body image · eating · Uncategorized

Ana, Mia, and the Health Imperative: Do We Have to Eat for Our Health?

Example of thinspo "pro-ana" inspiration: "Stop stuffing your fat face.  eat. feel guitly."
Example of thinspo “pro-ana” inspiration: “Stop stuffing your fat face. eat. feel guitly.”

A long while back, after I’d just stumbled into the pro-Ana and pro-Mia communities (not as a member), which I had no clue about before I started blogging about fitness and health, I wrote “Why the Thigh Gap Makes Me Sad.”  When I re-visited that article later, “Revisiting the Thigh Gap: Thin Body Shaming Isn’t Okay Either,” I remarked that it contained some thin-body shaming. Based on what I’ve learned over the year and a half or so of blogging on these things, I said a lot of thing I wouldn’t say (or would say quite differently) now.

A couple of days ago Sam sent me a news story from the National Post that is essentially a commentary on pro-Ana and pro-Mia websites and on-line communities.  It’s entitled: “‘Anorexia is a lifestyle, not a disease: an investigation into the harrowing on-line forums promoting extreme dieting.

The author opens with a bit about a woman named Jade,

Jade calls herself an “ana veteran.” Her aim is to provide “tips, tricks and information” for others who, like her, are in the grip of an eating disorder. Her readers, she says, are “girls who are desperate in their anorexia and willing to do anything to lose weight. They are sick, but they don’t see it as an illness. I’ve been anorexic for 10 years and I know this is the way I want to live.”

Instead of urging her readers to stop starving themselves, Jade helps – often encourages – them to embrace their eating disorder. “I eat three meals a day but make sure I never take in more than 50 calories,” she writes in one post. Another boasts: “I’ve reached a point where I can go without food for three or four days. You can do it too, but it will take discipline and hard work.”

Moving into commentary now, the author says:

Her attitude is chilling but far from unique. Jade is part of a growing international group of “pro-ana” (pro-anorexia) and “pro-mia” (pro-bulimia) bloggers, who perceive their illness as a “lifestyle.” Though sites like this have been around for years, hers is one of a worrying new generation of online communities that have turned anorexia and bulimia into an aspirational state.

The attitude is a bit chilling, I agree. But as an onlooker, my thoughts about this issue have evolved quite a bit over time. One thing that comes up regularly on this blog is a rejection of the idea that health is an imperative. There is no requirement to be healthy, to choose healthy options, to pursue healthy goals.

If there were such an imperative, that would support all sorts of interventions that most of us think cross the line by violating people’s autonomy and right to make their own choices.  Is forcing someone with anorexia to eat any different from forcing someone who is extremely obese to diet or mandating a committed smoker to quit or even forcing a thin couch potato living on junk food to make healthier choices?

It’s not clear to me that it is.  This is not to say that health is not a good. I think, in fact, that good health is an objectively valuable thing to have and to aim for.  It’s an important part of a good life and contributes something fundamental and basic to human flourishing (I’ve been teaching Aristotle lately!).

And still, it’s not something to be forced on people.

I get, too, that anorexia and bulimia, both of which are promoted in these on-line communities, are considered to be illnesses.  Considering them as illnesses, the people who have them are actually ill and in need of help.  But we allow other people with illnesses get to make their own choices.  If I’m diagnosed with cancer, it’s up to me whether to pursue treatment, not up to anyone else.  And if I chose not to, surely there would be support for my decision and people would respect it.

But with eating disorders it’s quite the opposite. Few anorexics or bulimics will find support from family or friends.  From the article:

Dr. Helen Sharpe, a professor at the Institute of Psychiatry, King’s College London, has conducted research into pro-ana and pro-mia websites. They are, she says, “incredibly common,” and though they don’t cause eating disorders, they can perpetuate them. “What do they give people that they can’t get elsewhere?” she asks. “Eating disorders can be extremely isolating conditions, and so finding a community of other people who think like you can be a powerful draw.”

This idea of community, of anorexics and bulimics wanting to “belong” to a virtual family, is played out across the websites. On the world’s largest pro-ana forum, which has 65,000 users and 1.5 million posts, many topics are available exclusively to members, with layers of access granted the longer they stay with the site.

A couple of comments. As Sharpe says, these communities do not cause eating disorders even if they promote the idea.  I’ve lurked on some of the message boards a bit and seen that when someone comes on looking for advice about how to “become anorexic” she (usually she) is certain to get flamed.  She is urged to get out and to get a grip. Members explain to her that it’s an illness.

So even within the idea of anorexia as a lifestyle, there’s an implicit often unstated assumption at work: that it’s only a “lifestyle” for those who are already afflicted with an illness. There is a further assumption that it’s a difficult and painful lifestyle. No wonder they are seeking mutual support.

The shocking element for an onlooker is the type of support–it’s a lot of support to maintain and sustain the condition in a stealth way, so as to minimize interventions and comments from friends and family members.

But perhaps, like addicts or alcoholics whose chances of successful recovery are low if they’re forced, much better if they choose it, pro-ana and pro-mia support communities can nudge people into the direction of choosing something different and seeking help and healing:

Not all online discussion of eating disorders is negative, either. There are a host of websites that are more constructive than destructive. These ones, suggests Susan Ringwood from Beat, may hold the key to encouraging sufferers to have more positive discourse.

Ruby, a 32-year-old from the West Country, runs one such blog. She has lived the “half-life” of anorexia since she was 16. With her doctors’ permission, she writes to me from inside a psychiatric unit, where she is seeking treatment after decades of concealing her illness. “It’s a daily battle,” she explains. “There is a tug-of-war going on in my head. Recovery or eating disorder. Life or death. Fight or give up.”

Though she shares some characteristics with other sufferers who write online, Ruby’s blog is different from a pro-ana website. There is no claim that anorexia is a lifestyle, no “10 thin commandments,” no telling others off for eating.

Instead, there are sections entitled “myths”, “the facts” and “treatment”. Her writing is stark and honest; her acceptance that she has a mental illness clear. Most importantly, she urges her followers to seek help. “I don’t think pro-ana girls realise how dangerous their behaviour is,” she says.

There are signs, too, that writing has spurred Ruby on towards real-life recovery – a result that, experts say, might encourage others. “It’s a sad truth that my virtual life is more active than my real life,” she writes in a recent post.

I guess what I’m saying is that the issue is much more complicated than I thought it was when I first encountered it.  The article in the National Post would have had me nodding along a year ago. But today, I’m more cautious.  I still feel as if there is a reason to feel sad when people choose to pursue a life that restricts their range of choices and, by all accounts, promotes an excessive focus on one thing (much as an addict or alcoholic is focused on one thing).

But I don’t think that people can be forced to pursue healthy options even if they’re ill.  And that’s because health is a value, not an imperative.  And yes, watching people make choices that we perceive to be harmful, to support their illnesses, is a difficult thing to do. But the bottom line is, no one has to eat for their health.

body image

Revisiting the Thigh Gap: Thin Body Shaming Isn’t Okay Either

judging-any-body-is-wrongWe talk a lot on the blog about body-shaming and usually it’s code for fat-shaming.  But thin bodies can also be “shamed,” and this has been brought to my attention a few times in recent weeks.

In December, I showed the film, Arresting Ana, to one of my Women’s Studies classes. It’s a documentary about the potential criminalization of the pro-Ana (pro-anorexia) movement in France.  At one point, they show a billboard campaign in Italy [first campaign shown in this link] that was meant to scare women out of being anorexic.  The billboards depicted an extremely thin model posing nude, with the caption “No!.”

At the time of the photo shoot the model, Isabelle Caro, was recovering from near death from her eating disorder. According to her interview in the film, she weighed 75 pounds in the photo.  Isabelle Caro has since died from her eating disorder at the age of 28.

When the lights came on and we started our discussion, several of my students said that they found the billboard campaign and the discussion of Isabelle Caro’s body to be body-shaming. Yes, she was skinny–deathly so–but the idea that simply showing her body would be enough to shock contains an implicit negative judgment.  The judgment is something along the lines of: NO ONE should want to look like this woman.

Then, remember when Jennifer Lawrence got called out for body-shaming by Jenny TroutI picked up on that, claiming it was a bit harsh.  Well, one of our readers pointed out that one of the quotes was incomplete. Jenny Trout quoted her as saying this: “I’d rather look chubby on screen and like a person in real life.”  The full quote was actually this:

I don’t really diet or anything. I’m miserable when I’m dieting and I like the way I look. I’m really sick of all these actresses looking like birds… I’d rather look a little chubby on camera and look like a person in real life, than look great on screen and look like a scarecrow in real life.

I think the context is important.  But unfortunately it’s not totally redeeming. Why, because it tilts in the other directions. Now, thin women are “scarecrows.”  Not so nice either.

And just recently, someone wrote in on my old and still oft-read post, “Why the Thigh Gap Makes Me Sad.”  The commenter said:

I take exception with the remark that the girls “look like they could use a few good meals.” Naturally thin people can eat good meals and still look the same. Eating more food does not necessarily equal gaining weight, and frankly, telling someone they look like they need a good meal is just as rude as telling someone they look like they could afford to lose a few pounds.

And you know what? She’s right. The comment that they look like they could use a few good meals oozes with judgment and the presumption that I know better. Point taken.  My comment was an instance of body-shaming.

Until these few incidents, I confess to never giving the body-shaming of thin women much thought at all. Yet it happens a lot. Even in a culture where we prize thinness, it’s just not true that “you can never be too thin.”  Media leaps on celebrities when they gain weight, for sure. But they also leap on celebrities who lose weight.

There’s a whole thing about Angelina Jolie — a media obsession with how thin she is and calls for her to “eat a sandwich.” This article talks about skinny-shaming and how unhelpful it is.  Shaming in general isn’t a great strategy for altering behavior.

It is most certainly true, for example, that Isabelle Caro had a severe eating disorder and was not a healthy woman. She herself says as much in the film, Arresting Ana.  But as Dr. Gail Saltz, writes in her article about “skinny-shaming”:

Skinny-shaming, calling someone — celebrity or otherwise — “emaciated” or “stick thin,” or telling the person to “eat a sandwich,” as the cliché goes, is as unhelpful as fat-shaming. It is our skewed view as a society obsessed with being thin that left us open to commenting on Jolie, forgetting that any extreme in appearance can be a difficult and painful place to be (just ask any adolescent).

A loving discussion from someone known and involved can be a life-saver, whether you are too thin or too overweight. If you notice your friend is seeming to shrink before your eyes, you could try saying something like, “I’ve noticed you’re looking quite a bit thinner recently, and as your friend, I just wanted to check in. If something’s wrong, please know I’m here to help you.”

But comments from the public at large should avoided — or, at the very least, used to empathically understand a real issue that may be going on for many women.

Notice how she says this kind of approach should only come from an empathetic friend. It’s just not okay for complete strangers to approach people. It’s really no one’s business. And body-shaming is not the kind of approach that will help.

Is and expression of concern necessarily body-shaming?  People who appear overweight often report that they take “concern” as intrusive.  We have a difficult time separating judgments about weight from judgments about health.  Does it go the other way, where extreme thinness is concerned?  I’m not entirely sure.

So body-shaming is not okay in either direction or for any reason at all–there are all sorts of ways to body-shame that have nothing to do with size.  At the same time, the thigh gap does still make me sad. But it’s not because of the way it looks. It’s more because in many cases, engaging in disordered eating is the only way to get it.

aging · body image

Midlife, body image, and eating disorders: A better way

Fit Villians

First, the bad news. Eating disorders in midlife are on the rise.

“In her new book, Midlife Eating Disorders, Bulik reveals a hidden problem: the most common profile of someone suffering from an eating disorder is a woman or man in their 30s or 40s. Bulik believes that in the medical field, typecasting eating disorders as a teen issue poses a risk for adults seeking care. Due to this typecasting, primary care physicians, obstetricians and gynaecologists and other health care providers can overlook these disorders in adults. Countless people in mid-life from all ethnic backgrounds struggle with eating disorders, Bulik says. Some have suffered with a chronic eating disorder for their whole lives, others relapse mid-life. Some are experiencing an eating disorder for the first time.Common to all these groups are particular stressors often associated with events that occur mid-life: infidelity, divorce, parenting or the death of a loved-one are key triggers.

Bulik says a common scenario is when someone gets divorced and they view themselves as being ‘back on the market’.‘They go to extreme measures to change their physical appearance—usually an extreme diet. And that might be their first step down that slippery slope to an eating disorder’.Financial hardship can also trigger an eating disorder, as can the stress that often comes with retirement, illness, surgery or unemployment.Bulik also believes a ‘culture of discontent’ is a major cause of adult eating disorders—reinforced by the fashion, cosmetic, pharmaceutical and diet industries.‘What they do is plant worms of discontent in your mind—that you should be unhappy with your physical appearance, you should be unhappy with the process of ageing … then they sell you this product or present you with this surgery that somehow is going to miraculously remove that discontent. They make you feel badly about yourself and then they sell you something to make you feel better. And the problem is that engaging in some of those extreme behaviours can be the first step toward an eating disorder.'”

See Mid-life eating disorders: the divorcees and exercise junkies flying under the radar

Second, some slightly better news. Active women are more likely than inactive women to be happy with their bodies, even at the same size. See Few Middle-Aged Women Are Happy With Their Body Size: The ones most likely to be are highly active.

“A study of 1,789 women, age 50 and older, found that only 12.2% of the women said they were satisfied with their body size. Body satisfaction was defined as having a body size equal to their preferred body size.

Body satisfaction reflected considerable effort by the women to achieve and maintain rather than passive contentment, according to study authors. Satisfied women had lower BMI and exercised more than dissatisfied women, while weight monitoring and appearance-altering behaviors, such as cosmetic surgery, did not differ between the two groups.

Satisfaction with body size, however, did not mean that these women were totally satisfied with their appearance. Many reported that they were dissatisfied with other aspects of how they look, including their stomach (56.2%), face (53.8%), and skin (78.8%).”

See our other thoughts on menopause and bodies:

Accept your changing body

Understand that menopause affects metabolism

And it starts with perimenopause

athletes · body image · competition · eating · Rowing

Lightweight rowing and disordered eating

Weight categories in sports are tough. See Audery’s post on kids and weight categories in martial arts. And I’ve written about why the Athena category in running and in multisport events is fairly useless.

Sports introduce weight categories when there are size differences that result in performance differences such that putting differently sized people up against another wouldn’t be fair. Think boxing. Or weight lifting. Larger people have an advantage.

Weight categories have been employed for centuries as a method of equalizing competition in a number of different sports. In sports where the physical strength of the combatants was understood to be crucial to their ultimate success, weight categories recognized the fundamental principle that, all things being equal, in strength sports the larger athlete was likely to be the stronger athlete. Stated in the alternative, where two athletes possess equal technical skill in a strength-oriented sport, the larger athlete is more likely to overpower the smaller athlete. FAQ, World of Sport Science

That’s true too in rowing. It’s better to be big. Rowing just has two categories, light and heavy. See LiveStrong on the difference between lightweight and heavyweight rowing

What are the categories?

“At the international and college level, a male rower is not eligible to compete in lightweight rowing if he weighs over 160 lbs. A woman cannot row in the lightweight division if she is over 130 lbs. While a good lightweight rowing team can sometimes beat a heavyweight team, the sport of rowing favors the tall and strong athlete. Height gives a rower more leverage to propel the boat through the water. Strength gives a rower the explosive power to propel the boat faster.”

(The subject of what happens when a lightweight boat does beat a heavyweight boat is a frequent source of humour on rowing tumblrs.)

Why have weight categories in rowing?

“According to the Federation Internationale des Societies d’ Aviron, or FISA, the international governing body of the sport, lightweight race was introduced “to encourage more universality in the sport, especially among nations with less statuesque people.” Lightweight events were introduced at the World Championships in 1974 for men and 1985 for women, and it joined the roster of events at the Olympic Games in 1996.”

What are the worries about weight categories?

“The practice at some colleges of using heavyweight rowers to drop sufficient pounds to qualify for the lightweight boat is controversial on two grounds. First, drop-down rowers replace “normal” lightweights in the boat, cutting opportunities for smaller rowers to compete. Second, allegations of eating disorders among both women rowers and male drop-downs have been widespread. A female college rower at the Everything 2 website tells of men “living on carrots and multivitamins for weeks while doing full workouts every day,” in a misplaced attempt to demonstrate discipline toward their sport.”

To this, I’d add a third worry. There are people in the middle who don’t fit into either group.There are, for example, women who are larger than lightweight and who can’t weigh down but who aren’t tall enough to be competitive in the open class. I met a woman recently who at 5’7 was throwing up her hands ( and her oars) and switching to cycling. She couldn’t get light enough for lightweight, despite pressure, but at her height she is nowhere near large enough make it in heavyweight competition.
You might think lightweight rowing made it possible for small women compete in rowing but in fact competitive lightweight rowers are usually well above average height for women. They’re not short by any means. They’re thin but not small.  It’s shocking to think that if I’d discovered rowing earlier and if I was any good at it (two big “ifs”) that I would have been pressured to row lightweight. The last time I weighed in the 130s was grade six! And I’m in the middle, clearly not tall enough for heavyweight.Is losing weight to row lightweight a successful strategy? Not always.  The issues are very complicated. To get a sense of the debate see National Eating Disorder Awareness Week: Lightweight Rowing

“One study that’s cited a lot when talking about weight loss and lightweight rowing is this one. Some of you guys have asked me about this too – can a smaller heavyweight rower lose weight and be competitive as a lightweight? This study found that it is possible, but what I think is worth noting is that the “heavier” heavyweight athletes lost more muscle than fat mass over the course of the 16 weeks this study was conducted. 16 weeks…that’s roughly four months. Winter training through mid-spring season is about four months, so think about that if you are considering making the transition. Preparation must start well before the time you plan to fully compete as a lightweight. The rowers who suffered the greatest loss in muscle mass weren’t able to be competitive as lightweights because of the drastic reduction in power output, energy, etc.”

rowingfog

Further reading:

 Prevalence of eating disordered behavior in collegiate lightweight women rowers and distance runners.

This study examined eating behavior in collegiate women lightweight rowers, runners, and controls. It was hypothesized that rowers would show an increased prevalence of restraint in their eating behaviors, but not probable eating disorder cases as compared with runners or controls, because they are required to make their target weight but are discouraged from further weight loss.

http://www.ncbi.nlm.nih.gov/pubmed/11176143