Anorexia nervosa is one of the most prominent mental health diseases in the United States and the rest of the world.  It directly affects millions of young women in the United States, but indirectly affects even more. For every case of overt anorexia nervosa, there are many more possible cases or borderline cases.  That’s where the problem lies – the signs of anorexia nervosa are not always obvious, and people who aren’t showing outward anorexia nervosa symptoms can still be sensitive to insensitivity about people’s weight.

The causing factors of anorexia nervosa aren’t known exactly; it’s thought to be a combination of genetic factors (children of anorexic parents have a much higher rate of developing the disorder). Biological factors (women are affected more commonly than men), and the person’s environment.  One factor that’s almost always present, however, is a distorted body image and fear of gaining weight. People with anorexia nervosa symptoms will avoid eating to the point of malnutrition in extreme cases, and distorted and negative feelings make them more sensitive towards even off-handed comments about weight – even if it’s not aimed at them.

The Psychological Impact of Insensitivity

Whether or not they are getting professional help for anorexia nervosa, people with body dysmorphia tend to take any kind of negative comments about weight personally, even if they’re just a joke or are tossed off casually.  Even media representations of “thinness” or “fatness” can have an impact. 

  • For example, a person with anorexia nervosa may look at a Weight Watchers before and after image in an advertisement.  Whereas a person without a distorted body image might think to themselves, “I could stand to lose a few pounds,” a person with body dysmorphia might think they look like the “before” picture and pledge to try even harder to lose weight – even though they may be dangerously underweight.
  • Fat-shaming in other forms of media can also reinforce disordered feelings and behaviors associated with anorexia nervosa.  A movie comedy that portrays overweight people as comically lazy, gluttonous fools, like The Klumps, can unwittingly signal that being overweight makes someone a bad person.  When added to an existing fear of gaining weight (which is a prime symptom of anorexia nervosa), this kind of portrayal can doubly reinforce someone’s attempts to avoid food and caloric intake and take ever more extreme measures to counteract what food is taken in (through excessive exercise, etc.).
  • Although there has been a recent trend in advertising and modeling circles to promote inclusivity for more body types and weights, there is still a tendency for stick-thin models to grace the covers of magazines and billboards.  In many cases, the images are photoshopped to reduce curves as well as eliminate “flaws.” This creates an extremely unrealistic ideal of attractiveness and beauty that can have a huge impact on people who are already sensitive to negative feelings about themselves.

It’s important to note at this point that no one should be expected to curtail their speech or walk on eggshells all the time.  It’s just that thinking about the potential consequences of these kinds of jokes beforehand might be able to help avoid pushing at-risk people further into disordered behaviors.  In addition to the ways the media can unknowingly (perhaps uncaringly) perpetuate eating disorders like eating disorders by preying on sensitivities about body image, there are even more ways that insensitivity to eating disorders can keep them going.

Recent Controversies Bring Eating Disorder Issues to Light

Anorexia nervosa has been listed in the DSM-5 (the national official listing of mental health disorders) for over 60 years, and it’s generally among the more well-known mental health disorders.  Anorexia symptoms are familiar to most people: avoiding food and eating, extreme weight loss, repeated dieting, malnutrition.  However, even though it’s relatively well-known to the general population, and has been recognized by professional mental health, experts, the modern age has brought new challenges to inadvertently promoting eating disorders

Casual Fat-Shaming by Businesses

The recent controversy surrounding “fat-shaming” dinner plates brings this issue to light.  Earlier this year, Macy’s began selling a series of plates at their stores. These plates had concentric circles on them, with different messages, from “skinny jeans” on the smallest circle to “favorite jeans” on the middle circle, to, finally, “mom jeans” on the largest circle – the clear implication being that if you want to be “skinny,” you can’t eat a full plate’s worth of food.  

Macy’s and the plates’ manufacturers claimed they had not considered that these products might promote eating disorders, especially anorexia nervosa.  They instead thought the plates would be quirky additions to a dinner set which would “raise the important issue of portion control” – although they were aimed at women, who have higher rates of eating disorders in general and anorexia nervosa in particular.  To their credit, when the controversy was raised, Macy’s did pull the plates from their stores. But why was this an issue?  

It’s quite simple – people who have eating disorders almost always have two sets of behavior in common – a distorted sense of their body weight or size, and a history of dieting and disordered behavior with food.  So, when this person, who is already concerned or obsessed with not being “fat,” sees a product that pressures her into eating smaller portions to fit into “skinny” jeans, it can compound existing feelings of being overweight.  That leads to further food restriction, which of course can have severe health consequences.

These plates are certainly not the only product that have accidentally promoted eating disorders or negative body image (which can lead to them).  But they do pinpoint how an insensitive comment or product can make a bad situation worse, and perpetuate an unhealthy mindset. Worst of all, they can take someone on the precipice of showing the signs of anorexia nervosa to a full-blown disorder.  

Social Media Bullying

Social media, including Facebook, Twitter, Instagram have totally saturated our lives, and especially the lives of the younger generations.  While they fill a useful and fun role in people’s lives, spreading news and ideas, and allowing people to connect socially, several difficulties come along with them.  As they relate to eating disorders like anorexia nervosa, social media platforms come with two major issues – bullying and the presentation of impossible beauty and weight standards.

As reported by several outlets in the US and the UK (it’s easy to forget that the need for anorexia nervosa recovery is not only an American phenomenon), bullying on social media platforms is a serious, endemic problem.  In the past, bullying at school and after-school activities was, of course, a problem, but since the 2010’s the presence of social profiles have taken the opportunity for bullying to come into young adults’ homes and phones as well as their in-person lives.  Kids who are harassed at school for their weight and appearance might get ganged up on when, for example, they post a picture of themselves. This can exacerbate nascent symptoms of eating disorders and push young adults struggling with negative body image into a more destructive, disordered pattern of behaviors.

Bullying goes far beyond mere insensitivity, though.  However destructive it is, a far more pervasive issue with social media and eating disorders is the presentation of impossible weight and beauty standards found on social media platforms like Instagram. We highlight Instagram because it is image / video-focused.  On Instagram (and of course other platforms) people tend to post images of themselves that are carefully curated to highlight their best sides and those which make their lives look like a never-ending stream of achievements and positive memories. This isn’t inherently bad – however, when it centers around dieting, a social profile can make people with eating disorders or developing disorders feel worse about themselves.

People with anorexia nervosa, bulimia nervosa, and binge eating disorder almost always have a troubled history with dieting, often trying several different kinds of fad diets.  These might include juice cleanses, keto diets or other types which restrict certain food groups, or calorie-counting diets which promote smaller and smaller portions. When someone with a distorted body image, who perceives themselves as overweight in the face of contrary evidence, sees a social media profile featuring weight loss through a particular diet, they may feel a compulsion to dive headfirst into that diet.  When it’s a friend or colleague whose profile features these kinds of posts and images, it can be even more compelling than when a celebrity or influencer posts them.

Of course, influencers can also be problematic when it comes to what and how they post about diets and weight loss programs.  Influencers are people with large social media followings, who are paid to promote products and services on their social media profiles.  This can be extremely lucrative. Influencers are often models and other beauty industry professionals, meaning they have a clear profit motive to promote weight loss products and services.  

The images and videos influencers use to promote these kinds of product are often altered via Photoshop or a video editing filter, and they are consciously shot to make the influencer appear skinnier than they are.  This contributes to poor body image and consequently the development of eating disorders by creating an unreachable goal. People who are already dangerously dieting can feel a need to go even further or adopt an entirely new dieting strategy when exposed to these kinds of images and promotional campaigns.

Insensitive Comments and Products Influence Disordered Behavior

It must be said that there is usually no malice in the types of insensitive behavior we’ve outlined.  The producers of the plates or social media influencers aren’t trying to cause eating disorders, of course.  However, the prevalence of advertising and media, both traditional and social formats, in everyday lives means that we are all bombarded moment to moment by images and ideas which affect how we think and feel about ourselves.  That leads to neurosis and often, to disordered behavior – whether that’s an eating disorder like anorexia nervosa or another behavioral health disorder.

If you or a loved one is struggling with body image distortions or showing the signs of anorexia nervosa or another eating disorder, don’t hesitate.  Contact us at (866) 511-4325 or click here to speak to our compassionate admissions team and get started on the path to a full recovery today.

Carrie Hunnicutt

With 20 years of behavioral health business development experience, Carrie combines world-class marketing, media, public relations, outreach and business development with a deep understanding of client care and treatment. Her contributions to the world of behavioral health business development – and particularly eating disorder treatment – go beyond simple marketing; she has actively developed leaders for her organizations and for the industry at large.

Oliver-Pyatt Centers is grounded in mindfulness and the belief that each person has the capacity for a mindful relationship with food and their body. Present in every aspect of our program, this philosophy encompasses nutrition and eating, as well as movement, with an emphasis on becoming free from negative habits, behaviors and rigidity. We work from a place of empathy and wisdom, using a medically grounded, psychologically gentle approach.

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