We are excited to announce our Eating and Body Image Therapy Group for men beginning in September 2022 over Zoom.
This group is for men who are looking for a supportive space to discuss issues around body and eating and/or are looking to add group therapy to their eating disorder recovery. If you are tired of pursuing thinness/fitness, have struggled with disordered eating, and are interested in divesting from diet culture, this group is for you. Through connection, we will explore diet culture and the pressures on males to have a perfect body. We will work to heal your relationship with your body and will learn about non-diet approaches to health.
While eating disorders are often commonly believed to almost primarily affect females, eating disorders have been recognized as affecting males too–and as far back as 1689 when one of the first noted cases was of a male patient. Approximately 25% of the individuals with anorexia nervosa and bulimia nervosa are male. We recognize that males with eating disorders have different experiences and need their own space. Males with eating disorders may experience different symptoms including greater muscularity concerns and have a greater risk of suicidality. They may experience stigma for being seen to have what is commonly believed to be a female disorder and often are not diagnosed until later in their illness.
The group will meet weekly on Wednesday evenings at 6 pm over Zoom and is open to anyone ages 18 and up who identifies as male and is located in the state of California. This group is for you if you are looking for a supportive environment to discuss issues surrounding body image and eating and what it is like to be male in our culture.
The group is led by Jonathan Dang, LMFT, who is passionate about supporting males with eating and body issues. Jonathan is currently pursuing certification as an eating disorder specialist. To register email Hello@EDTLA.com and put “Male Group” in the subject line.
For a long time I was embarrassed to tell people that I was a figure skater. I was afraid that someone would look at me and laugh at the idea that someone like me skated. I felt this way because I am in a larger body and have always been. Even though I loved to ice skate, I somehow knew that I was not in the ideal body for this sport. It never occurred to me back then that these thoughts and beliefs were biases that I had been taught both implicitly and explicitly.
Biases are preconceived ideas about something or someone. They can be negative or positive but often we associate biases as negative. For me, I grew up with the bias that “real figure skaters” were in small slender bodies. I only saw petite tiny women (and girls) glide across the ice when I would watch the Olympics or National Championships. I never saw an ice skater that looked like me.
In my personal experience as an ice skater I can remember a dance and ice skating store shop owner looking down at me as she said, “we don’t carry your size.” I had coaches that reminded me that I’d skate faster if I was smaller and applauded me when I lost weight. I was highly aware that some coaches weighed their students and told them what they could and could not eat. It is really no surprise that in the sport of figure skating there are increased rates of eating disorders and overexercise, and many skaters experience poor relationships to food and body.
I was surrounded by weight stigma as I was teased by kids at school for being fat. It definitely reinforced the belief that my body was wrong. Fortunately I had friends and family who didn’t judge me and supported my passion for skating. Regardless of my size I was a real figure skater. I wore the sparkly dresses. I could do difficult jumps and all types of spins. I competed in competitions and even took home a few medals and trophies. I learned to ice dance with a partner. I performed in ice shows and represented my college at the Intercollegiate Nationals three times. I even took home a silver medal for my event. Eventually I would go on to teach others to skate. I was in love with this sport and I guess in some ways I pushed some invisible boundaries by not succumbing to the negative messages about whether I belonged on the ice or not.
Biases can be so harmful because they create this belief that the size of your body cannot do a certain sport, wear a certain piece of clothing, or just feel like you don’t belong. It was not until I was into my coaching career that I truly saw how our biases could stand in the way of doing something that could be fun. I had two students who changed the way I saw what someone can or cannot do.
The first was a 60 year old man who wanted to learn how to ice skate so he could skate with his grandson who was a hockey player. He shared that he was diagnosed with Parkinson’s disease and wanted to ice skate with his grandson before the disease progressed enough that he wouldn’t be able to do difficult physical activity like ice skating. He told me his left leg was already significantly weaker than his right leg, but he wanted to try so that he could surprise his grandson.
The second student was an eight year old boy who was on the autistic spectrum. His parents wanted him to learn to ice skate because his father was a hockey player and wanted to be able to ice skate with his son. Unfortunately, this student’s autism was severe enough that he would never be able to play on an ice hockey team or join in an ice skating class with others his age. Our one on one lessons focused on just teaching him to stand on the ice, feeling the cold ice with his bare hands, and marching his feet.
If we listen to what society says about only one type of body being right we might miss out on something pretty incredible. Too often in my work as a therapist I hear clients say they can’t do something because their body doesn’t fit the expectations of what has been deemed normal by society. My two ice skating students were people who many might presume were unable to ice skate because of their bodies. They did not struggle with weight stigma, but stigma around disabilities. Many coaches did not want to teach them because they felt it would be too hard to work with them. For me, it was a blessing.
I wish there was more representation of different types of bodies in figure skating and in all sports for that matter. I hope that we can tear down these negative fat biases and that more people in bigger bodies get the opportunity to do the things they wish. Maybe some things need to be modified and maybe you won’t be an Olympic champion, but body size should not be a limiting factor of what one is allowed to do. Think about how your own biases prevent you from doing something.
I am no longer ashamed to tell people I was a figure skater. I am proud to share about my ice skating experiences and the jumps and spins I was able to do. I do not care if there is judgement because figure skating is hard. I bet most people couldn’t do a flying camel spin into a sit spin combination. But, I could, and I deserve to show that off.
In November of 2018, my boyfriend proposed to me. It was one of the most exciting days of my life thus far. With a proposal comes the next exciting chapter: wedding planning. For many brides-to-be, this entails finding that perfect gown.
Sadly, although not surprising, once I got on bridal mailing lists, I learned I was also being targeted by gyms for “Bridal Boot Camps” and “Sweatin’ for the Wedding.” The weight loss industry found yet another way to weasel their way into a life event that should have nothing to do with changing one’s body.
Why is it that you could be with someone who you love for a certain amount of years, and suddenly the moment they place a ring on your finger you need to change your body? Why does looking beautiful equate to weighing less?
Unfortunately, it has become the norm in our culture to experience pressure to lose weight for special events. A friend once shared that when she was dress shopping her consultant actually wrote down smaller measurements because “all brides lose weight.” When my dress consultant mentioned letting her know if I lose weight, my initial thoughts were, “Are you telling me I need to lose weight? Am I supposed to lose weight? What if I like my body where it is? What if I want to gain weight?”
Granted, our bodies can change. But, hearing about weight loss, exercise programs, and diets specific for the big day can be detrimental to our physical and mental health. The diet industry has found another market and doesn’t care how it impacts the people getting married.. Wedding planning can be stressful enough with trying to create a special day without the added pressure to create a “perfect” body.
But, here is the thing. Your fiance asked to marry you not because of what you’ll look like on that one specific day, but because they are in love with you and everything about you. Getting married is about making a commitment of love to one another. Your wedding day should be a celebration of that.
As brides or grooms, we should dress up and present ourselves the way we want to on this day but, it should not be at the expense of our health and well being. Remember what this day is about. Your wedding is not about the celebration of the size of your body but about the love between you and your significant other and making a commitment to one another.
What to do Instead of “Sweatin it”
Here are some tips I have developed to use myself and also with my clients who were wedding dress shopping:
Buy a dress that fits you now. Don’t buy something a size smaller. Don’t use words like “my goal size” or “I’ll be pretty when I fit into this.” Fighting your body to go to a size it isn’t meant to be is only going to add more frustration, stress, and sadness. If the person selling you a dress keeps harping on “when you’ll lose weight” or “all brides lose weight” speak up and tell her that isn’t your plan. You do not have to be a victim of diet culture. Buy the dress that makes you feel pretty right now. Also, do not forget that many dresses you try on are just sample dresses. It’s okay if it doesn’t fit perfectly when you try the dress on. The one you get will be tailored to your already beautiful body,
With that, remind yourself of the things that not only make you look beautiful but what makes you feel beautiful. One of my bridal consultants asked me when picking out a dress, “Do you want to feel whimsical? Do you want to feel like a princess? Do you want to be sexy vixen?” Wedding dress shopping became ten times more fun when I could close my eyes and imagine what style of dress would make me feel the most beautiful.
Write down what you want to feel on your wedding day. Write down your hopes and excitements for this day. Think about what memories you want to hold onto. While the idea of “looking perfect” in your wedding photos may be a strong drive to engage in diet culture, think about what those photos are truly capturing. Most likely, you’ll want to remember this as a day of celebrating love and new beginnings with your partner.
It’s okay to exercise and it is okay to eat. It’s okay to follow your normal routine, As you plan for your wedding continue to follow your intuitive voice. For many people, weddings take months if not years to plan. Do not remove fun foods out of your diet for the sake of just one day. Listen to your body when it comes to exercise. Exercise because you want to give your body the gift of movement, but know it is okay to take days off too. Exercise should not be a punishment to your body.
You do not need to lose weight for your wedding day. Ultimately, remember what this day means to you and your partner. Your wedding dress should be the accessory to the already amazing you. You know, the person that your partner wants to spend the rest of his or her life with. So, when it comes to “sweatin’ for the wedding,” say, “I don’t.”
In today’s digital age, photos of ourselves are everywhere. For many people with eating disorders and body image issues, they can be a source of distress.
Do you avoid photos? Do you refuse to let people take or post photos of you? Do you hide in the back when asked to be in a group photo? Do you agree to be in them but then feel awful when you see them because you can’t stop critiquing your body? Do you spend hours looking at old photos and longing to look like you used to?
If you relate to any of these scenarios, you are like many of my patients who feel uncomfortable with their bodies and either avoid photos altogether or obsess over them. I’m going to suggest some strategies that have been helpful for my patients.
The first thing to understand is your anxiety is almost always increased by the avoidance of something that is distressing but not dangerous. When a situation makes you anxious, the only way to get over it is to face it. With time, your brain learns to tolerate it—we call this habituation. This means that avoiding photos entirely will just increase your distress.
Next, consider how sad it is to not be photographed. As Alison Slater Tate wrote in her widely-shared article “This Mom Stays in the Picture”, “I’m everywhere in their young lives, and yet I have very few pictures of me with them.” I’ve worked with patients that have so avoided photos there was almost no record of their lives. How sad for the people that love them!
On the other hand, it is also unproductive to take photos and then scrutinize the results for each of your flaws. This kind of obsessive focusing is destructive and only makes people feel worse. It also defeats the purpose of having taken the photo.
Photo Exposure Strategies for Body Image
Here’s what I suggest:
When you look at a photo, resist the urge to zero in on your areas of body concern with an eye to criticize. Instead, look at the image of your entire body more holistically. Try to be nonjudgemental and curious.
Remember that what you are looking at is not actually your body, but a representation of your body. Many factors influence this representation—the lighting, the angles, the quality of the camera, the capability of the photographer. (How many times have you taken a number of photos in a row and the people look different and better or worse from one to another?). If you take enough photos, it’s an inevitability that some will be good and some will be bad.
Think about the purpose of taking the photo. Set aside social media bragging rights—the authentic purpose of a photo is to capture a moment in time, to remind you of a feeling you have experienced, to recall a place that is special to you, or to celebrate a relationship.
Take, for example, a woman who attended her sister’s wedding. When she looked at the photos, she could choose to focus on how unmuscular her arms were, the imperfections in her hair, or how she was bigger than certain other guests. Alternatively, she could focus on why they took the photo: the joy she felt in sharing this special occasion and her love for her sister.
Also, keep in mind that your perception of the same photo can differ over time. How many times have you hated a photo when it was taken but looked back on it later and loved it?
So this is my challenge to you: when given the opportunity to pose for a photo, seize it. When you look at the photo, practice not critiquing your appearance or comparing yourself to others or to past versions of yourself. Instead, ask yourself what is important about the photo—why you took it and what you wanted to remember about the moment it captures.
“Body positivity can’t be just about thin, straight, cisgendered, white women who became comfortable with an additional ten pounds on their frame.” —Stacey Rosenfeld, Ph.D., Shape magazine (July, 2018).
Eating disorders are about so much more than body image, but the current diet culture, idealization of the thin ideal, and “war on obesity” make it much harder for people with eating disorders to recover. We are barraged on a daily basis by media images of people who represent only a small portion of the population.
As Dr. Muhlheim discussed in a previous post about fat photography, the mainstream media images we see are not diverse, and the images we do see of larger bodies are often portrayed in a particularly negative and stigmatizing way, adding fuel to the fire.
Thus, an important exercise for people of all sizes in recovery is to curate their social media feed by removing accounts that perpetuate the thin ideal and expand the range of body sizes and types to which one is exposed. Adding diversity to your social media feed isn’t only important for people in recovery, it can be just as important for partners as Sarah Thompson wrote about here. It would even be useful for parents and family members of those recovering.
The term used to describe the absence of representation in media was coined by George Gerbner in 1972. This phenomenon is “symbolic annihilation.” Gerbner was a Hungarian Jewish immigrant and communications professor who researched the influence of television trends on viewers’ perceptions of the world. According to Coleman and Yochim, Gerbner explained that “representation in the fictional world signifies social existence; absence means symbolic annihilation.” Representations, or lack thereof, lead to assumptions about how the world works and who holds power.
Gerbner did not assign symbolic annihilation to any particular group, so it has since been applied to many different identities. We can apply the concept to non-dominant systemic identities, such as larger bodied people, people of color, trans and gender-expansive people, disabled people, etc. If we don’t see bodies like our own represented, we may come to believe “my body doesn’t matter”. Often, this can turn into “I don’t matter”. This means that for people whose bodies are marginalized in any way, it is essential to see images of people that look like them.
We have developed a roundup of Instagram accounts to help you on the journey. While it is not comprehensive, it is a starting point. What follows are some Instagram accounts that show body-positive images that celebrate diverse bodies in ways that mainstream media does not.
At the time of this posting, these accounts are free of body shaming, fat shaming, food shaming, and disordered eating. Some are people in recovery from eating disorders. If we missed one of your favorite accounts that consistently publishes photos of bodies at the margins, please email us and let us know!
People of color
Gender diverse people
People with disabilities
Other body positive accounts to follow
Coleman and Yochim. The Symbolic Annihilation of Race: A Review of the “Blackness” Literature. Perspectives. Spring 2008. http://www.rcgd.isr.umich.edu/prba/perspectives/spring%202008/Means%20Coleman-Yochim.pdf
I’ve recently returned from the Association for Size Diversity and Health (ASDAH) Conference and I’m reflecting on all I’ve learned. I’ve wanted to share and further explore Substantia Jones’ keynote, “Fat Visibility Through Photography: the Who, the How, and the Hell Yeah.”
Jones is a photographer, a “Fat Acceptance Photo-Activist,” and the proprietor of the Adipositivity Project. She started Adipositivity in 2007 to “promote the acceptance of benign human size variation and encourage discussion of body politics” by publishing images of women, men, and couples in larger bodies. Substantia is passionate about the fact that fat people don’t see a balanced representation of themselves in the media—as she says, “Humans need visibility. Positive and neutral visibility is being denied to fat people.”
So many of the media images we see of larger-bodied people portray them in negative and stereotyped ways: unkempt, unhappy, eating fast food, and often headless—as if they are ashamed to show their faces. At the same time, the range of body types provided by media images does not really represent most bodies. The media typically culls the thinnest or fittest sliver of the population, and then proceeds to photoshop the images of these bodies. According to the Body Project, “Only 5% of women have the body type (tall, genetically thin, broad-shouldered, narrow-hipped, long-legged and usually small-breasted) seen in almost all advertising. (When the models have large breasts, they’ve almost always had breast implants.)”
In September 2009, Glamour included a photo of Lizzie Miller, a model who is a size 12-14. The photo showed Lizzie nude and looking joyful while displaying a roll of belly fat. The response was overwhelming—American women were thrilled to see a woman who looked more like them and was happy to boot.
While this was groundbreaking, the average American woman is a size 16. So where are the images of the upper half of the weight spectrum? It should be noted that it is not only larger bodies that are marginalized; other bodies are often not portrayed in mainstream media. These include bodies that are darker-skinned, disabled, aging, and gender diverse.
It is important that people in larger bodies see images of people that look like them. It is also important for all people to broaden their aperture on what people should look like. This includes viewing images of fat people who are happy, sexy, desired, and beautiful and engaging in all the activities that make up a fulfilled life.
Those working in the field of body acceptance confirm the therapeutic value of seeing attractive images of larger-bodied people. Unfortunately, these images can still be hard to find. One must look outside of the mainstream media. With that in mind, I thought it would be useful to provide resources for beautiful, artful photos of people living in larger bodies.
During her keynote, Substantia shared photos from several of her favorite fat-positive photographers, including those that inspired her. Below I list some of the photographers she shared and where to find their photos and information about them.
The photography of Patricia Schwarz can be found in Women of Substance – Portrait and Nude Studies of Large Women, published in Japan in 1996 by The Kiyosato Museum of Photographic Arts. Little has been published about her aside from this article, which states that Schwarz, who belonged to the fat liberation community in the 1980s, specialized in full-color photography of fat women. The book features women posing in domestic, natural and urban settings in various stages of clothing and nudity.
Laura Aguilar is known for her photographs of people from various marginalized communities (including fat, lesbian, and Latina). She is particularly known for portraying her own nude body as a sculptural element in desert landscapes.
Leonard Nimoy (yes, that one) published The Full Body Project, a collection of black-and-white nude photos of members of a burlesque troupe called the Fat-Bottom Revue. According to Nimoy, the purpose of the book was to challenge the harmful beauty ideals promoted by Hollywood.
A blog post by The Militant Baker with some photos
Catherine Oakson was described in an obituary as a creator of “artistic self-portraits—some playful, some sensuous—and messages of body positivity.” Unfortunately, since her death, her photographs are extremely hard to find. Her website, “Cat’s House of Fun,” is only available via web archives (web.archive.org). Search for the website, http://catay.com and look at screen grabs prior to 2017
Shoog McDaniel, an artist and photographer living in Florida, was also present at the ASDAH conference, and their art was used in the conference program. Shoog was featured in this article in Teen Vogue which described them as “the photographer pushing the boundaries of queer, fat-positive photography.” Shoog states “the work that I do is about telling the stories of people who are marginalized and not usually put on the forefront, and whose lives are beautiful and important.”
Although Substantia’s presentation did not touch upon it, it’s worth mentioning Representation Matters, the world’s first website providing high-resolution, royalty-free, stock images of diverse bodies for commercial use. (The image in this post is from Representation Matters.) They specifically include larger bodies portrayed in a positive light. These photos are available for purchase.
Unfortunately, diet culture and thin privilege are alive and well, and those in larger bodies remain marginalized and excluded from most mainstream media. I hope you’ll check out these resources and come to appreciate the vast diversity of the human body. I purchased some photography books to share at my office. Together we need to work to challenge the notion that there is a best way to have a body and learn to celebrate the beauty of all bodies.
Baker, Cindy. 2013. “Aesthetic Priorities and Sociopolitical Concerns: The Fat Female Body in the Photography of Patricia Schwarz and Jennette Williams A Review of Patricia Schwarz: Women of Substance, by Patricia Schwarz, and The Bathers: Photography by Jennette Williams, by Jennette Williams.” Fat Studies 2 (1): 99–102. https://doi.org/10.1080/21604851.2012.709447.
Like many of us, I grew up in a family that possesses a great deal of weight bias. When I gained weight just before puberty my mother put me on diets. My paternal grandfather bribed me to lose weight with the offer of a car. I realize my family members meant well. They stated at the time they were worried I would not be well-liked if I was overweight. At 101 years of age, my maternal grandmother still weighs herself daily and credits the diet she started in high school as the cause of my grandfather falling in love with her.
I have already recounted how I helped my older daughter gain weight when she fell off her weight curve at the age of 12—despite her pediatrician’s misplaced admiration, “You’re just how we all want to be,” (75%ile for height and 25%ile for weight [= thin for your height])” My son and younger daughter gained weight before their growth spurts, which led to that same pediatrician warning me about weight gain and risk of obesity for the two of them. This succinctly illuminates our culture’s weight bias: obesity is a far greater concern than anorexia nervosa.
Now let’s fast-forward to 2 years after the obesity warning for my younger daughter. Nearing the end of her height growth spurt, she has fallen off her weight curve. What is an FBT-trained professional therapist and enlightened mother to do?
She is about 10 pounds below where she should be according to the weight graphs (ignoring the single spurious plot point when I got the obesity warning). She is definitely slender. She does take a medication that could reduce appetite. However, even when she doesn’t take it, she has a small appetite. She does not show any other signs of weight or body concern, eats a range of foods, and is not very active (unlike her older sister when I intervened on her behalf to restore weight).
I notice my admiration for her current shape. I notice the temptation to leave her alone and let her remain on the thin side. After all, my son has gained weight now that he is no longer in high school sports. I notice a stronger urge to react to his food choices than I did when he was thinner. And with some larger relatives in their genetic heritage, I have had the fleeting thought that I would rather keep my daughter thin. WHAT?! I caught my thoughts unconsciously falling into programmed family and societal beliefs that I do not actually agree with on an aware and conscious level.
I examine my feelings and beliefs about what weight gain means for my daughter. I quickly recognized my over-valuing of her slenderness and my own projected anxiety about her potentially being larger. After questioning her pediatrician, who is, not surprisingly, unconcerned, and obtaining a print-out of her growth and weight curves, together we (my daughter and I) settled on adding a daily liquid supplement and mild encouragement to eat more. And, my daughter seems to feel it is a fun challenge.
I do what I ask the families I work with do, which is challenge the bias that thin is better and focus on keeping my daughter on track on her own weight curve, which I know is healthiest for her long term.
This summer (2016) I read the novel Dietland by Sarai Walker. It’s rare to find a novel that is both relevant and sensitive to the concerns of my patients, rarer still one that features a main character in a large body whose happiness is not predicated upon successfully losing weight. I found the book so empowering, I’ve been recommending it to patients.
The book tells the story of Plum Kettle, a young 300-pound woman who lives in New York and works as a ghost-writer answering angsty emails to the editor of a teen magazine. She has been on multiple diets and is planning to have weight loss surgery. While living in the crowded city, she tries hard to not be noticed. Rather than living in the present, she focuses on planning for her future life as a thin person. She orders clothing online that will fit her future thin body.
Walker vividly portrays the stigma and unjust treatment faced by people who inhabit larger bodies. Like many of my larger patients with histories of repeated dieting, Plum suffers from depression and oppression related to being in a larger body. Living in a larger body in a world consumed by diet culture means not physically conforming in certain situations (think restaurant booths, waiting room chairs, and airplanes) and leads to shame and fear of being persecuted in social situations due to one’s size. Not surprisingly, people in larger bodies often have histories of dieting to try to make their bodies conform to the thin cultural ideal. However, because dieting doesn’t work and weight suppression ultimately drives eating disorders and weight regain, people in larger bodies often experience weight regain binge eating, and anxiety and depression.
Out of fear of being teased about her weight, Plum avoids parties, clubs, bars, beaches, amusement parks, and airplanes and, painfully, spends most of her time alone, answering emails either from the café or at home in her apartment.
Through a series of unconventional events, over the course of the book, Plum gains the strength to resist the unrealistic cultural archetype. She turns her anger outward, confronts weight stigma, and stands up to the pressure of society. Ultimately Plum finds her voice and becomes empowered. She learns to accept a body that does not fit the thin ideal, stops putting her life on hold, and starts living her life as she is:
It felt good to be free. With unexpected power in my legs, I kept going, racing ahead with the wind and the sun on my face, taking a leap into the wide world, which now seemed too small to contain me.
While the treatment I offer to patients is more traditional than Plum’s journey in the novel, I hope my patients will undergo the same transformations. In my work with all patients of every size, I employ CBT for eating disorders, but I supplement this evidence-based treatment with a weight-neutral approach and education about the impact of diet culture and weight stigma. I help clients to cultivate a more accepting and compassionate relationship to their bodies and to turn their anger outward, holding up a new lens through which to see the world. I seek to empower them to advocate for their needs while challenging diet culture. This transformation is profound and exciting to witness.
My favorite passage in the book is a line of questions I want to ask my clients:
“I want you to consider something, hon. What if it’s not possible for you to ever become thin? What if there is no one day? What if this is your real life right now? What if you’re already living it?”
The book is both fun and inspiring.
Addendum: June 2018: And, it is being turned into a television show which premieres on AMC on Monday, June 4th and stars Joy Nash as Plum Kettle. Appropriately, the tagline is “Join the Revolution!” I hope you’ll join me and tune in. I was fortunate to attend an event with Marti Noxon, the producer to discuss some of the important issues that will be highlighted by the show, including weight stigma.
When is it ok to comment on another person’s body? Spoiler alert: Never!
By Elisha Carcieri, Ph.D.
As a relatively new mom of an 11-month-old, I’m on the tail end of almost two years of a complete metamorphosis. In nine months my body grew to accommodate another human, delivered that human into the world, and has since been slowly returning to its original, albeit changed, form.
Something bizarre happens when you’re pregnant. For some reason, people take this as an opportunity to comment on physical appearance, especially size and weight, perhaps more so than they do with non-pregnant women. Most don’t mean any harm, and most of the time no harm is done. But even so, I ask…why do it? And I beg…please stop! For the most part, commenting on another person’s body size is, at the very least, unproductive and unhelpful, and at worst a triggering assault on the already high-jacked consciousness of an eating disorder sufferer.
Oftentimes pregnant women will receive comments such as, “looks like you’re ready to pop!” or, “any day now, huh?” But what if that’s not the case? Saying this to a woman who has many months of pregnancy ahead of her has the potential to bring up all sorts of emotions and uncertainties. I recall a stranger stopping me on the street to give me her business card for prenatal water aerobics. She asked me how far along I was and promptly added that I was “showing early for being only 6 months along” and could therefore especially benefit from her services.
As a society, we’re generally obsessed with weight loss, wellness, thinness, and, with regard to pregnant women, “bouncing back.” I think there is an assumption that if you’re saying someone is small or thin, then its fine. But my caution against body comments rings true for comments about thinness or smallness just as much as it does for fatness, largeness, bigness, etc. It can be difficult to understand how comments about smallness might affect someone. We all want to be thin, right? But for a woman carrying a baby, being told you’re looking small can be scary and can bring up unwarranted uncertainties and fears. I can recall being told at the end of my pregnancy that I looked small. “What a tiny baby bump,” “you don’t even look like you’re about to have that baby.” (Mind you, this was the same body that elicited the above “big for 6 months” comment.) These comments came after my doctor told me that I was, in fact, measuring small during that particular week of pregnancy. It took some work to cope with and wrangle the anxious thoughts running through my head. I went on to deliver a 9lb baby…further illustrating the fruitlessness of sharing our flawed perceptions of another person’s size or shape.
The truth is that you just don’t know what another human is dealing with at any given moment. You’re also not likely to be telling them anything they don’t know already. So what’s the point?
Experiencing these comments on my body during and after pregnancy has had me thinking about how difficult it would be to tolerate for someone with an eating disorder, and how difficult comments on body shape and size must be for those with eating disorders even in the absence of pregnancy. I do want to clarify here that no eating disorder is caused by comments made by another person or even necessarily by the negative body image that can result from being on the receiving end of body-focused comments. We don’t know what causes eating disorders. Eating disorders are likely the result of a myriad of genetic/biological, social, and psychological factors. However, we do know that for many men and women suffering from an eating disorder, there is often a core overvaluation of weight and shape in the person’s overall self-concept that places them at risk for engaging in efforts to control their weight or shape. This dieting or extreme restricting food intake can result in binge eating and subsequent control behaviors such as vomiting/laxative use/over-exercise/further restriction of food intake, resulting in a vicious cycle.
For a person in the throes of an eating disorder, a positive or approving comment on weight loss can serve as fuel to the already burning fire that is the eating disorder mindset. Also, what is the message we are sending when we comment on another person’s appearance with approval only when there is an observed weight loss? Isn’t the underlying message that that person is not worthy of approval when their weight is higher? Why would you want to send that message to a loved one? Alternatively, for someone in any stage of recovery from an eating disorder, comments on weight gain can be difficult to manage. I’ll also say that even for those of us who are neither suffering from an eating disorder or in recovery, fielding, and processing these comments simply sucks.
So, the next time you feel compelled to comment on another person’s body shape or size, no matter the circumstances, just don’t! Ask them about themselves, share something about yourself, tell them how great it is to see them, or comment on the weather if there is nothing better to talk about. There is little to gain and much to lose from body-focused comments, no pun intended.
Despite being widely thought of as a disorder primarily affecting females, we know that people of all genders experience eating disorders. The experiences of males with eating disorders may be different so read on to learn more.
It is difficult to know exactly how many males are affected, partly because they have not been researched as much and partly because they are less likely to get diagnosed and treated.
Although it is widely quoted that only 10% of people with eating disorders are male, this is a likely underestimation. More likely, approximately 25% of individuals with anorexia nervosa and bulimia nervosa are male. Males make up even a larger percentage of the people with two more newly recognized diagnoses, Avoidant Restrictive Food Intake Disorder (ARFID) and Binge Eating Disorder. It is estimated that 40 percent of people with binge eating disorder are male. As many as 67 percent of children with ARFID may be male.
Eating disorders in males have been noted since 1689, when Richard Morton, an English physician, described 2 cases of “nervous consumption,” one in a male patient. Males later fell off the radar of eating disorders. Less than 1% of the papers on eating disorders focus on males.
Males have been largely excluded from the literature and research on eating disorders due to a variety of factors including stigma and biased assessment measures. Men may be less likely to endorse symptoms of what is commonly seen as a female illness and reluctant to ask for help. Because eating disorder awareness efforts typically target only girls, boys and men also may be less aware of eating disorders and less likely to recognize their problem as one. For these various reasons, males are likely underreported in prevalence statistics.
Additionally, since all of the available measures used to assess eating disorders were designed for females, they may not capture males with eating disorders. For example, the Eating Disorders Inventory has a question, ” I think my thighs are too large. ” This item is less likely to be endorsed by males because it does not reflect their body image concerns. A male-specific eating disorder assessment tool is the Eating Disorder Assessment for Males (EDAM). For example, a corresponding item on the EDAM might be something similar to, “I check my body several times a day for muscularity, ” which is more oriented toward males’ concerns.
One of the most striking differences between males and females with eating disorders is the difference in body image concerns. This seems to be a reflection of the difference between perceived ideal female and male bodies. While women are encouraged to be thin, males are encouraged to be muscular. There is research indicating that while the ideal body shape for females has gotten thinner over the years, corresponding research shows the ideal for men has gotten bulkier and more muscular.
Whether an eating disorder presents as a desire for thinness or muscularity appears to be related primarily to gender role identification; that is, feminine self-identification appears to be a risk factor for the development in men of thinness-oriented eating disorder psychopathology, while masculine self-identification is linked with the drive for muscularity and may contribute toward the development in men of muscularity-oriented body image concerns.
There is a question as to whether muscle dysmorphia is a type of body dysmorphia (itself a type of obsessive-compulsive and related disorders) or an eating disorder. Dr. Stuart Murray’s research supports that it is an eating disorder because it typically includes both compulsive exercise practices and disordered eating. Disordered eating practices are usually central to muscle dysmorphia, which is why it is not just body dysmorphia. As with female eating disorders, the compulsive exercise practices associated with muscularity-oriented eating disorders are often driven by appearance rather than health or performance.
Muscularity disordered eating may look quite different than the disordered eating more commonly seen in females. Girls and women with eating disorders usually restrict intake of high calorie food items. Males with eating disorders may increase their intake, especially of protein sources, and may also use appearance-enhancing substances such as supplements, steroids, growth hormone, and clenbuterol.
Other Differences Between Male and Female Eating Disorders
Exercise is more central to male presentations of bulimia nervosa than is purging or laxative use. Male eating disorders most typically involve two dimensions for male body image: leanness and muscularity. These may often be mutually exclusive. This can cause a cyclical nature to male eating disorders of bulking (weight gain) followed by cutting (weight loss). Males with bulimia may also not engage in typical binge eating, but may instead have “cheat meals.”
Males with eating disorders have a later age of onset, a greater likelihood of previous overweight status, greater psychiatric comorbidity, and a greater risk for suicidality. They are also less likely to seek treatment and when they do, it is common after a longer period of illness, which reduces the likelihood of a full recovery. Males suffer from many of the same medical issues as females with eating disorders but also may experience decreased testosterone and problems with sexual functioning.
Treatment for male patients with eating disorders must be gender-sensitive and address the stigma of being seen for what is commonly known as a female disorder. Clinicians should explore with male clients what it means for them to be male and how their body reflects that. Treatment with males often focuses more tightly on addressing exercise, which is often the first symptom to present and the last to remit.