Sticks and Stones
Social media has conditioned Americans to internalize the "thin-ideal" and has ultimately cultivated an extremely judgmental society.
Her hips are huge.
He’s way too skinny.
Her nose is too big.
Her eyes are so far apart.
He is so fat.
In a world where the size 0 model is the norm and the new size 10 Calvin Klein model is considered “plus size,” conversations focused on judging others’ body shapes are all too common. The effects of these comments can kill someone, both emotionally and literally.
Sound dramatic? Say all of this to me a year ago and I would have definitely said yes. I have seen countless teammates and friends battle eating disorders and I was never fully able to understand what they were going through.
A turning point for me was the time I spent as a dietetic intern in an inpatient eating disorder unit last year. My entire perspective has since changed and I will forever value being able to help the women, girls, men, and boys of all ages that I was able to work with. The progress these people made was astonishing and to hear their stories was often breathtaking.
What is an eating disorder? Eating disorders exist on a spectrum of severity and are defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) V. These include anorexia nervosa, bulimia nervosa, and binge eating disorder(1).
Who is affected? People of all ages and genders are affected by eating disorders. I have worked with 13 year old girls all the way to men in their 50s.
What are the causes of eating disorders? Eating disorders are multifactorial in nature. Comorbid psychiatric illnesses, the media, genetics, gastrointestinal problems, poor self-esteem, bullying, and traumatic experiences such as sexual abuse are among the factors that contribute to the development of eating disorders(2). Most importantly, people DO NOT choose to have eating disorders.
I want to share some of my experiences to hopefully cause a shift in what our society perceives as a healthy body figure, strengthen body satisfaction, and most importantly, help others think before they speak.
The first time I stepped into the inpatient eating disorder unit as a dietetic intern, I was stunned at the appearance of these patients. Those suffering from anorexia nervosa physically resembled skeletons with thinning hair, pale skin, protruding cheekbones, and sagging skin draped over their brittle bones. Internally, these patients had severely decreased heart rates, blood pressures, and body temperatures(2). Their electrolytes were so severely depleted that their calorie intake initially had to be restricted to 1500 calories and slowly advanced or metabolic shifts would have lead to fluid retention and possible cardiac arrest. They had anemia, high cholesterol, and a multitude of vitamin and mineral deficiencies(2).
Those suffering from bulimia nervosa were of normal body weight or overweight. Their parotid glands were inflamed due to the effect of constant vomiting. Their teeth were eroding and they had abrasions on their fingers from making themselves vomit after eating. Internally, their electrolytes were also abnormal.
Many of the eating disorder patients had amenorrhea, gastrointestinal complications, fluctuations in mood, and impaired hunger cues(2).
Watching the patients struggle at mealtime to simply finish a cup of ice cream without crying was hard to handle. They would be in physical pain because their bodies were so severely malnourished and not accustomed to eating. They would have emotional breakdowns almost daily. They would even lash out at the doctors and nurses caring for them and not remember doing so the next day.
The treatment process included a team effort from nurses, psychologists, social workers, dietitians, and medical doctors. My role was to improve patients’ relationship with food and work towards improving their body satisfaction with the ultimate goal of having the patients focus on overall health rather than perfecting their image. My most difficult task was overcoming social media influences and developing a plan to help them cope when they saw pictures in the media that portrayed the “thin-ideal.” I had to assure them that the pictures they saw were often altered and not an accurate depiction of optimal health.
The best reward was seeing these patients succeed and walk out of the hospital with smiles on their faces. Eating disorders are a lifelong battle and having the opportunity to play a role in their recovery was humbling.
The majority of these patients regardless of age and gender noted that they were bullied as young children and faced strong social pressures to conform to the norm.
Combating eating disorders starts with shifting this norm to focus on life-long health and empowering others to love themselves.
So when in doubt, think before you speak.
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Did ya know?
If Barbie were an actual woman, she would be 5’9”, have a 39” bust, an 18” waist, 33” hips, and a size 3 shoe.
Slumber Party Barbie was popular in 1965. She came equipped with a bathroom scale permanently set at 110 lbs and a book called “How to Lose Weight” with the pages inside stating, “Don’t eat.”
Based on her height and weight, Barbie would have a BMI of 16.3 and therefore be classified as having anorexia.
References
(1) American Psychiatric Association. Feeding and Eating Disorders. DSM-5 Development website. Published 2013. Accessed November 12, 2014.
(2) Golden NH, Miller CA. An introduction to eating disorders: Clinical presentation, epidemiology, and prognosis. Nutr Clin Pract. 2010; 25(2): 110-115.
(3) Chapman University. “Get Real Barbie” Fact Sheet. Chapman University Student Psychological Services website. Accessed November 12, 2014.
Picture courtesy of paradigmmalibu.com.
