer, Disabled. They hold a master’s degree in art therapy and their specialities include Their current specialties include gender affirming care, fat and body activism, intersectional social justice, complex trauma and eating disorder treatment.
Ragen Chastain (she/her) is a Speaker, Writer, Researcher, Board Certified Patient Advocate, ACE Certified Health Coach and Functional Fitness Specialist. She primarily writes about the intersections of weight science, weight stigma, health and healthcare at the WeightAndHealthcare substack
SJ (they/them) is a Coach, Consultant, And Soon To Be Social Worker Focused On Fat Liberation Based In Anti-Racism And Anti-Colonialism.
Dr. Asher Larmie is a fat doctor campaigning for an end to medical weight stigma so that everyone can access fair and equal healthcare irrespective of the number on the scales.
Shira Rose (she/her) is an eating disorder therapist, LCSW who operates from a fat positive + Health At Every Size framework
Virginia Sole-Smith (she/her) writes about diet culture, anti-fat bias, feminism and health. She is a journalist whose latest book is, Fat Talk: Parenting in the Age of Diet Culture
FEDUP is a collective of trans+, intersex, and gender diverse people who believe eating disorders in marginalized communities are social justice issues. Their mission is to make visible, interrupt, and undermine the disproportionately high incidence of eating disorders in trans and gender diverse individuals through radical community healing, recovery institution reform, research, empowerment, and education.
Christyna Johnson, MS, RD, LDN is a non-diet registered dietitian specializing in eating disorder, disordered eating, intuitive eating, and body image. She sees the world through a liberation lens and advocates for collective care to move us forward.
Stacie Fanelli, LCSW is an AuDHD eating disorder therapist who discusses neurodivergence, EDs, intersectionality & treatment reform
Dr. Rachel Millner is a psychologist, Certified Eating Disorder Specialist and Supervisor, and a Certified Body Trust® provider. Her work is trauma-informed, fat-positive, anti-diet and rooted in feminist theory, relational theory, social justice, and body liberation
FEDUP is a collective of trans+, intersex, and gender diverse people who believe eating disorders in marginalized communities are social justice issues. Their mission is to make visible, interrupt, and undermine the disproportionately high incidence of eating disorders in trans and gender diverse individuals through radical community healing, recovery institution reform, research, empowerment, and education.
The EDC advances the recognition of eating disorders as a public health priority throughout the United States.
As a member of the Collaborative of Eating Disorders Organizations (CEDO), the Multi-Service Eating Disorders Association Inc (MEDA) strongly opposes the new clinical guidelines introduced by the @Ameracadpeds. We do not support intentional weight loss in children via the methods included in the guidelines, especially the recommendation of bariatric surgery and pharmaceutical products for children.
The AAP’s guidelines for childhood “obesity” are harmful, may increase or exacerbate eating disorders or disordered eating, significantly contribute to medical weight stigma and fat phobia, and are not in the best interest of children. We strongly ask the AAP to please reconsider the guidelines, and engage with the eating disorders community to reduce the potential for harm to children.
Why Eating Disorder Screenings Should Check for Addiction
By Timberline Knolls
Eating disorders and addiction are like partners in crime. Where one goes, the other often follows.
Up to 50% of people who are in treatment for an eating disorder also have a substance use disorder, while about 35% of those who are in treatment for addiction also have an eating disorder. Experts estimate that people who are suffering from addiction are 10 times more likely to have an eating disorder than the general population.
So why are these behavioral health conditions so connected?
The Battle with Body Image
Part of what ties these two conditions together is their connection with body image. Feeling uncomfortable with the size or shape of your body can be upsetting, and it can make even everyday activities too nerve-wracking to get through. When you spend nearly every day with that kind of stress, you may look to almost anything to change how you feel about your looks.
Some turn to over-the-counter medications like laxatives and diuretics, while others misuse prescription stimulants like Adderall® and Ritalin® and still others may use illegal drugs like cocaine and methamphetamine to control their weight.
For many people, abusing certain substances is the only way they know how to manage the distress they feel about their body. The unintended consequence: an eating disorder and addiction.
Numbing Difficult Feelings
But eating disorders don’t always have to do with the way someone feels about their body. Sometimes someone’s relationship with food is actually tied to painful memories or difficulty managing intense emotions.
Research shows that people who have an eating disorder are much more likely to binge eat on days when they are feeling depressed, anxious, or stressed. Eating in certain ways can be a coping mechanism in the absence of healthier strategies.
But if those feelings or memories become overwhelming, a person might try to self-medicate the emotional pain they’ve been experiencing by abusing a substance like alcohol or prescription painkillers.
If they don’t receive any sort of professional intervention, that puts them at a high risk for developing an addiction on top of the eating disorder they’re already struggling with.
Comprehensive Screenings Are Key
There’s no doubt that eating disorders and addiction can be intertwined in many ways. That’s why it’s so important for someone who has an eating disorder to also be screened for addiction.
By conducting a comprehensive evaluation before a person starts eating disorder treatment, their care team can assess whether their life has been impacted by substance misuse. This will allow the care team to create an eating disorder treatment plan that also integrates therapies and services that are geared toward addiction recovery.
Living with two behavioral health conditions can be incredibly challenging. But with the right treatment, it’s possible to live a healthy, productive and satisfying life.
Navigating Weight & Scale-Neutral Conversations With Your Doctor by Sara Remus, MEDA Social Media Manager
While the concept of Health at Every Size (HAES) is slowly making its way into the medical field, finding HAES practitioners remains a struggle. While they do exist, they are still few and far between. That makes it all the more important to know how to advocate for yourself when moving through the health care system, especially as it is very likely that many of your providers will not be HAES informed. In Massachusetts, there are just 14 healthcare practitioners on the official HAES registry.
This doesn’t mean that your provider may not share HAES values. It does mean that you should be prepared to champion your needs when visiting your doctor, and that goes well beyond your physical health. We’ve compiled some tips to help you guide your interactions with your health care team to a place that is safe for your body and mental well-being. Read on for some ideas for having a weight and/or scale neutral conversation with your doctor.
If you have the opportunity to communicate with your provider through a digital platform, use it to start the conversation.
Many health care facilities use secure digital patient portals to schedule appointments, provide test results, and offer payment options. This can also be a great resource for setting expectations when you request an appointment with your provider. Usually, these programs will give you the ability to submit a note when requesting to see your doctor. You can disclose as much or as little as you feel comfortable with. This is an example of how you could potentially make the request:
“Hello, I’m looking for an appointment to be seen for (insert issue and any details here). Please add a note in my request that I would like for this appointment to not involve any discussions around weight, and would prefer to not be weighed. If I must be weighed, due to something like medication whose dose is weight dependent, I request that the nurse and doctor allow me to be weighed with my back to the scale and not share any of my weight information with me.”
If you are comfortable doing so, you can share that you are recovering from an eating disorder, and that these sorts of conversations and having information about your weight tends to be triggering and not helpful in your recovery process. However, you are certainly not obligated to provide this information!
If there is not a patient portal available for communicating with your doctor’s office, you can also offer this information over the phone. If you’re not comfy doing so, you could also draft a hand-written or typed note that you can fax to the office ahead of time or hand deliver to any medical personnel when you arrive for your first appointment. You might find it handy to keep several copies of this note in your wallet or bag, so that you can hand it to a provider in a pinch. If, for example, should you end up in an emergency or last-minute situation where there isn’t time for the conversation to be had ahead of time.
If you have a behavioral health provider, ask them for help.
If you have a counselor, therapist, or social worker that is helping you through your recovery, ask them for advice in navigating your specific needs with a medical doctor. In many cases, your behavioral health provider will be happy to communicate with your doctor directly, with your written permission to do so. These communications typically happen over the phone or hrough a secure platform. You can ask to see what is being communicated between your providers (or not!). Your counselor, therapist or social worker can handle discussions with your provider that you may not feel comfortable having.
If you feel you are being diagnosed incorrectly due to your size, be vocal.
It is a sad truth that some health care practitioners blame weight as the culprit for illness or injury before investigating and addressing other potential causes. We know that weight is usually not the cause of problems that typically lead us to visit our doctor.
If you feel that your doctor is attributing your pain or condition(s) to your weight, try asking them the following questions:
If they insist that the issue is weight related and refuse to talk to you about any other potential causes, you can request to see a different provider. Having these sorts of conversations with your doctor can be quite uncomfortable, so if you decide not to push back on your provider, walk away from this appointment without answers and go elsewhere, that is completely understandable. It is important to remember that you are entitled to look for other doctors. When looking for a new provider, make sure to ask if they’re willing to have a weight-neutral discussion.
Lastly, if you have ever worked with a specialist for an eating disorder, they can be a great resource in helping you find educated medical practitioners suited to provide you with quality care that doesn’t revolve around weight. You may also find that asking around in your recovery group is a great way to find a doctor you can trust. Don’t be afraid to advocate for yourself. If that sounds a little scary, remember that it’s OK to lean on others for support!
What do Children’s Fairytales Have to do with ED Advocacy?
By Andrea Piazza, Primary Therapist at Center for Discovery
Diverse identity and body representation in children’s books is a crucial building block of a size inclusive culture.
The fairy tale princesses and character’s we grew up with have had an undeniably damaging effect on the expectations we set for our bodies. We grew up dressing like these characters for Halloween and pretending to be them in our imaginary games. What did we learn from these characters; that our looks are more important than our intelligence, that we need attractive bodies to have good lives? These narratives do not serve us. We need new narratives that take the good pieces from the classic stories we grew up with and then shift the focus from our bodies as a tool for power and security to our kindness as a tool for growth and happiness.
According to numerous studies, Body Dysmorphic Disorder has a prevalence rate of 2% to 13% in nonclinical adult student samples meaning its relatively common. Characterized in the DSM-5 as “a distressing or impairing preoccupation with slight or imagine defect(s) in one’s physical appearance.” Another to a recent journal article in The Journal of Family Medicine and Primary Care by Himanshu body dysmorphia is on the rise. It’s easy to see how media consumption plays into the way individuals measure their own features against the cultural beauty standards.
As an eating disorder therapist, I am constantly helping clients investigate their own body image development. Characters in the movies and books they grew up watching are nearly universal archetypes for the qualities one needs to possess as an adult… which tend to be physical. Patients will mention dressing up like Hercules or Princess Jasmine and subsequently looking at themselves in the mirror attempting to suck in their tummy or flex their muscles only to be overcome by a child’s sense of inadequacy. In even more heartbreaking stories patient share how they were so excited to dress up or pretend to be these characters with no initial self-doubt, only to have someone say they would need to eat differently to look like that character.
Imagine a world where the characters we grew up modeling ourselves around were diverse with realistic bodies and had goals that were about accepting oneself and or others. How would our dress up change? How would our play have changed? It’s said that we learn just about everything we need to know by age 5 or within a critical period from 5-7. Imagine a world where we learned about body neutrality and inclusion and diversity during our critical period.
The critical period is Noam Chomsky’s idea that language acquisition is learned during a critical period in childhood. It’s the reason it is so difficult to learn a new language as an adult and that its likely that we will always have some challenges speaking it even if we do. It also makes sense why it feels so much more natural to have conversations around the ways we want to change and modify our bodies than the things we appreciate or like about our bodies.
Larger bodies are also villainized in the stories we grew up with. They are the bodies that are drowned in the seas or beat out by stronger more able bodies. They are the bodies that end up alone and bitter.
Even worse than that people of color and people of diverse ability are often completely absent from the narratives we grow up with. In this moment of finally valuing diversity and inclusion we start to realize how intentional we need to be to make change because it’s not something we have been practicing. We need stories that highlight the powerfulness of inclusion and treat it as something normal and basic. Imagine if we saw as many montages about inclusion and accepting ourselves as we are as makeover montages…
Stories like Peter Pan in Everland by Andrea Lynn Piazza and Nicole Warren where tropes are countered on every page from having open discussions on autism and adaptive technology, to women working while the man vacuums, are incredibly important. Even the details in the story can lead to a huge cultural value shift and to an overall healthier and more inclusive society. We need more children’s literature and media, in general, that focuses on body acceptance and inclusion.
By retelling classics with inclusive casts of characters in diverse circumstances we can create a new set of fairytale heroes for our children and therein new healthier expectations for their minds and bodies. It is important to understand the profound impact of seeing characters of all abilities taking part in the stories we already know and love.
Bjornsson, A. S., Didie, E. R., & Phillips, K. A. (2010). Body dysmorphic disorder. Dialogues in clinical neuroscience, 12(2), 221–232. https://doi.org/10.31887/DCNS.2010.12.2/abjornsson
Himanshu, Kaur, A., Kaur, A., & Singla, G. (2020). Rising dysmorphia among adolescents : A cause for concern. Journal of family medicine and primary care, 9(2), 567–570. https://doi.org/10.4103/jfmpc.jfmpc_738_19
Hartshorne, J. K., Tenenbaum, J. B., & Pinker, S. (2018). A critical period for second language acquisition: Evidence from 2/3 million English speakers. Cognition, 177, 263–277. https://doi.org/10.1016/j.cognition.2018.04.007
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
https://www.amazon.com/Peter-Pan-Everland-Inclusive-Retelling/dp/1955077002
Dieting Apps for Kids Send All the Wrong Messages by Timberline Knolls
The American Journal of Clinical Nutrition has found that the incidence of eating disorders has more than doubled over the past decade. The emergence of dieting apps during that same time period is more than just coincidence.
In 2019, WW, the company formerly known as Weight Watchers, unveiled a health coaching app called Kurbo that is geared toward kids ages 8-17.
Kurbo’s website claims that the app helps kids and teens build healthy habits for life by picking what they eat, receiving weight coaching advice from experts, and then seeing progress in real time, but dietitians, doctors, and therapists noticed a number of red flags immediately.
Parts of Kurbo are based on the traffic light diet, a program first developed in the 1970s for children that has a murky track record. That regimen — and many elements of the Kurbo app — flies in the face of 2016 advice from the American Academy of Pediatrics (AAP) that said that children shouldn’t be placed on diets and the focus on kids’ health shouldn’t be on weight loss due to its documented association with eating disorders.
“Giving an app to your child to solve difficult problems like relationship to food, movement, and body is like taking a pill the doctor prescribed while telling you ‘there’s a 95% chance this won’t work,’” Rebecca Scritchfield, a registered dietitian nutritionist, author of Body Kindness, and owner of a non-diet medical nutrition therapy practice, told U.S. News and World Report in a 2019 article.
There are many healthy foods, like nuts and milk that Kurbo considers “red lights,” items that, while not restricted, are designed to be limited. It’s easy to see the dangerous path this could lead most 8- to 17-year-olds down rather quickly.
Kurbo isn’t the only calorie and diet tracking app children and adolescents are using. Apps like MyFitnessPal and Noom require users who sign up to be 18 or older, though kids can get around those restrictions pretty easily. But the fact that Kurbo is specifically targeting children as young as second grade is a different world.
If you have a child who has a difficult relationship with food, diet apps and food trackers aren’t the answer. Help your child listen to their unique body, teach them about body diversity, and stick to normalized eating patterns whenever possible.
Most importantly, encourage them to feel good about themselves. Real wellness is about much more than a diet.
TikTok and Its Effect On Your Teen by Rebecca Manley, MS, CTC, CCTP, MEDA Founder
Dieting is the most common precipitating factor in the development of an eating disorder. In the United States alone, 30 million people struggle with an eating disorder and every 62 minutes someone loses their life due to direct complications of their eating disorder.
As a teen coach, recently I have had increasing numbers of clients talk about the weight loss posts suggested to them on TikTok AND how these posts are harming their mental health and well-being.
41% of TikTok’s 800 million monthly users are between the ages of 16-24. This age group is already at a heightened risk of eating disorders and to encourage them to diet further is can be detrimental to their long-term mental and physical health. By promoting dieting and weight loss, as well as before and after transformations, TiKToK is perpetuating dangerous weight stigma, which is the second most common type of discrimination after gender. Weight stigma can increase body dissatisfaction, a leading risk factor in the development of eating disorders.
Adults think with their prefrontal cortex, the brain’s rational part, which helps with decision making, good judgment and an awareness of long-term consequences. On the other hand, teens tend to process information with the amygdala, the emotional part of their brain. In teen’s brains, the connections between the emotional part of the brain and the decision-making center are not fully developed until age 25 or so.
TikTok exposes tweens/teens with developing brains to weight loss messages constantly. Currently, children of any age can view these harmful messages and videos. TikTok accounts #dailyweightlosstips has 560 million views and #weightloss transformation (fat phobia fuel) has 28 million.
Many of these viewers are watching the videos, comparing themselves, which may lead them to engage in unhealthy behaviors, such as skipping meals, using fad diets, drinking home-made weight loss concoctions, drinking diet teas or excessively exercising. Our teens are not aware of the health risks associated with these actions. Dietary supplements, like teas and powders, are associated with serious health risks and side effects including organ failure, testicular cancer, heart attack, stroke and even death.
What can you do to protect your child?
*Talk with your child about the dangers of dieting and engaging in diet culture.
*In addition, watching weight loss videos and engaging in unhealthy weight loss behaviors leads to body dissatisfaction. The result of these behaviors can result in the development of a deadly eating disorder. They certainly result in lowered self-confidence and increases in anxiety and depression.
*Be a positive role model and talk about your body in an affirming way.
*Focus on health not weight in your house. Don’t push your child to eat and don’t push your child to restrict.
*Promote body positivity and diversity in your home and community.
*Discuss the importance of appropriate activity with your child. Emphasize the importance of moving for pleasure and how it helps our bodies feel better. Do not equate exercise with weight loss.
*Monitor your child’s social media use. Children under the age of 11 (6th grade) should not be engaging in social media.
*Slowly add social media to your child’s technology diet. Add one app at a time. See how they handle one before adding more. In addition to people, consider following a nature, cultural or arts app.
*Friend or follow your child on all social media outlets.
*Sign the TikTok petition at https://bit.ly/3cwTqdS to ensure that children under the age of 18 are unable to post or view videos under all weight loss categories.
If you think your child maybe struggling with an eating disorder or poor body image, MEDA can help. Contact us at info@medainc.org or call us at 888-350-4049. THE SOONER THE BETTER
MEDA’s Statement on WW’s App Kurbo
Dieting is dangerous—no matter your age.
Here at MEDA, we are seeing younger and younger people with concerns about body image, disordered eating habits, and a constant preoccupation with food, body, and exercise.
We are saddened and angry with WW for encouraging young children to focus on food morality, weight, and BMI through the use of their newly launched app, Kurbo. We stand with those who have voiced their concern and echo their thoughts: health is more than physical.
By encouraging people to focus on physical health—especially weight—we are contributing to an appearance obsessed culture that fails to accept and respect all body sizes and often neglects mental health.
This app does not recognize the multitude of factors that contribute to a person’s overall health, or normalize weight gain as a necessary and healthy part of child development and puberty. Children who grow up in households where weight is a common topic of conversation—which this app promotes–are at an increased risk for unhealthy attitudes and behaviors around food and body.
Research shows that weight stigma is linked to a decrease in both physical and mental health—often leading to depression and low self-esteem. Eating disorders and disordered eating habits are serious and can be life-threatening—and they affect people of all body sizes, races, genders, ages, and socioeconomic statuses.
We ask that you carefully consider the various risks and the emotional harm that come along with these types of tracking apps before using or suggesting to others.
MEDA continues to work with professionals, clients, and the community at large to further educate about the dangers of dieting in order to support those in their recovery and prevent others from struggling with disordered eating and body image issues.
Fatphobia is probably something you’ve heard about but didn’t have a name for.
Written by Meagan Mullen, Clinician and Community Outreach Specialist
It is no secret that our society can be judgmental, competitive, and appearance-obsessed. So it’s no surprise that people in bigger bodies can be treated poorly. Most people are probably aware of the fact that being in a bigger body comes with a certain stigma, and having negative attitudes or thoughts about these people is called fatphobia. Similarly, weight stigma is stereotyping people based on their weight.
These types of thoughts and beliefs can often lead to chronic dieting, disordered eating, or full blown eating disorders!
There have been plenty of articles (here and here) that highlight the dangers of fatphobia (and weight stigma!) and showcase how present it is in our society, but what do we do to work against this type of discrimination and unhealthy belief?
There are a few steps we can take to address this issue, and they might be easier to achieve than you think.
1. Recognize your own bias.
Just like with any type of discrimination or unfair treatment, it’s important to be aware of our own biases. It can be hard to live in a society with such apparent judgments on appearance and not catch ourselves slipping up. In a way, we’ve been taught to think certain things that we hear from others, from the media, or even from parents, friends, and family. That being said, acknowledging our own biases is the first step in changing our thought patterns and beliefs.
2. Challenge fatphobic thoughts you have or words you use.
When you catch yourself saying things that might have a negative connotation in relation to someone’s weight or size, STOP! Be patient and kind to yourself as you work against these beliefs that have been ingrained in so many of us. Try using language that is more neutral like “bigger-bodied,” or just drop the body descriptors all together!
3. Read up/learn more about Health At Every Size® (HAES) or body positive movements.
Research and engage with communities/resources online or in person to learn more about how toxic diet culture is! Not only will this information help to challenge some of your own biases, it will also provide you with the necessary language and information to educate/share with others.
4. Set boundaries with others in regards to their language.
If you hear someone else making comments that are fatphobic or degrading about someone’s weight or size, speak up! You can always try to educate others about the Health At Every Size® (HAES) movement, or you can simply tell people that commenting on appearance isn’t appropriate and can lead to negative body image and disordered eating. You can also talk with a trusted friend, adult, family member, or therapist to strategize ways to set these boundaries. My personal favorite: reminding people that there are more interesting things to talk about than someone’s body, diet, exercise, etc.
5. Advocate for and work towards body acceptance.
This is a lifelong goal! So many people are affected by negative body image, chronic dieting, and eating disorders. Helping others realize that a lot of what we’ve been taught about weight and size is false can continue the growth of body positivity.
While no single person can change the world alone, there are plenty of likeminded individuals who see the harm that fatphobia does. Working on these small steps in your own life can begin to change your thought patterns, beliefs, and might even improve your own body image!
Written by MEDA Undergraduate Intern, Lauren Kim
If you’re Asian American, you know that there is nothing good about hunger. Many of our parents, whether they came to the country as immigrants or refugees, know real hunger. They make sure that we never leave the house without full bellies and greet us when we return with heaps of warm homemade food. Food is our love language – the one thing that transcends the language barriers, the cultural differences, the generation gaps, and all the other things that keep us from saying “I love you” out loud.
But by twisted logic, food is also the enemy. If you’re Asian American, you also know that being fat in an Asian family is tantamount to falling short of making the honor roll. It is understood as an indication of personal weakness – a lack of discipline, laziness, failure. When you’re “fat” by Asian standards, it can be hard not to feel like a burden to your family because you’re told, either implicitly or explicitly, that the shame is not only carried by you, but by your family as well. And so, the burden of shame begins to feel even heavier.
What makes things exponentially more complicated is this idea of familial duty. Because so many Asian Americans are commonly raised on the rhetoric of hard work and sacrifice, we are ingrained with a deep desire to express our gratitude to our parents by fulfilling their hopes and dreams for us. For some, that might mean becoming a doctor or a lawyer. But for others, it could mean losing weight to get closer to the ideal Asian body – small, pale, and willowy thin.
One thing that sets Asian culture apart from others is the level of brutal honesty with which people speak. Time and time again, I’ve noticed that there is a general willingness to make comments, especially on other people’s appearances, which can be so abrasive that they sometimes err on the side of cruelty. When you are taught that being thin is a virtue, and that being heavy and being happy cannot be feasibly reconciled in one body, “fat” becomes the worst thing you can be called. So whether we want to or not, Asian Americans cannot help but internalize our culture’s guidelines on what a desirable body looks like, and by default, what its converse looks like.
Growing up, I resented the unreasonable expectations placed on me by my family and my culture and I looked to every family gathering with anxiety and dread. Being around extended family always meant one thing: that I’d have to bear hours of being force-fed excessive amounts of food by the same people who would tell me to my face that I had gained weight since the last time they saw me. And through it all, I would force a tight-lipped smile and try to maintain my composure. If I was ever so bold as to politely refuse the food that was offered, I’d be urged by my mother to “just be polite” and eat. And if I did accept the food and finished it, more would immediately be piled onto my plate, pressuring me to eat way past the point of fullness.
As my fellow Asian Americans know all too well, there is no winning when you grow up in this contradictory culture. The only thing that never seems to change is our culture’s steadfast commitment to a singular definition of beauty. In a world that has begun to promote loving yourself and finding beauty in your flaws, Asian culture has not managed to keep up. There’s an overbearing pressure to be perfect naturally, or to constantly be improving yourself if you’re not. This mentality helps to make sense of why plastic surgery is so prevalent and even normalized in Asian countries. Why love your flaws, when you can remove them, right?
It’s easy to see how these dangerous messages can encourage body dissatisfaction in the Asian American community and eventually manifest as an eating disorder. According to a statistic cited on the National Eating Disorders Association’s website, Asian, Black, Hispanic, and Caucasian youth have all reported attempting to lose weight at similar rates [1].
But there’s no way that you would know that, judging by what is commonly portrayed in the media. Eating disorders continue to be an issue that is typically attributed to white, straight, cis-gendered, able-bodied women of high-income backgrounds. Though we are slowly making progress in challenging this narrow-minded view of what someone with an eating disorder looks like, there is far more work to do. The lack of Asian Americans represented in the national discussion on eating disorders seems to indicate that many are still suffering in silence. According to Dr. Szu-Hui Lee, a clinical psychologist and director of training at the McLean Hospital at Harvard Medical School, Asian Americans tend to under-report mental health issues. She explains: “There’s a big stigma with seeing a psychologist. [Asian American] parents are more likely to send their kids to an academic counselor than a psychologist.” [2]
In a culture where optics matter so much, it is not hard to see why individuals with eating disorders struggle to speak up and ask for help. The stigma attached to mental illness is so severe in our culture that our parents are likely to respond to our pleas for help with fear, denial, blame, and anger.
As someone who has struggled with and recovered from my own eating disorder, I am familiar with this kind of reaction. When I found that I could no longer keep my suffering at bay, I rehearsed the words I wanted to say before mustering up the courage to tell my parents. Their response was dismissive at first, eventually evolving into frustration and then hopelessness. As much as they wanted me to get better, they didn’t understand why I was doing this to myself, and had no clue where to go for help. And when I tried to learn more about treatment and recovery on my own, I found that my background bore little resemblance to the movies I watched and the stories I read online. For a long time, it seemed like nobody understood quite how I felt.
While eating disorders certainly span all cultures, the way they are experienced can differ drastically depending on the culture in which an individual is raised. For me, being Asian felt like an obstacle to my recovery because I had trouble overcoming my shame and locating the resources I needed to get better. It is evident that the Asian American community is in desperate need of greater awareness and more resources catered to our experiences. Hiring people of different backgrounds and making efforts to provide intercultural awareness trainings for clinicians is a good place to start.
And to those who are recovered from or currently struggling with an eating disorder, don’t be afraid to talk about it. Allowing yourself to be vulnerable with someone you trust could be the first step to healing. It was for me. Uprooting a stigma that is so deeply entrenched in our culture can’t be done overnight, but we can start to chip away at it by exposing our suffering and finding strength in our shared experiences.
Like what you read? Check out Lauren’s final MEDA project, an E-Zine on the topic of eating disorders and body image in the Asian American community: https://issuu.com/kimlauren97/docs/eating_disorders_in_asian_america
[1] https://www.nationaleatingdisorders.org/people-color-and-eating-disorders
[2] http://www.mochimag.com/article/diagnosing-the-asian-american-eating-disorder/
Written by Monique Bellefleur, Ed.M, LMHC, MEDA Director of Community Education
I hear time and again from clients that they are afraid to go to the doctor’s office. I don’t blame them when I hear their stories: The doctor told them they were eligible for gastric bypass surgery (even though they had not asked about it and have an active eating disorder); They had a heart rate in the low 40’s and the doctor told them they were perfectly healthy (even though they had a BMI of 17 and an active eating disorder); They went to the doctor’s for a sinus infection and the doctor told them they need to lose weight. The list goes on…
However, it remains important to receive medical care. Although we wish the medical community understood more about eating disorders, we unfortunately have to learn to be our own best advocates until the medical community catches up.
Here are MEDA’s 5 tips for speaking to your doctor about their weight stigma and/or your eating disorder:
Resources to bring to your doctor’s office on eating disorders and weight stigma:
Citations:
Mahr, F. , Farahmand, P. , Bixler, E. O., Domen, R. E., Moser, E. M., Nadeem, T. , Levine, R. L. and Halmi, K. A. (2015), A national survey of eating disorder training. Int. J. Eat. Disord., 48: 443-445. doi:10.1002/eat.22335
Smink, F. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports,14(4), 406-414.
Every 52 min someone dies from complications due to an eating disorder and 28.8 million people in the US will struggle with an eating disorder.
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