You certainly got a 'Hallelujah, Amen' from me on this one Carrie - as I'm ure you you knew you would!

I suffered from a very complex mental illness (i.e. anorexia nervosa = AN) for nearly 30 yrs. It started back in the late 1970s when I was 11 yrs old and there was ZERO media reporting on EDs, no internet, no photoshop and very few glamour magazines. The only magazine I read at the time was 'Beano' - a cartoon comic. I had never heard of AN and neither had my family.

What I think distracts/misleads some professionals is that some (not all) girls with AN are drawn to media images of thin women AFTER they have developed the illness, and particularly when they are being treated by re-feeding and instructed to gain weight. It is well documented that people who are ill with AN selectively process disease-salient cues and (subconsciously) seek-out environmental triggers that exacerbate their disturbed mindset. For some patients these media images also serve as justification to remain thin - i.e. 'models are thin so why are you telling me I should be bigger than them?'

Having now recovered from AN I find it embarrassingly frustrating that when I tell people I had AN they immediately start talking about cultural pressures on women to attain a 'perfect' body. That is soooooo NOT what my AN was about.

Benjamin Radford: thank you!

Oh my goodness, I think I found another hero. Well done that man!

I actually find such a hard line on eating disorders being purely biological to be surprising. I don't have AN, but was diagnosed with BN and was in patient a few years ago. But for me, as much as it disgusts me to admit it, it was because I wanted to be thin. It actually did start as a "diet gone wrong." Obviously, I had the predictors: high anxiety levels, a big perfectionist streak, impulsiveness (that's for BN, not AN)... But I was very influenced by the media. I got the message loud and clear: If I was going to be "pretty" and successful and happy, I needed to be very thin.

I'm only bringing this up, because I think that attention paid to the media messages about thinness are good. It undoubtedly contributes to the unrealistic ideal that girls feel the need to strive for.

(Please don't flame me. I don't often comment, but I wanted to bring this up and I am curious about the subject, that's all.)

I have never once thought that I "got" an eating disorder from the images of thin models or a cultural expectation to conform to a standard of slender beauty. I am thinner than most of them and think I look like shit.

The fact that my anxiety and "issues" manifest themselves in eating disordered behavior doesn't automatically clump me into a neat group of girls striving for success through skinniness. Being underweight is a byproduct of my behaviors, not the goal.

It's extremely frustrating when people assume body image is the main factor, when in reality, it's the farthest thing from my mind. I have never compared myself to others--only compared myself to myself, always trying to best my last effort, if that makes sense.

Anyway, add him to my list of new favorite people.

I applaud Mr. Radford for his comments. While I think the media is wrong for using such thin models, I would not say that it is what's causing so many people to have eating disorders. It definitely plays a big part in lowering women's self-esteem and conveys a false idea of what beauty is, but like you said, eating disorders go beyond that. It bothers me sometimes that people forget that eating disorders are a mental disorder. Even if they started using more realistic models in the media, it wouldn't cure eating disorders.

Hear hear.

It's very true that there is a strong biological link to EDs more so than most people want to acknowledge...I think what gets confusing for most people is that people with EDs do have body image disturbances and those may or may not have existed before the ED.

I do like these kind of shows because a lot of women who do not have EDs have issues with their bodies that ARE largely cultural (I believe cultural images of beauty can causes dissatisfaction, chronic dieting ect in "normal women" but does not cause EDs). So I like things that challenge the ideal and this challenging can help women who might have a poor body image gain a better one, but it won't help prevent EDs.

Carolyn,

If anyone flamed you for voicing your opinion on my blog, they would be banned. I don't want anyone to EVER worry about disagreeing with me.

You do raise a good point: EDs aren't all biological. There's a cultural aspect, absolutely. Dieting is seen as an innocent pastime, and women do feel intense pressure to live up to impossible standards of beauty. An ED can start with a diet--mine did. I wanted to lose a few pounds to look and feel better. If I didn't live in such a diet-philic culture, would it ever have occurred to me to try and lose weight? I don't know.

But in the end, once my eating disorder took hold, the social and cultural aspects became less and less relevent because my illness took on a life of its own.

Thank you for sharing your view, though. I know it takes a lot of courage to disagree with people, and I'm glad you felt safe enough to share.

Carrie,
This is an interesting take on the cultural influence. While I don't agree with everything, it's a different perspective.

http://www.washingtonpost.com/wp-dyn/content/article/2010/03/04/AR2010030401436.html

@Carolyn & Jessa;
I think I hear what you are saying. Each of your posts addresses the proximate triggers you experienced. What Radford, (or at least the part of the quote that we have) is addressing is the ultimate cause of EDs. These are seperate issues, of course.

I agree that Radford quote can be read in such a way that someone might think "thinspo" isn't real, or the pressures brought to bear on women particularly to be skinny have no effect on the people who wind up suffering from EDs. I think that such a position is demonstrably not true. Many people with EDs can point to a specific trigger or starting point - my kid among them. I can easily see how that quote sounds like it's invalidating experiences that many people have actually had.

But consider this; a common arc between people with and without EDs would be the occurance of a trigger, followed by diet and or excercise changes, right? However, the difference that makes the difference is what happens next. Without the biological predisposition, the person may develop disordered habits, may continue to be very unhappy, depressed, & etc. Or they may make moderate and lasting changes. Or they may decide, screw this! find HAES and learn how to deflect the pressures to be skinny and diet.

WITH the biological predisposition, the bio-physiology involved in dieting completely changes. The person indadvertantly starts a feedback loop over which they do not have lasting control from the inside - ie by using willpower or "wanting to change". That neuro-physiological feedback loop affects appetite regulation, perception, proprioception and ultimately how the person thinks and feels and experiences life. It also generally requires outside intervention to correct.

Radford is addressing that latter part. Given how imbued with body-shaming, food-shaming, and youth-worship our culture is, you'd have to be deaf, blind, alone, and living under a rock NOT to be affected by it. But where some people are affected in one kind of unhealthy direction, other people who are wired differently wind up actually behaviorally expressing a disease state.

For the people who have the privilege never to have suffered from ED themselves, the message Radford is sending is important. The people with EDs aren't the most gullible, or weak, or vain amongst us. This isn't a superficial problem. It's a real physical condition that is life-shortening and life-threatening.

I'll give you a hallelujah, amen. HALLELUJAH, AMEN. I'm all worked up and bothered at the idea that this new show is going to perpetuate this tired idea that eating disorders are caused by pressure to be thin and "pretty." I'm so sick of that. I was nodding my head enthusiastically while reading what Radford said. YES! He's got it EXACTLY right. These are rare, biological illnesses we're talking about, not attempts at vanity. I'm so sick of this idea. One of the main reasons I'm shy about discussing anorexia in "real life" is because I don't want to deal with the stereotypes. But, maybe that's exactly why I should "come out."

"What Isabelle Caro, Jessica Simpson, and the VH1 show don’t realize is that anorexia has little or nothing to do with fashion modeling."

Um...it does for the models...have you SEEN Isabelle Caro? Heard of Ana Restin, Luisel Ramos?

"Images of thin people cannot 'encourage' anorexia, any more than photographs of bipolar patients 'encourage' bipolar disorder, or photos of diabetics 'encourage' diabetes."

Better example: Living in a society obsessed with thinness, beauty and dieting can trigger anorexia like living in an isolation pod for a year can trigger psychosis...and being surrounded by fast food on every corner can trigger type II Diabetes. Oh yeah, and it can encourage people to purge, use laxatives, and take un-prescribed diet pills.

"...Nearly every woman in America regularly sees thin women in everyday life and the media, yet according to the National Institute of Mental Health, only about one percent of them develop the disease."

Again, it appears that other eating disorders don't count, and the rise of disordered behaviors as young as elementary school are not counted since they are sub-clinical.

"efforts to educate young girls about the artificiality of airbrushed media images won’t do anything to treat or cure anorexia."

Really? It won't help anyone? And who is it going to hurt? The big picture is being missed here. The show wants women and girls to stop hurting their bodies in the name of beauty--whether they are clinically diagnosed with anorexia like Isabelle Caro, bulimic, or overweight and depressed because of growing divide between reality and what is presented to us as perfection.

There are certainly environmental factors that influence the development and course of bipolar disorder and diabetes. (Sleep in the case of bipolar, for example.)

I think there's a plausible case to be made that ubiquitous diet advice might be a factor that precipitates or perpetuates an eating disorder in some cases. It's hard to imagine it does anyone much good.

http://pediatrics.aappublications.org/cgi/reprint/119/1/e30

Poor body image was a motivator for me to lose weight, but I didn't realize I had AN at the time. My horrible body image preceded the ED and I would often look at magazines in grade 7/8 and wonder why I could not look like those other girls as opposed to being fat/dumpy, etc.

I think growing up in a society that is LESS preoccupied with body image would have lessened my chance of getting AN. Media is not a CAUSE but it IS a percipitating factor.

As you said however, once weight loss occured to an extent, I wasn't one to pull myself out of it and it took on a life of its own. It made me feel calm and powerful and CONFIDENT for the first time in my life.

I think it is important to remember that non-fat phobic anorexia is the minority while many anorexics DO have body image issues. These may FURTHER perpetuate the disorder.

I know I would have an easier time gaining weight if there wasn't so much societal emphasis on size, looks, etc and I am NOT one to read fashion magazines. I just happen to like clothes that fit . . . in smaller sizes. . . that DON'T make me look like a freaking elephant.

Media alone doesn't cause an ED. But wouldn't the world be a much healthier place (and EDs easier to recover from) if diet/fat talk wasn't so common?

As another commenter said, I can't help but wonder if a small minority of EDs have NO genetic predisposition and are simply diets gone wrong --> these may be EDs that are subclinical or reverse/normalize quickly after
refeeding. We do NOT know enough about the genetics to say that EVERY AN sufferer carries genotype X that indicates AN.

Additionally, many women I was in treatment with (including myself) had no family history of EDs, though there may have been a history of mental illness (as is my case.)

Just some thoughts. I think balance is important when looking at these issues

A:)

Adria,

I'm not against the show's premise, which is to help fight oppressive standards of beauty in women. But the thing is, people with eating disorders aren't "hurting themselves in the name of beauty." That's the misconception I'm rallying against. That's the mistake that too many people make. Eating disorders biologically-based mental illness. Environment isn't irrelevant, but eating disorders are so much more than a beauty quest gone wrong.

Yes, models can have anorexia. So can athletes. So can geeky science majors. But neither modeling, nor athletics, nor a penchant for science "causes" eating disorders. Without the biological background, no amount of environmental triggers can "cause" an eating disorder.

Eating disorders aren't beauty illnesses. They're not caused by airbrushed models and unrealistic beauty standards. That could be the proximate trigger, as IrishUp said, but that's not a cause.

Thanks for your great post Carrie. "Without the biological background, no amount of environmental triggers can "cause" an eating disorder" - yes, yes indeed.

My knowledge of the scientific side of things is quite limited...I haven't taken science since high school, actually. So if this is a horribly ignorant question, I apologize in advance.
But...even though AN has little (if anything) to do with images of skinny models...aren't BN and ED-NOS a lot more connected to it? And also, isn't starving in itself a trigger for AN? So isn't the cultural imperative to be stick-thin still damaging, even though it can't directly cause AN? I mean, it probably DOES cause a lot of cases of BN and ED-NOS, and seemingly-innocuous diets can set off an existing genetic predisposition to AN.

I wonder if a lot of the problem here is the word "cause." It seems to me like too simple a construct to be very useful. I find the genetic and neurobiological research on AN very compelling, but I'd be hesitant to say genes or neurobiology cause AN (maybe Radford or others would--I don't know). It seems to me more accurate to say they are responsible for risk. I really think the predisposing/precipitating/perpetuating model makes much more sense than saying, " X causes (or does not cause) AN."

Although I have a special interest in adolescent AN, I agree with Adria and Melissa other eating disorders (as well as disordered eating) merit consideration. Social influence might not be the same across eating disorders.

Yeah, I agree with Jane--what is worse than the increasing numbers of childhood obesity that we hear about all the time--is that because of media pressures, we are finding an alarming number of children who would rather fast, purge, or take prescribed diet pills to lose weight. If society were to do something about the pressure that is being put on these children, we will not save all the anorexics, but we could minimize one trigger for it, and could help the much larger numbers who suffer from bulimia, ed-nos, sub-clinical disorders, and disordered eating which can wreak havoc on a developing child or adult's health(people who ARE, in many cases, suffering for beauty).

Hi

Wow its really good to have found you all.I live in England and am trying desperately to raise awareness of the biological causes of Anorexia. I have been in and out of hospital for the past 12 years and done just about every therapy and actually my eating has become worse.I am in touch with a Doctor who works closely with your Dr Walter Kaye so I am uptodate with research and the latest findings etc.Its so interesting and have always believed in my heart that it is not psychological for me and likewise others.Unfortunately over here no one wants to listen to that, they continue to advise friends,family,the public that this illness is psychological and that if treatment doesnt work then its because the patient 'isnt ready to change' or isnt engaging in treatment!I think its terrible they are doing this, we already suffer enough without brainwashing people who should be supporting us not getting angry with us.I am trying to get things changed here but I am alone doing this and unwell at the same time. I feel that this attitude and 'one size fits all' treatment really needs to be updated into the 21st century.If they think people actually starve themselves to be thin then they really shouldnt be working in eating disorders.The stigma of it being a choice is being started and continued from within the mental health professionals over here, theres not much chance of changing things until they do. I also think that Anorexia has become rather a 'fashion accessory' and people are being diagnosed with it when actually they are extreme dieters. That is completely different and whilst is unhealthy I do believe that is purely about self esteem and losing weight to look better to improve on themselves which I would say is psychological. I lose weight because it makes me feel better inside. I dont like how I look (being thin), its ugly, I dont feel I cant control things in my life and I dont believe its attached to my emotional state either - these cliche statements need challenging.Many professionals keep saying its not about the food - well actually I think it is because if it is a problem in my brain (which they suspect)then it is what I feel when I eat that stops me from doing it not because of how I look or an emotion I surpressed when I was 5! Thank you for making this discussion - I have always felt like a freak over here and a failure in treatment because it never works. I dont feel that the media is responsible for Anorexia but i do think they are responsible for encouraging unhealthy food and eating behaviours. They also dont help with Anorexia - I have tried to get my story into the newspapers but they wont do it unless I give them photos of me in a bikini or simila, they told me they needed the 'shock factor' - I told them I wont do it - Im not trying to raise that sort of awareness I want to make it positive and about how it really is for people living with this - that also suggests that only underweight people suffer from Anorexia - like it goes away when you gain weight !so for that I think they have a huge responsibility.
If anyone has any links or help for me to bring into the public eye please could you let me know or if I can help with something in the u.s then pls let me know.Most of my family live over that way so its cool with me.

Thanks for the space to talk
Farli x