Hi Carrie,

Just out of curiosity, what are your beliefs in regards to the idea that, for the development of eating disorders (as well as other things I'm sure), "biology loads the gun, environment pulls the trigger." (or something close to that).

I wonder what you think about that idea because, if that statement is true (which, as of now, I think it is true), then environment does matter for eating disorders. Sure, you have to have the biology to go along with it, but the environment still matters, right? Kate Moss's comment would be considered part of the environment - as would the rest of our dieting-obsessed culture that believes thin = happy. You wrote that "these comments... don't really encourage anorexia." Do you really believe that? Wouldn't these comments be part of the environment part of the 'Environment + biology = ED' equation?

I just wonder what you think about the idea that biology loads the gun and environment pull the trigger because, from your posts, I get the idea that you rarely think any external factor (fashion magazines, dieting culture, sports, etc.) cause EDs. (I think most people agree that they don't, alone, cause EDs... but I get the sense that you think they have very little to do with the development of eating disorders. Is my sense right or am I misinterpreting?) And, for me personally, I don't think I ever would have ended up with an anorexia diagnosis (which has morphed itself into an EDNOS) if I didn't identify myself as a "person who is supposed to be thin," if I didn't do gymnastics, if I hadn't grown up with people telling me "you're so tiny" all the time, etc., etc., etc. Yes, these comments people made, these sports I played, these cultural ideas I absorbed didn't, alone, give me an ED... but would I have ended up with an ED without these comments/ideas/situations? I'll never know, but it's likely not.

So I guess I'm trying to ask you if you really think that Kate Moss's comment doesn't really encourage anorexia? Couldn't comments like that be someone's environmental trigger?

Just thinking....

Oh, ketosis breath, how I loathe thee...definitely a taste I don't miss.

I agree with you about the ridiculousness of referring to anorexia as a "lifestyle choice." I think it is a misconception that is WAY too common, and if the kerfluffle (that is the scientific term) over the Moss comment had to happen, I wish it would have done more to address that issue. The main thing that struck me was that such an intense reaction to her comment mean that it was repeated to way, way, way more people than would have heard it (just in case anyone had NOT heard that quote before, which may be unlikely, but still) than if it had just been passed off as a dumb remark and let go. Because although having an ED is definitely not a decision, remarks like that can easily be latched onto by people who are already in the downward spiral. So I would also agree with Laura, that things like this could indeed serve as triggers, but not in the simplistic way that the gossip columns suggest.

Anyway, you make many good points, as usual. I wish that if the mass media were going to put on an indignant act about being concerned over ED issues, they would at least do it in an informed manner.

Now,

I tend not to blog about environmental factors for several reasons, the largest of which is that lots of people discuss that with more expertise than me. I have found my little science niche because not many others were covering it, and I loves me some good research.

I don't think environment is irrelevant, and I've never said so. Environment matters, and it matters a lot.

Could a quote like this be someone's trigger? Perhaps so. Just like encouragements to wash your hands could be a trigger for OCD. But encouraging people to use hand sanitizer and wash their hands and not touch the doors in the bathroom and...whatever, though perhaps excessive, doesn't really encourage OCD. Those are encouraging cleanliness. Moss was encouraging thinness. This isn't exactly the same as encouraging anorexia.

The other part of the irritation is that this is where a large chunk of media coverage on eating disorders comes from. It's not the majority of the coverage, but the coverage of models and EDs is overblown in proportion to which the link actually effects rates of eating disorders.

I don't know how to separate genes and environment, and research is showing that you really can't. And I guess so much of what we read about anorexia emphasizes the "thinness" factor, when really, low weight is a symptom of anorexia. It's not the disease itself.

But it's still so damn addicting.

And that's where it comes from. That no food can be as pleasing to taste as the pleasure from the addiction to the eating disorder of starvation may be. God, sometimes I feel like I'm high, I swear it. It's sick, it's weird, it's the strangest sensation. When I have not eaten in way too long, I get really spacey. I think I can dance on the clouds, and I get grinning (by myself, of course), and I start humming, and dancing, and smiling at my reflection even sometimes. Hell, yeah, that's better than ordinary, plain old food! I actually LIKE myself when I'm fasting! I know this is a disorder, but I can allow myself to enjoy things, like music and art and light and photographs so much more. I'm less depressed when I'm less fed. That's just from someone still on this side. Who likes to not eat because I love (*am addicted to*) that euphoric, floating, empty feeling so much more than I like to feel weighed down by ordinary, plain, everyday, normal food.

Sorry, I kind of went off on a rabbit trail. But I can understand the common quote "nothing tastes as good as thin feels." And I can imagine that making a connection in someone's brain whose had experiences already with that empty, euphoric feeling. That, like Now.Is.Now said, could be a trigger (even though not an "encouragement").

THanks for elaborating, Carrie. That all makes good sense to me. As always, thanks for such an interesting read of a post/comment!

Also, Carrie, I like what you said about low weight being a symptom of anorexia and not the disease itself. Very much agreed! I've never heard it said like that.

[But It would be way easier to treat if low weight were the disease in its entirety wouldn't it? Just force feed. gain weight. poof. cured. ... It's a tad more complicated than that.... just a tad ;) ]

I blogged about this last week and my post was picked up and quoted by a BBC blogger. I was pleased at first but my goodness, some of the comments from the general public were disgusting. Apparently anorexics are vain, stupid, ridiculous, vacuous, and have 'father complexes', whatever one of them might be. Oh, and anyone who doesn't agree with this statement must be 'overweight and envious' ...yeah, I don't miss ketosis that much either! I don't believe that the media cause eating disorders, but statements like this one from Kate Moss can be used by unwell people to further justify and normalise their behaviour to themselves. Anything that puts a further obstacle in between people who are ill and recovery is a bad thing. And it's highly annoying for someone in recovery to find themselves being called fat and vacuous. I'm a physics student, I'm not vacuous :P

Do you ever get unhelpful comments about your books/blog from the general public Carrie? How on earth do you deal with them?!

The 'fall-out' and 'hysteria' over Kate Moss's comment did huge damage to the understanding of EDs (+ support for their recognition as serious illnesses).

I have NEVER, EVER - in my 32 yrs of struggling with anorexia nervosa - met anyone who developed an ED because they set out to look like a skinny model/celebrity. It is true that some people with EDs become obsessed with thin images and 'pro-ana' chant AFTER they have developed an ED - but this is a SYMPTOM of their ED - not the CAUSE.

It is well known that many people with an ED are sensitive to disease-salient stimuli - be these thin models, food, media advice about diet and exercise etc. Such individuals will be equally sensitive to thin women they see in the street. Executive function is abnormal/unusual in people with EDs - in part due to starvation - but attention to detail while failing to see the bigger picture is probably also an inherent trait.

What's the world to do? Ban ALL slim pretty women that someone with an ED might meet in real life just in case they trigger ED patients?!

There is NO WAY that Kate Moss (or other models idolised by teens) actually CAUSE EDs. EDs are neurobiological.

And, of course, it's essential to remember that many people with EDs are NOT affected by pro-anorexic material. Personally, I feel that 'pro-ana' is ridiculous. It's dangerous for the reason that it simplifies a complex mental illness - i.e. anorexia nervosa - to a fashionable cultural whim.

The more the media (and worse still professionals) continue to harp on about the dangers of what the likes of Kate Moss says, or airbrushed images as a cause of EDs, the more individuals suffering with these serious illnesses will be mocked, sidelined - and potentially blocked from receiving (e.g.) disability support or support for effective medical care.

Part of the reason this statement prompted such outrage was that people without EDs but who may worry about their weight probably felt slayed by it.

Let's say an editor picks up on the statement, feels personally wounded by it and rightly recognizes that others may as well. But in order to make it newsworthy instead of just an odious comment, the editor ties it to eating disorders--meaning well, and in sympathy to ED sufferers. But sympathy without empathy on this topic contributes to misunderstandings of EDs...like that it's really just all the thin "lifestyle." (Ugh.)

Thank you ALL for your comments. I have the best blog readers, EVER!

I wasn't irritated so much at the media's coverage of her comment (which was just dumb, and it was insulting to those with an ED, because we do get addicted in a sense to our symptoms, and there were lots of times in my life where nothing tasted as "good" as starvation), but that it seems the majority of intensive media coverage of eating disorders tends to focus on models and fashion and wanting to be thin. The last is a feature in many (but not all) people with EDs, but it's not just wanting to be thin. OCD isn't wanting to be clean, depression isn't wanting to be sad, and schizophrenia isn't wanting to hear more voices. Wanting to be thin (or fat phobia) is a prominent feature of many EDs, but that's not at the core of an ED.

Katie,

Yes, I have gotten numerous less-than-helpful comments. They have been in the extreme minority of comments, but I have gotten them. I don't feel comfortable discussing specifics in public, but I would love to chat more if you email me at carrie@edbites.com I have plenty of experience getting feedback on my writing from a professional standpoint, and it's a skill to learn how to handle it.

Carrie