I’m going to do something different today. I’m going to talk about some of the problems I see in how eating disorders are discussed by some media organizations, ED awareness groups, and ED advocates.
This isn’t meant to be an exhaustive list of everything that’s wrong (and there will be a follow-up). It is my personal opinion and IĀ strongly encourage readers to leave comments if you disagree with me or feel that I’m missing something important.
I saw this quote on tumblr two days ago:
Anorexia is a young personās game and I donāt have the time or energy to play any more.
This quote is amazing for all the wrong reasons. It is soĀ wrong, so harmful, and embodies so much of what’s wrong with mainstream ED discourse.Ā It was written by Emma Woolf.Ā I traced the quote back toĀ thisĀ document put out by the UK organization ED awareness organizationĀ b-eat.
Let me be clear: I do not care who said this quote, or what was meant by it, or what context it was said in. The quote was floating around the internet, and most would read the quote out-of-context. This has nothing to do with Woolf, as I know nothing about her (I’m simply attributing it the proper source). I’m using this quote as a starting point to talk about some things that I think need to improved in how we talk about eating disorders. Especially when these discussion within the community, where the context and nuances might be well understood, reach the non-ED community and getĀ misinterpreted.
So, here is a list of some unhelpful and dangerous implications I see in this quote that I often see echoed in mainstream media.Ā
Framing anorexia nervosa (or any eating disorder) as a game ignores the seriousness and complex etiology of EDs.
- Instead of “anorexia” substitute, “major depression,” “social anxiety,” “schizophrenia,” “bipolar disorder,”or “post-traumatic stress disorder.”Ā They are not games, they are serious, and sometimes life-threateningĀ (and here) mental disorders, with lots of medical complications.Ā
- A “game” is something we choose to play. Eating disorders are NOT choices. Eating disorder have complex and multi-faceted causesĀ (see all the posts under “Etiology.”)
- (Side-note: someone with an eating disorder claiming it is a “choice” is similar to an addict claiming they can “stop any-time.” I think it has to do,Ā in part,Ā with the inability to understand or admit to oneself the seriousness of the problem, and the inability to admit to oneself that these maladaptive eating disorder behaviours are powerful, and thereby useful, ways to modulate emotions.)
Framing anorexia nervosa (or any ED) as being exclusive to young people or something youngĀ mindedĀ people engage in.Ā
- Anorexia nervosa and EDsĀ in general are NOTĀ exclusive to young people. A look through the post archives will reveal that for most studies I’ve blogged about, the mean age of participants is in the mid 20’s. Of course, this isn’t a representative look at all the studies published on ED patients, and I’m personally more interested in studies on adults with EDs. Still, these studies will disabuse anyone of the notion that EDs are for young people.
- If by young what was meant wasn’t “young in age” but “immature” then what about male veterans with EDs who are in their 40’s, 50’s, and 60’s? What about Princess Diana and countless other men and women that have done so much good for the world, and yet, at the same time, struggled with eating disorders. Eating disorders areĀ notĀ limited to a particular age group, gender, race or ethnic background, socioeconomic status, or sexual orientation.
Framing anorexia nervosa (or any ED) as something only people with extra “time” or “energy” to “play.”
- The idea EDs are something that only people with extra leisure time have is ridiculous. It implies, indirectly, that EDĀ sufferers are adolescents from middle-to-upper class families who just have way too much time on their hands.
- It also implies something even worse. It implies that once someone with an ED gets busy, you know, with a kid, or a real job, they’ll recover. They’ll recover because they just don’t have timeĀ for an ED. Don’t you wish recovery was that easy?Ā Just get a job already, will ya.Ā
- This implication frustrated me because I was going to blog about motherhood and eating disorders today. Women in their 20’s, 30’s, and 40’s who are pregnant or have a child and continue to struggle with EDs/disordered eating. They are not immature, they have no extra time, and yet they continue to struggle with EDs. Why? In part, probably because the traits that propel their ED (such as anxiety, depression, perfectionism) continue to dominate their lives.
And this is, in my opinion, the biggest problem with this quote.
Most importantly, framing anorexia nervosa (or any other ED) as a “game” shifts the blame on the patient. It isĀ BLATANT patient-blaming.Ā
- It implies that if someone hasn’t recovered, it is because they are not trying hard enough, because they are still stuck playing that childish game.Ā This glosses over the fact that some individuals invariably have more genetically-based EDs than others. Some have a long history of EDs or disordered eating, anxiety, perfectionism, and depression in their families, putting them at a disadvantage when it comes to recovery. Moreover, comorbid disorders also make recovery harder.
To quote myself here:
Furthermore, the precise influence of genes to environment will vary from person to person. For some patients, genetics may be the main factor, while for others, the environment might play a more important role in leading to anorexia [any eating disorder]. Naturally, this complicates the picture, in terms of research but also in terms of treatment. Perhaps–and this is just my hypothesis–this may explain why patients respond differently to various treatments. Perhaps a large part of [this difference is] due to differences in the degree to which genetic and environmental factors played a role in the development and maintenance of patients’ eating disorders.
- The quote also ignores that some people don’t have access to any treatment, or good treatment, or even understanding family members that are able to support them through recovery.
- Recovery is possible, at any age. (And high heritability does NOT mean genetic determinism and is ‘no cause for therapeutic nihilism.‘)Ā But it is wrong to assume that everyone can put their life “on hold” for recovery (money, responsibilities), that everyone has access to adequate treatment (money, insurance, location), or support (family, friends, partners). For some, even being diagnosed with an eating disorder is a challenge because of the misconceptions doctors have aboutĀ who gets eating disorders (Hint: your ethnicity matters).Ā
To reiterate, Woolf might not have meant the things that I think are implied in the quote (I doubt she did), but at the end of the day, it doesn’t matter. I used this quote as a starting point to talk about some problems I see in how we (as a society, I suppose) talk about eating disorders. My main concern is that individuals who don’t have an ED or don’t know anyone with an ED will come across quotes like this, and in their mind, they will get the impression that EDs are things young and immatureĀ girls “play,” and that recovery just means “growing up.”
READ MORE in my next post where I focus on what ED organizations and individuals with EDs who do any kind of awareness/advocacy work can do to improve the situation (in my opinion, of course).
Agreed. On all accounts. I hope your next one includes the fact that even ED awareness orgs continue to place the most blame on the media, insinuating that EDs are diseases of vanity, that all sufferers just want to be thin and pretty.
Yes! You have read my mind! It will be largely about that (I say largely because I don’t really plan my posts well in advance.) But yes, that’s exactly it. Thanks Jessica!
I think context can be important. Memoirs or diaries are usually very raw. If the above quote came from one of the above then i’m not going to knock her for that. Those are her feelings that are not dressed up. If not, then it could have been worded better for sure. Still though, I am a veteran of 39 lol i’m not offended because i can see where she is coming from. She is likely talking about the impact of the ed on life and health at an older age.
Missr, you are right in that if it came from a diary or something, then it is slightly different. Still–we make choices about what we quote from our diaries and I think we need to think about the implications of what happens when things get quoted out of context. Particularly how they appear to individuals without knowledge in eating disorders.
I don’t find it offensive at all, I find it unthoughtful.
“Women in their 20ā²s, 30ā²s, and 40ā²s who are pregnant or have a child and continue to struggle with EDs/disordered eating.” YES. I have a few friends with a history of EDs who are parents & one of them explicitly expressed frustration at the lack of specific spaces of discussion/support for pregnant women/mothers with eating disorders. I look forward to reading that post.
Re: this post – I agree whole-heartedly. I’ve always been incredibly annoyed by the simplification of EDs & the dismissal of EDs as a topic of complex discussion in an intellectual/academic setting. I also remember years ago, getting a newsletter-type email from NEDA that mentioned a contest they were having – & in the description, they specifically asked the written entries to be as simple/uncomplicated as possible – which, as a writer who appreciates anyone who captures the various nuances of mental illness, I thought was ludicrous.
I mean, if we don’t complicate our discussions of eating disorders in the public eye (& NEDA is arguably one of the most public of ED-related figures), how are public understandings of eating disorders supposed to change?
Definitely. It is in the works–but will probably come next week sometime. I really want to use this space to talk about things I think are not talked about often enough when it comes to EDs.
Yeah, exactly. I am just in love with Cynthia Bulik’s talk here: http://www.youtube.com/watch?v=zi2xXEz0JOg#t=5m25s
She calls it the “tyranny of face validity.” So spot on. I recommend 5:30 mins – 11 mins or so especially.
I am a recently pregnant, new mother. I got pregnant a month after a 7 month inpatient stay. Everyone said the baby would “cure” me. Nope.
Maya, I’m really sorry to hear that you are still struggling (though I wouldn’t expect a baby to “cure” anyone–EDs are very complex and it is not that easy, unfortunately). Are you receiving any additional support for your ED at the moment? (As I said, I will be blogging about motherhood/pregnancies in women with eating disorders next, perhaps it will offer some support or at least a feeling that you are not alone in the struggles and thoughts you are going through?)
Tetyana
I want to send this blog post to every single person who has ever, ever insinuated the above to me. I know I’m going to quote it in the future a lot.
Yes to the vanity thing, to choice, to playing games, to being immature, having too much time on your hands, to first world problems/rich white girl problems, to being manipulative..
I think another one that really gets my goat is that people with EDs are privileged, well-off, and have never been exposed to any kind of struggle so they ‘don’t appreciate how good they have it’. Comments being along the lines of “You’d appreciate that food if you were in Africa/third world country/drought/famine”
Yes, definitely. It is a shame that these myths still persist. Feel free to quote (please fix any spelling/grammar mistakes in the process, hehe), of course.
Thank you, thank you, thank you. So agree with this. As I mentioned to you on Twitter, I’m 32 and am currently dealing with a very severe bout of anorexia which came on at 30. (This is my second bout, the first occurring from about 22-23, though that was MUCH less severe and I got past it without medical help and without much trouble.) I have been struggling so hard for recovery and am just finally beginning to make some tiny bit of progress. When I see the way EDs are talked about with language like that – that it’s a silly thing, a “teenage” problem, something you can just choose to stop and “get over”…it makes me so angry and frustrated.
Even if the context of the speaker’s quote would change it a bit, as you said, most people will see it out of context, and all it does is add to the prevailing problem: the majority of people who don’t have an ED or know anyone close to them with one, know NOTHING about them and yet THINK they know quite a lot, because they watched a Lifetime TV movie or whatever. A quote like this just supports all that BS š
It appears to come from this online diary feature.
http://www.thetimes.co.uk/tto/health/article2803780.ece
”
Weād had this conversation before ā sometimes in anger, sometimes sadness or despair ā but this was different. We talked about the future with a new seriousness, all the happiness that could be just around the corner, if only I could get myself unstuck. Like most young women, Iāve always assumed that Iāll have children when Iām ready. But unless I gain weight (11lb to 22lb, according to my doctors) babies will not, cannot, happen for me.
Looking at T, thinking about our future, our baby, making a home, a family together, I think I want that more than I want to be thin.
When I remember the wasted years, the evenings alone, the friends lost, the conviviality and enjoyment of eating with others, all those shared meals Iāve avoided . . . it makes me incredibly sad. Iāll never get those years back. Anorexia is a young personās game and I donāt have the time or energy to play any more. Eyeing my running shoes later that evening, I realised that this was going to be hard to put into practice. Waking up and not running? Waking up and eating instead? How do other people do it?”
Ironically, I think quoting it out of context did her a favour. Reading the passage it is clear to me that this is a great example of exactly what I mean when I say the way we often talk about eating disorders in the media and in ED communities needs to change.
It is a shame, in my opinion, that present and past ED sufferers make these mistakes without thinking about the implications of these passages to present ED sufferers, an more importantly, to individuals who know nothing about EDs and continue to believe that sickness is defined by how low your weight is, that they are something only immature young girls struggle with, that recovery means “growing up,” and if you are not recovered, it is completely your fault.”
Also to clarify, by diary I meant something she had written when she was sick, maybe a few years back. She wrote this in the present tense, this is what she means and thinks now–it is not a diary, they are thoughts she has now that she is sharing in an article with the world, about eating disorders (trying, I presume, to “raise awareness”).
But most importantly: this has nothing to do with Woolf. I used the quote as a starting point to talk about what’s wrong with ED discourse in the media and in ED communities. Woolf is not the first, the last, or the only person to make these mistakes (I think they are mistakes, anyway). No one is perfect, and certainly I’ve probably made these same blunders, but I do think it is important to discuss it so that we can improve how we communicate about eating disorders to non-ED individuals, patients, families, physicians, and so on.
Cheers,
Tetyana
Hi Tetyana, I believe the quote is by Emma Woolf, not Emily.
Thanks for spotting that! I fixed that.
After reading the link to the article that features this statement, I have no reason to believe that it was meant to promote misconceptions about eating disorders. Perhaps, the quote was meant to reflect the author’s personal experience with her own eating disorder.
Unfortunately, the statement doesn’t convey that eating disorders are illnesses that affect diverse populations. I think sometimes there is too much focus on spreading general awareness about eating disorders and not enough focus on providing people with a deeper, more accurate understanding of the illnesses.
I would be curious to hear Emma Woolf’s thoughts about our discussion and find out what she was intending to communicate in her statement.
Varsha, thank you for your comment.
As I said, I don’t doubt at all that she didn’t mean to spread misconceptions about eating disorders. I do not doubt her good intentions at all. This has little to do with her quote, and more to do with criticising general eating disorder discourse. Her quote is one of many examples I can pick out from what’s on-line and in magazine articles. It was just something that came up recently, so I thought I’d use it as an example. As I said in the post, it is not about her, and it is not about her quote as much as it is about the message that these *types* of statements send the general public and eating disorder sufferers, regardless of their original intentions (which, as I said, I don’t doubt are good).
The point that I’m trying to make is precisely that it doesn’t matter what she was intending to communicate. What matters is how people who do not have eating disorders, who carry the myths about eating disorders (and some of these people are doctors, nurses, and healthcare staff, for example) will take away from her quote or her article which MissR quoted more of. We can’t ask what everyone’s intentions are with everything they write, which is why it is important to be clear and to think about the implications of what we write and how they will be understood or misunderstood by the general public.
I really have no intention to attack or single Woolf out. I am merely using her quote as a starting point to discuss much bigger and more important (I believe, anyway) issues. It has nothing to do with her, I could’ve invented a quote (and I almost wish I did because there’s too much focus on her and what she meant, when what I want to point out is what’s wrong with ED discourse more broadly). As I said, Woolf is not the first, last, or only person to say things of that nature.
Varsha, I agree with you completely in that I think what needs to happen is awareness about the complexity of eating disorder causes and the diversity of eating disorder sufferers.
Tetyana
Yikes. I’m starting to feel the need to go off and scan my own memoir for dodgy quotes. I’m aware that I wrote that bulimia is my new religion. …
I wouldn’t worry about it too much, Natasha. I am sure I’ve said tons of things like that in the past myself. I’m sure I’ve mentioned my lowest weight, how little I used to eat, or how much I used to binge and purge. I don’t mean to police any one, because that’s not the point. My point is just to discuss these issues and think about it a little deeper, think about what it means in the eyes of the non-ED public. I think because I’ve started thinking about it more (perhaps because of the blog), I felt it was an important thing to bring up. I don’t mean to say we should all rush out to edit everything we’ve ever written about our eating disorders to make sure there are no hidden and crappy implications in there. I’d rather just focus on the future š
Tetyana
A typical misconception in the media that frequently frustrates me is the ‘type of person’ who gets an ED – white, middle class teenage girls. As a male, when I was still suffering with my ED, I found my own condition consistently overlooked in general discussion. Even among my peers, I don’t think they realised that I had an ED. They knew something was wrong, but I was a guy, and men are hardly ever shown as having EDs. So I don’t think it really clicked for them. One friend even said to me, ‘You look positively anorexic!’ in a concerned way. So she could even say the disorder to me, but still not make that final link.
There has definitely been more emphasis on the fact that ‘men get EDs too’ recently, which is a good thing to increase awareness. However, this post has helped highlight to me that there are other niches with their own particular sets of circumstances that are still being ignored in the media.
Thankfully, I never encountered any stigma because of my gender when dealing with health professionals. I was always treated as though my ED was as ‘valid’ as anyone else’s, for lack of a better term. But I fear that many others may be overlooked because of age, race, gender etc.
Rian, thank you for your comment! I am so happy to hear that you didn’t face many troubles in getting proper treatment! I’ve blogged a bit about male experiences with eating disorders (under the sexuality & gender section, which hopefully in the future will be split into two, since they really are separate issues) and it is very eye-opening to read about personal accounts of males who’ve had to go through the ED treatment system.
One of the ED journals did a whole special issue on males with eating disorders, so I definitely agree that there has been more emphasis on the fact that “men get EDs too” (and I’m happy to see that organizations like MGEDT exist). I’ve been meaning to blog about some of the papers but haven’t gotten around to it yet.
I think there are so many issues here that need to be discussed and deal with, mainly, I think 1) male patients tend to be overlooked or not taken seriously (which is true for some ethnic groups as well), and 2) treatment often centres around issues that pertain mostly to women.
I’m curious to know what treatment was like for you? Did you do any group therapy or found yourself mostly surrounded by females?
Tetyana
I’ve also seemed to find that a lot of male sufferers themselves are not only under-represented in treatment and professional circles, but tend to have a problem in speaking out about their disorder. They seem to feel the stigma of being a man with an ED, so I hope that this can change.
I’ve found treatment to be a positive experience. I never did any group therapy, but I’ve only come across one other male who suffered from an ED. The rest have all been female, though I never looked specifically for men to connect with over this. I felt that my gender shouldn’t really be relevant – if someone else knew what it was like to have an ED, male, female, black, white, old, young, then we would have something to offer each other. Because I could communicate with others about my ED, and get support from them, my gender never seemed an issue. I wish that this was the case for other male sufferers who seem to have a harder time of it than I did in terms of the stigma they face.
But in treatment itself, again, my gender was never an issue. I was always taken as seriously as anybody else and all the proper procedures were followed. The staff were always professional and I built up a rapport with them. I felt comfortable discussing any issue because I knew that they would listen, and they never doubted the truth of my condition. I guess it helped that I was very candid with them in therapy sessions.
Treatment is very female-dominated though in terms of the staff. I requested to see a female therapist since I tend to relate to women better, but I think that for a lot of men this might be an issue, perhaps a fear of being misunderstood? So it’s very good to see MGEDT, which can address this issue.
Rian
Thank you for your response Rian, it is very informative and again, I’m glad you have a positive experience with treatment.