Body Image & Eating Disorders

I've always felt too big, like I take up too much space. I feel disgusted when I look in the minor, I've tortured myself with diets, but nothing works. Even if I lose a few pounds, I put the weight back on as soon as l let down my guard. Then I get depressed and eat even more. My boyfriend tells me that it's not my fault that I'm heavy; he says that when babies are fed too much they develop extra fat cells. I just hate my body!

- Marlene, a 17-year old woman with a fine, healthy body.

We are all affected by society's unrealistic standards of beauty and body size. They are imposed upon us every time we turn on the TV, sit through a film, flip through a magazine, or overhear self-critical conversations by friends and family members. This standard is used to test our mettle, as if accepting ourselves as we are is some kind of major social rebellion. How is it that we are literally made to "feel too big, like we take up too much space?"

The images of thin, athletic, tanned (or pale in the case of images of women of color), flawless female models are intended to represent the picture of health and happiness for women. In fact, 95% of women could never achieve the weight or body proportions of models. Top models are anything but healthy and happy themselves–rates of substance abuse, eating disorders and stress-related illness are extremely high among these women.

The battle between women and their bodies feeds the $33 billion diet products industry, the $20 billion cosmetics industry, and the $300 million plastic surgery industry. This battle robs us of our selfesteem and confidence. It saps our strength and energy. It perpetuates sexism by forcing us to accept beauty and body size as criteria for job competence and social worth.

It is commonly believed that to be excessively slim and trim is to exude radiance and health. However, there is no substantiated health reason for this obsession with thinness. To the contrary, recent studies show that people who are underweight experience more illness than those who are overweight, except in cases of extreme obesity. In accordance with these findings, the "deal weight" charts developed by the Metropolitan Life Insurance Company have recently been revised upward by about ten pounds. (Because one's ideal weight is subject to so many genetic and environmental variables, these charts are useful only in a most general way.)

The most ironic and insidious thing about all of the pain and suffering involved in trying to be thin, is that it doesn't work. Extremely low-calorie dieting simulates the body's starvation mechanisms. Metabolism slows down to preserve resources, which makes it more difficult to lose weight. In addition, the extreme hunger cause by deprivation may lead to binge eating.

Medical experts estimate that up to 50% of women in the United States suffer from a damaged relationship with food that interferes with their daily living. Eating disorders–anorexia and bulimia–are, in part, extreme responses to women's obsession with thinness (very little is known about eating disorders in men). Anorexia is a very serious health condition which involves self-induced starvation due to an irrational fear of fatness. A woman suffering from anorexia may lose up to 25% of her original body weight. Bulimia involves eating large quantities of food in one sitting and then purging by self-induced vomiting, use of laxatives, excessive exercise or periods of starvation. Many women have some symptoms of both of these eating disorders without meeting the diagnostic criteria for either.

Anorexia and bulimia can be treated if they are identified early. Like other kinds of substance abuse, the treatment of eating disorders involves several components applied simultaneously. The primary objective is to help the person with an eating disorder reach and maintain a weight which is reasonable for her.

Those with eating disorders are often filled with shame, guilt, and self-hatred. They experience a loss of control over their actions and their bodies. Therefore, a major component of the treatment should address these issues and others which affect self-esteem. In cases where eating disorders go untreated–and many women don't seek treatment because of the social stigma–the mortality rate may exceed 15%.

We need to take action individually and collectively to challenge and change the destructive image of the "ideal body" which is imposed upon us. As individuals we can explore our own concepts of beauty and think about what influences our deals. We can take time to understand our bodies and to pay attention to how our feelings about ourselves fluctuate depending upon menstrual cycle, life cycle, and other factors. We can give affirmation based on who people are, not what they look like. We can buy clothing that fits and that is comfortable. We can examine social and media messages with a critical eye, and encourage our friends and family to do so as well. We can raise questions about appearance codes in places of employment. We can help teach our daughters to love themselves. We cantry to learn to love ourselves.

Gen Stewart has a master's degree in public heath education. She works at The University of Michigan as a health educator and has a special interest in women's health issues.