Eating Disorders In a Sociocultural Context

“Think of your meal plan as a minimum. But we don’t want you eating too much over your meal plan either.”

“Don’t worry. If you’re gaining too much weight too fast, I will let you know and we can deal with that together.”

“You gained a normal amount of weight this week. You’re doing everything right. You’re not gaining too much weight.”

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These words, which have been uttered to me by eating disorder professionals, have both petted and provoked my eating disorder.

On one end, it brought me peace to know that my treatment team would always “have my back,” ensuring that I didn’t spiral into a grimy vortex of ceaseless eating. Ahh… Thank goodness! My dietitian won’t let me get fat…

On the other end, it enkindled a fiery confusion inside of me.

Whoah, whoah, whoah.

I have anorexia and you’re telling me not to eat “too much?”

Hold on just a second.

If I gain “too much” weight, I’m doing something wrong?

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I’d walk out of my treatment teams’ offices with a bad taste in my mouth, as though I’d just downed a tall tumbler of fatphobia.

I’d walk out into the world, step into my car and turn on the radio. What would I hear? A weight loss commercial, feeding me the “thin is good, fat is bad” paradigm. Despite already feeling stuffed from the fatphobia I’d just guzzled, I’d let the radio feed me the idea that being thin would solve my problems.

Suddenly, I’d remember that I was in recovery from an eating disorder.

Radio off.

I’d drive to the nearest shopping center, step out of the car, and head to a restaurant to meet a friend. As I’d mull over the menu options, I’d notice the calorie counts printed next to each menu item. Gulp. Didn’t need to see those numbers.

After further pursuing the menu, my eyes would feel drawn to the lower calorie “Enlightened” or “Healthy Eating” options. So does eating fewer calories make people “enlightened” and “healthy?”

Thankfully, my treatment team had already encouraged me not to order based on calorie counts, so I’d feel empowered to order what I truly wanted.

“I’ll have a cheese-burger with sweet potato fries, please,” I’d say.

My friend would stare at me as though I’d just killed our waiter with my butter knife.

“How can you order that and stay so skinny? You’re so lucky you’re thin!” She’d cry, turning to the waiter and saying, “I’ll have the [insert menu item here] from the ‘Enlightened’ menu, please.” Her face would glow with pride over her righteous order.

After lunch, I’d scroll through my Instagram feed whilst walking to my car. Some girl, who was “instafamous,” would post a photo of herself. I’d read the comments people posted on the photo:

“I would love your nutrition plan for this amazing body.”

“Body goals!”

“Those abs!”

“I love how I am looking at this while eating a chocolate bar.”

“I think this is the kind of body that I want to achieve. Beautiful <3”

My stomach would wring into a tight knot.


One week later, I’d visit my treatment team again.

I’d step on the scale, facing away from the numbers.

Perplexed expressions would spread across their faces.


Before discovering the Health At Every Size® movement, my recovery was inconsistent.

In a vacuum, cut off from the rest of the world, I felt that recovery was in my reach.

When I was on a meal plan, I knew that I needed to follow the plan and never go under it.

When I wasn’t on a meal plan, I genuinely wanted to honor my hunger/fullness cues and eat anything my body asked me for.

Aside from the visits in which I received confusing messages from my treatment team, I’d have fantastic therapy and dietitian sessions. Quite often, I’d leave their offices feeling inspired to combat my illness, ready to use my healthy coping skills! But then I’d dive back into the real world, paddling and nearly drowning in a sea of conflicting information.

Society, which so radically prizes thinness and fitness, always prodded holes in my pro-recovery floaties.

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In a culture that promotes dieting, extreme exercise and “clean eating,” it is nearly impossible to empower oneself to gain weight (or not lose weight), eat sufficiently, eat normally (e.g., not spooning out the inside of a bagel, not eating only the inside of a sandwich, etc.) and exercise intuitively. How can one break away from disordered eating in a world that encourages disordered eating? How can one maintain a normal way of eating when society advocates for eating abnormally?

From a clinical perspective, how can eating disorder patients fully recover when their treatment teams are setting arbitrary limits on their weights? “Don’t eat too much over your meal plan.” “If you’re gaining too much weight, we’ll deal with it.” “You’re doing everything right because you’re not gaining too much weight.”

The issue: Eating disorder professionals (dietitians, doctors, therapists) are held to standards that tie them to the traditional medical model, which is ultimately weight biased and fatphobic. As I’ve educated myself about the detrimental effects of calorie restriction and the reality that health can be achieved at any size, I feel oppressed by my treatment team. As a woman willing to take up space and ready to accept the weight at which my body naturally settles, I now resent my treatment team for trying to suppress my weight, because these are the subliminal messages I’ve received:

“Overcome your eating disorder, but stay thin and socially acceptable.”

“Recover but don’t recover too much.

“You need to gain weight until you reach a BMI that falls in the “healthy range,” but then you need to maintain that weight… sometimes by restricting your intake.”

As a recovering anorexic, I feel trapped in a system that has taught my treatment team the exact opposite of what is actually going to help me recover from my illness. Not only am I receiving implicit messages from the people who I am paying to help me recover, but I am receiving explicit messages, which promote diet culture, from everyone else around me.

Professionals who treat eating disorders need to realize that eating disorders are not only a psychological issue, but a reflection of a sociocultural issue. Necessarily, eating disorders NEED to be placed into a sociocultural context, so that professionals can arm their patients with the skills to counter society’s anti-recovery messages. Because thinness often results in pervasive admiration and privilege, professionals must be cognizant of what clients fear they are going to “lose” as a result of recovery. Addressing the sociocultural origins of these fears will help professionals better understand and tackle their clients’ resistance to recovery.

The truth is that nobody pops out of the womb with congenital fat phobia. People fear fat as a result of weight discrimination. At a certain age, we all become aware that the thinner child next to us possesses more social status than we do because of the cultural climate in which we live.

In the second grade, I distinctly remember feeling ostracized because I was chubby, pale and hairy. Other little girls used to call me “gorilla.” Meanwhile, my thin best friend received so much positive attention from all the children around her. I distinctly remember a little boy saying he didn’t want to hold my hand because he wanted to hold her hand instead. Ouch.

Weight (and appearance) is a form of social status, of social value, of social currency… If the social value of being thin had not been defined for us as children, perhaps none of us would care about being thin or fat. Likely, we would all be existing peacefully at our bodies’ set points. Perhaps that little boy would have wanted to hold my hand. Instead, the people in our culture obsess about thinness and fatness, and treat non-thin people unfairly, because of the social status (or lack thereof) attributed to each of these things. Yet, clinicians who follow the current medical model expect patients to recover from their eating disorders in such a hostile sociocultural context.

From the Science of Eating Disorders:

“In terms of social capital (the benefits a person derives from their position in society), bodies engaged in continual pursuits of “self-discipline,” as eating disorders are often framed from the outside, receive social benefit. Giving up this safety and social acceptance is not easily done. (1) Particularly when a person’s body is otherwise marginalized – along the lines of race, class, ability, gender, etc. – enacting thinness and/or fitness and discipline can provide a kind of protection against further discrimination.

None of this is to say – and this is important – that people choose to have eating disorders, want to keep them, or don’t suffer when they have eating disorders. What putting eating disorders into sociocultural context does, however, is highlight just what we are asking of people in recovery in this time and place, in which so many public resources are devoted to preventing the kinds of bodies that they might recover into. (2) The uncertainty of what kind of body might result when one stops eating disordered behaviour – and the impact that living in that body might have – can be enough to sustain disordered relationships with food.

I’d like to elaborate on the statements I underlined above.

  1. Particularly when a person’s body is otherwise marginalized – along the lines of race, class, ability, gender, etc. – enacting thinness and/or fitness and discipline can provide a kind of protection against further discrimination.”
    • Personally, as a Latinx woman, I certainly felt the need to pursue thinness in order to protect myself from bullying. I didn’t have golden hair on my arms and legs like the other girls did. Because I was so pale, the black hair on my arms and legs stood out, which led to people calling me “gorilla” and comparing me to the monster girls from The Grudge and The Ring.
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    • However, being fair-skinned, I realize how much privilege I have.
      • About 5% of our population consists of naturally thin, white women and the other 95% are told they need to look like this thin, white woman–regardless of their race, size or ability. This idealized thin, white woman possesses the most value and privilege, so the rest of society feels the need to contort themselves in order to look like her, thus “earning” that value. Someone who is not white cannot control the color of their skin, so they may feel the need to at least be thin in order to gain some of that privilege.
  2. “The uncertainty of what kind of body might result when one stops eating disordered behaviour – and the impact that living in that body might have – can be enough to sustain disordered relationships with food.”
    • THIS is among my most intense struggles. My eating disorder began when I was 14. I am now almost 24. I am positive that my set point at age 14 was dramatically different than my set point at age 23, so I genuinely have no idea what kind of body “might result” when I fully let go of my eating disordered behavior and entirely surrender myself to my body. Because I have been “thin enough” to procure attention from our diet-obsessed culture for eight years, I am afraid of living in the body I may naturally have. What if I have the type of body that society tells me is “wrong” and stereotypes as lazy? As a result of my fear, those disordered weight control behaviors creep in and thus impede my recovery.

This is exactly why we need more eating disorder professionals who are prepared to step outside of the current-weight based paradigm and start to work with their clients on rejecting diet culture. In other words, we need more HAES-informed dietitians, therapists, and doctors.

To eating disorder clinicians:

We do not need our weights to be controlled and suppressed.

We do not need you to “save” us from becoming fat or gaining “too much” weight.

We need your help in recovering from these consuming illnesses, which wreak physical, mental, relational and emotional havoc. We need your help in taking up more space and becoming anti-diet rebelsall while living in a culture that tries to keep us small and docile.


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