Eating Disorders: Fat Phobia
A while ago, we here at TS started a series about eating disorders, and I do believe it’s time for an update. Recently I’ve been spending a lot of my time at Science of EDs, a completely fascinating website that provides a lot of information about studies and the science of eating disorders. A couple of the articles I ran across tackled the idea that a fear of gaining weight is a defining characteristic of eating disorders. One of these articles focused on individuals who had eating disorders and also happened to be blind, while another focused on eating disorders cross culturally. These articles really hit home with me on a personal level, and I thought that I would do what I could to dispel the still common misconception that at root, eating disorders are about weight and body image.
A common trope about patients with anorexia or eating disorders is that they have a phobia of gaining weight. This is even in the DSM-IV as part of the diagnosis for anorexia. Most of us accept this without much question: a person with anorexia or an eating disorder is someone who will do anything to avoid gaining weight, who will practice extremely unhealthy habits to avoid gaining, and who cannot see their own, real size in paranoia over gaining weight. Seems simple enough, right? I mean we all know that eating disorders aren’t about food, but of course they’re about self-esteem and body image, right?
For a long time I bought into this trope. I even let my disorder trick me into thinking that I was restricting for the sake of my weight, that I was really just worried about gaining and that I’d be fine with maintaining. I believed that the reason I restricted was because my body was not right. And many others believe that as well. While I never bought into the idea that Western values and conceptions of beauty were what had led me to believe I shouldn’t gain weight, I did believe that weight and beauty were at the core of my disorder. In a recent study, the majority of participants believed that societal influences like skinny models or beauty ideals were what cause eating disorders. That’s blatantly false, as twin studies have shown a significant genetic impact, but the trope remains: eating disorders involve a phobia of gaining weight.
Over some time with my disorder, I came to understand other things as motivation for my behaviors. I began to see how I used it as a coping mechanism for other things that I felt I couldn’t deal with. But it was only when I stumbled across these articles about blind women and women in other cultures who had eating disorders that it really crystallized for me: it was about losing. In a cross-cultural study, women from Asian cultures in particular who had eating disorders did not have a phobia of gaining weight, but were obsessed with losing. This also held true in the study of blind women with eating disorders.
Now it may seem that these are exactly the same thing, but in reality there is a world of difference. When I was in the midst of restricting, I knew that I was at an unhealthy weight. I knew and believed that. And I continued to want to lose because I wanted the pain of it, I wanted the disorder of it, and I wanted the self-destruction that went right along.
There were a wide variety of reasons that people cited for wanting to lose, but the one that summed up my feelings best is as follows:
“It’s like I never knew what self-respect was all about until now. The thinner I get, the better I feel … I’m proud of my stoic, Spartan existence. It reminds me of the lives of the saints and martyrs I used to read about when I was a child … This has become the most important thing I’ve ever done.”
I don’t think most of us pay as much attention to the possibility of gaining weight as we do to the necessity of losing it. Gaining only becomes a problem when we’ve failed so badly at losing. The fact that we want loss in our lives says something. That loss can be a manifestation of all sorts of things to different people. For some, it’s moral: we can only be good people if we give of ourselves, if we lose. For others, we can only be perfect if we lose. For some, we can only control this one thing, and so we want to control how much of us there is, how much we exist.
But the fear of fat is rarely the motivator for losing. For me, it was about the asceticism, the perfectionism, the impossibility of it, and the self-destruction. I grew up in a Catholic environment, and the atmosphere of self-denial got to me. Even in my immediate family, working yourself too hard and not taking care of yourself were synonymous with accomplishment, with taking care of the people around you, and with being a better, harder working individual. In my mind, I could only live up to others’ expectations if my life was difficult, if I was hurting, if I was being Spartan and denying myself things. If I was a saint, who lived through terrible hardship. Otherwise, what was the point of all the things I had accomplished? There was no suffering to make them worth anything.
I also felt that I could not make a single mistake in my life, and in many ways that meant giving things up. I had to give up everything about myself that was not “on track”, that wasn’t part of the plan. And gaining weight was not part of the plan. I also felt in many ways that I could do things that other people couldn’t. In school this was often true. I started to feel like I needed to live up to impossible standards. Surviving on less food than anyone else made me feel almost godly, it made me feel like I was not limited to this world, like I was almost in the next because I could do things that no one else could do and deny my body so much while still using my mind in amazing ways. And the self-denial was my retribution for that. I felt guilty for feeling like I was better than others, so I felt I didn’t deserve as much as they did, or like I needed to hate myself unless I lived up to my potential (which I saw as going on forever).
Loss meant a lot of things for me. It meant the balancing act between believing people’s compliments, and not getting a swelled head. It meant actually working for the things I got. It meant being moral and strong and perfect.
While it was easy to focus on the weight as a marker of how hard I was trying, what I was really in love with was the pain. When I couldn’t restrict anymore, I turned to SIB, another way of hurting myself. This fulfilled many of the same functions. I had a hard time finding meaning in my existence. For some reason, suffering seemed to create more meaning than anything else. It was certainly tinged with religion or spirituality for me, and it felt like a sacrifice for other people. It didn’t make any sense what I might be sacrificing myself FOR, but in Christian theology, Jesus sacrificed himself in a way that had nothing to do with the people that he was “saving”. It was simply his pain that saved us. So in my eyes, pain=salvation for others. I had to act as God.
The fat had little to do with it, except as a measure of my pain or acceptability. While these are all my own particular neuroses, I think they indicate how weight and fat can be morphed into something completely different in the mind of someone who suffers from an ED.
For many others, it also has to do with autonomy. I think that this was also part of my feelings about myself, and the article summed it up as well.
“Confucian familial practices do not encourage autonomy or the overt expression of hostility against authority figures (Rhi, 1998; Slote, 1998). These practices may render individuals susceptible to anorexia nervosa, a disorder that is frequently attributed to deficits in the development of an autonomous self. According to Goodsitt (1997): “Excessive attempts to control the shape of one’s body derive from a terrible sense that one’s body, as an aspect of self-organisation, is out of control—easily influenced, invaded, exploited, and overwhelmed by external forces, whether these are peers, parents, or food. (p. 210)”
All of these ways of viewing weight and weight loss do not circulate around fat phobia, but rather seem to circulate around ordering the world in some way that copes with an anxiety, a depression, a bad experience, or some other stress. The author of these articles describes it as “egosyntonic”, and sums up with this question:
“As I see it, a critical question is: what is the defining feature of anorexia? Is fat phobia with the non fat-phobic cases falling into the “atypical” category, or is it the seemingly more broadly applicable egosyntonic desire to restrict and lose weight? I think the egosyntonic nature of the disorder is definitely more defining of anorexia nervosa. And, by egosyntonic, I suppose I’m being broad, too.”
I think it’s clear from almost every one to one interaction with an eating disordered person that fat phobia is not the defining feature, rather emotional instability, or maladaptive coping strategies were. Almost everyone who I have spoken to about their eating disorder had an underlying motivation, something in their life that they were afraid of, worried about, stressed over, trying to control, or trying to understand.
In many ways, an eating disorder is a way of trying to assert power over the world. It’s trying to bend things so that they make sense and so that you can deal with them. But this assertion comes with the added desire to remain outside of the pain that this world causes us. We as eating disordered individuals are trying to manage the world while we escape from it, because there is something in our world that causes us too much pain or anxiety to handle. Each of us wants to assert our control, our independence, our bodily autonomy as part of this world, while taking ourselves as far away from this world as possible into a place where things don’t hurt as much, where they are numbed. The ability to choose numbness, to choose half-life is autonomy for us. I believe that that contradiction is the central dichotomy in a disorder that is full of dichotomies, and I believe that that is one of the defining features of eating disorders, probably more than fat phobia.