Category Archives: diet culture

Calories: Why You Need More Than They Tell You

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I’ve written about this before, but it’s so important that I decided that it is time for a refresher. It’s important because if you are following the recommended daily allowance of calories, or advice you’ve read on the internet, or used a calorie calculator to try and work out how much your body needs, then you are almost certainly not getting enough energy for your body.

So we all know that currently the RDA is 2000 calories for women, and 2500 for men, but what most people don’t know is that number is too low. Especially if you are under 25. For people in recovery from restrictive eating disorders, it’s wayyyyyy too low. Under-eating is damaging to our bodies and to our minds. People who do not diet and eat by listening to their hunger and fullness cues do not eat the RDA when it comes to calorie intake.

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So let me tell you a story.

In 2009 the calorie guidelines were reconsidered when a study found that energy requirements had been underestimated by 16% (around 400cals). What is telling is how the guidelines weren’t changed to accommodate these new findings. On the NHS website is written

“This news does not mean that everyone can, or should, now eat an extra cheeseburger or its equivalent in calories a day. The advisory committee makes it clear that the revised energy intake recommendations do not mean that people should increase the amount they eat and that, if people do eat more, they will need to do more exercise to avoid being overweight or obese.”

What we have here is science telling us that the current calorie guidelines underestimate the energy REQUIREMENTS, yet we are being told by our medical community and our government to not eat the amount that our bodies need. Regardless of the fact that studies found that we need more energy, the government put this on its website in 2017:

“The new campaign, due to launch in the spring of 2018, aims to help people be more aware of and reduce how many calories they consume from the 3 main meals of the day, in particular when eating on the go. There will be a simple rule of thumb to help them do this: 400:600:600 – people should aim for 400 calories from breakfast and 600 each from lunch and dinner.”

There the government are advising 1600 calories as a rule of thumb, and cited obesity as the reason for this. “As we are the sixth most overweight nation on the planet, we believe it is a sensible thing to do.” A sensible thing to do? To deny scientific findings, which have, by the way, repeatedly shown that the calorie guidelines are inadequate? To me that sounds like irrational fatphobia, and a complete misunderstanding about health, which is a pretty scary thought since this information comes from the government itself, not to mention our health physicians. It shows very clearly how our entire society including the medical community and our government is indoctrinated in diet culture and fatphobia, so much so that they will dismiss actual science in favour of advising that people restrict to stay thin. Even when this is unhealthy. Even when it harms us. How can we accept this?

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So what do we do about providing our bodies with enough energy? As stated above, evidence shows that adult women need around 2400 calories and adult men 2900 calories. This is extremely similar to the calorie guidelines shown on The ED Institute website run by Gwyneth Olwyn, who developed the Homeodynamic Recovery Method (formerly known as the MinneMaud Guidelines). Olwyn has always promoted 3000 calories for men over 25 and 2500 calories for women over 25. Under 25 the recommendations are 3500 and 3000 calories respectively, due to the fact that our bodies continue to grow and develop until around that age. Those who exercise or have children need more energy to cover this. On her website you can read an extremely detailed blog post on why the government approved calories guidelines are entirely inadequate, with far more scientific evidence than this simple refresher.

In remission you will have learnt how to listen and respond to hunger and fullness cues and your body will give you signals in order for you to provide it with the right amount of energy, without counting calories. Until then, it is advised that you keep track of calories in order to ensure that you are getting enough energy for your body (I wrote an entire post on this here). I urge you with all my heart to take note of the science, and take care of your body accordingly. Nourish your body. Respect it. Listen to it. Provide it with what it needs.

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On that note, it is also totally normal for someone in recovery from a restrictive eating disorder to eat far more than the calorie guidelines. This has been coined “extreme hunger” in restrictive eating disorder recovery. Extreme hunger is where you are eating above and beyond the calorie guidelines by quite a bit (e.g. over 4,000 calories). Eating between your guidelines and 4,000 calories is additional hunger but not classed as “extreme”, however the following explanation also applies. The reason you might find yourself eating an extreme amount of calories is because your body has acquired significant damages during your restriction and engagement with disordered and harmful behaviours. Your body needs energy for the day (actual daily guideline amounts – NOT the inaccurate government approved guidelines) but it also needs energy on top of that in order to heal the internal damage done to your body. Some people need more, and some people need less. Some people will find their bodies are calling for a more extreme amount for a shorter period, and some people may find that their bodies are calling for a less extreme amount but over a shorter period. This is something that will taper down in time to settle more around the guidelines, but whilst your body is damaged, it often will need more, and whilst it can be terrifying, it is normal. I always compare it to when burns victims are in hospital and put on a high-calorie diet in order to give the body enough energy to heal the damaged skin and flesh. It is a similar concept in that your body will need more energy on top of daily energy expenditure to restore itself to good health internally. You can read several of my blog posts about extreme hunger that include much more detail here and here. also I have my very own YouTube video on the subject, which you can watch here.

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It is a sad, and frankly terrifying fact that we can not always trust our own government or medical communities to ensure our good health. It is frightening how diet culture and fatphobia are so prevalent in every single area of our society, so much so that we can’t even escape it even when we turn to those whose responsibility is to provide us with accurate information in order for us to be as healthy as possible. What we must do is look for ourselves. Research for ourselves. Critical review the information that is given to us, and then take care of ourselves, and if we can, take care of others by enabling the science to be available to others. And most of all, heal the relationship between ourselves and our bodies, and then listen to them – our bodies have the most reliable information on how much we need to eat, and they share that information with us via hunger and fullness cues. Listen.

You can read my original and more detailed blog post on why we need more calories here.

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5 Tips For Coping With January’s Diet and Weight Loss Talk

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It’s January, and we all know what that means: a total inundation of diet talk. It’s EVERYWHERE. TV advertising is filled with diet promotions, “healthy” eating, exercise equipment, gym memberships, and low fat yogurts (although hell, when do those NOT appear in the ad breaks?!). Friends, family, and colleagues are on a mission to lose weight, tone up, or get super heallllltthhyyyyyyy (god, pleeeeeease make it stop). “Lifestyle changes” are being broadcast from the rooftops (it’s still a diet, Susan, don’t kid yourself). It’s really difficult trying to deal with all this talk when you are trying to recover from an eating disorder or dieting, and/or are on a journey towards body acceptance. It can be downright triggering. So here are some tips on how to deal with the diet culture disaster that is January:

1. Set boundaries

I know that this can be really tough for a lot of people, but it is so important. If someone is talking to you about their diet/lifestyle change/new workout routine/how many pounds they’ve lost since only eating lettuce for the past two weeks, or god forbid are trying to offer you “advice”, tell them that it is making you uncomfortable. Hell, tell them that it downright harms you when you are trying so hard to explore a different path. Let them know that diet and exercise talk is not appropriate or helpful for you and that you would appreciate if you engaged in conversation about other topics instead. If they are commenting on your own body or eating habits, let them know it’s entirely not their business.

2. Use facts as a weapon against disordered thoughts

When you are feeling the insidious pull of temptation leading you towards to some sort of restriction, consider the facts:
* Diets don’t work. 95-97% of people who lose weight on diets regain the weight within 2-5 years (if not sooner). They also often end up gaining more weight due to the body trying to protect itself against “famine”.
* Chronic restriction can push people’s set points (their natural, healthy weight that is individual to each person) higher, because the body becomes damaged by getting less energy that it need, and can alter its set point in order to protect itself from harm.
* The metabolism slows as a response to not getting enough energy, and this makes it harder and harder to lose weight – which if you have an eating disorder or have ever been on a diet, you know already.  Leptin levels also drop when our fat levels decrease. Leptin is a hormone produced by the fat cells in our bodies. It exists in the body in proportionate amounts to our weight. Our bodies want to compensate for this loss in leptin and respond by increasing hunger urges, which makes not eating enough super unpleasant – as you know already. Your body does not want to lose weight, and it is going to fight to keep it at its set point.
* Studies show that weight cycling (losing/gaining/losing/gaining) is much more unhealthy than just staying at a higher weight. It increases the risk of developing major illnesses such as cardiovascular disease.
* Restricting often leads to binging, and that’s a signal from your body that you are not getting enough energy on a regular basis. Binging also leads to emotions that are really not fun to experience, and can lead to even more unhealthy behaviours as compensation.  Restriction also leads to obsessing over food, and that means less time for doing things that are important, productive, and enjoyable. In addition, restriction leads to increased cravings – again, not fun to feel, and again, often leads to binging.
* Any type of restriction is a slippery slope. It could easily turn into a full-blown relapse. Don’t risk it.
* Losing weight won’t make you happier. It won’t. We’ve all been there before, ladies and gentlemen. Who’s life was super awesome with an eating disorder/chronic dieting? I’m betting no one at all.
* Did I mention diets don’t work?

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3. Unfollow or mute people on social media who are triggering you

This is advice for anytime of the year, but if people are going on about losing weight, cutting out certain foods, restricting their intake, or exercising then unfollow them. If anyone is making you feel bad about yourself, triggered, or is causing you to compare yourself to them, then unfollow them. If they are a friend or family member that you want to keep on your social media, you can mute their posts, or you can let the know that their posts are negatively impacting on your wellbeing (see tip number 1).

4. Fill your social media feeds with body positive and food positive people

This has helped me so much in the past few years, and is definitely one of the things that gives me ongoing support and a sense of community, hope, and positivity. Start following people who are body positive. Start following people who love food and have a healthy relationship with it. Start following people who are fat, trans, disabled, of other races than your own, etc. Fill your feed with people who are diverse. Fill your feed with people who look like YOU, and people who don’t. Just stop filling it with thin white women (or if you are a guy, muscly white men). Stop looking at people who you want to look like or be like, just because our diet culture told you that’s who you should look like or be like, and start looking at people who celebrate who they are. Start celebrating who you are.

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5. Write down reminders of why you made the choice to try something other than dieting/restricting

There’s a reason that you are in recovery for an eating disorder or chronic dieting. There’s a reason you chose to try going down a new pathway; why you decided to give another option a try. I bet there are quite a few reasons. Write them down somewhere where you can always see them if you need to. If you need any help with thinking of reasons not to relapse, you can check out my blog post ‘Repel the Relapse: 8 Tips for Staying on Track in Recovery from an Eating Disorder‘ or watch my video ‘Reasons to Recover and Reasons Not To Relapse‘ on YouTube.

I know that it sucks to hear the constant chatter about diets, weightloss, exercise, and the body-shaming that comes with it, but you know it’s all for nothing. You know that diets don’t work. You know that it is extremely bad for your physical and mental health. You know it won’t improve your life, or make you happier. Remember remember remember. Grit your teeth, and do your best. You can do this.

Our Bodies and Us: The New Years Revolution

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Artwork by Marie Boiseau

It’s approaching the New Year (another one already?!), and a lot of people will be suffering with those all-too-familiar post-Christmas blues. And a lot of those negative emotions will be coming from the shame and guilt so many of us feel for eating what we wanted and eating more than we usually would. Our cupboards are filled with leftovers: chocolates; biscuits;  crackers; cakes…not to mention the mountain of cheese in the fridge. We are slumped in front of the remaining Christmas TV and we are being inundated with advertisements. Diet advertisements. Like, seriously, they are really shoving it in our faces this year. Every time I turn on my TV there’s a woman with dead eyes smiling at me, talking about her calorie-controlled diet and how much weight she has lost. Her mouth says “this is great!” but her face says “help me I’m starving!”

The diet and weight loss industry raked in $66 billion in America in 2016, and in 2014 the British diet industry was worth £2 billion (and as far as I am aware that hasn’t changed). The UK has a £20 million laxative industry, and almost two thirds of Brits are on a diet “most of the time”, even though research has showed time and time and time again that diets do not work and that 95% of the time people regain the weight that they lost within 2-5 years (and frequently end up gaining more on top of that). In short, these corporate assholes are making money of our self-hatred, and they will feed into it (excuse the pun) as much as they can so they can continue bringing in the big bucks.

Their biggest secret? IT. DOESN’T. WORK. If it did, everyone who has been on a diet or restricted their intake (which if we are honest is pretty much all of us) would be thin, and we would be thin forever, because that is what a success is: reaching a goal and staying past the goal posts (obviously this is not what I view success as, but in that context that is what people on diets are aiming for). But we aren’t staying thin – if we even get there in the first place. Those who go on diets lose weight, then gain it back again, then find another diet to go on, and then regain the weight (and so on and so forth). Or they don’t lose weight at all. If we want to stay thin, we have to punish our bodies and our minds every single day; something that most people cannot sustain, and something that is extremely damaging. Those that can are nearly always the victims of torturous eating disorders – and some of us will die trying to reach an unattainable goal with ever-moving goalposts.

So this year, let’s go into the new year with a different motive. Let’s choose life. Let’s choose happiness. Let’s choose self-love, and body-acceptance. Let’s see food as just that – food. Let’s see how it brings us together. Let’s eliminate the use of labelling foods as “bad” and “good”, and let’s eradicate the words that send a shudder down my spine “I’m being good” or “I’m being naughty” (oh god I’m shuddering just typing it eaugh). Let’s choose to nourish our bodies with adequate and consistent energy. Let’s face our fear foods and overcome them. Let’s stand in front of the mirror and challenge all the negative things that we feel about our bodies. Let’s support our sisters and brothers in body positivity, and let’s make the promise to ourselves and each other not to waste time on diet and weight talk, and self-deprecating comments. It will take time, and it will be hard, but let’s make this not just a New Year’s Resolution, but a New Year’s Revolution. Let’s fight to end body hate, not be a part of it, even if that means taking it one small step at a time.

 

 

So Now We Have to Lose Weight to Get Surgery

On Sunday I read the news that obese NHS patients will not get non-urgent surgery until they lose weight.

It made me want to cry. I’m a recovered anorexic who is very active and eats a varied and balanced diet and because of that I am both fit and healthy. I also happen to fall into the “obese” BMI category. In order to lose weight I would have to restrict my food and exercise to the extreme, leaving me both hungry and exhausted; pushing my body below the weight that it sits naturally at. This is unhealthy, and it would mean that my physical and mental health would be in decline. I would also end up spiralling back down into a very dark and dangerous place, with even more devastating and continual effects to my physical and mental health. If I required non-urgent surgery, I would therefore have to force my body into a place where it is not at its healthiest, experience distressing physical symptoms, and in the process would be triggered into a life-threatening mental illness that could leave my physical health in such a bad way that it could kill me – if the torture of living with an active and consuming eating disorder didn’t tempt me to end my life first. In short, I would be put in a life-threatening situation in order to get non-urgent surgery. For me, it wouldn’t be worth the risk.

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Artwork by Francis Cannon

BMI is bullshit. All health professionals know this. And if they don’t, then they should: there’s been so much indisputable evidence that shows us that using a basic BMI chart to tell us whether we are healthy or not is ridiculously primitive, simplistic, and inaccurate. To think that I might not have access to the same healthcare as someone thinner than me after working so incredibly hard to get to this healthy and happy point in my life both physically and mentally makes me feel sick.

We all have individual natural and healthy weight ranges that our bodies choose and we maintain when we have a healthy lifestyle. We don’t get to choose that weight. No one else gets to choose that weight. Our bodies determine it. And those people who don’t fit into the “socially ideal” weight category (that literally wasn’t EVER intended as a way to measure health) get punished for it (whilst those who push the “obesity epidemic” and reinforce the stigma and myths around “obesity” profit from it). There is so much overwhelming evidence that it is possible to be healthy at most weights, shapes, or sizes (depending on yourself as an individual and what your own personal healthy weight is), and it is nauseating to think that people will be forced to make a choice that could cause them both physical and mental distress. 

Even regardless of health, “singling out patients in this way goes against the principles of the NHS,” says Mr Ian Eardley, senior vice-president at the Royal College of Surgeons in The Independent.

The article also reports on more details:

Patients with a Body Mass Index (BMI) of over 40 will not be referred for routine surgery unless they are able to reduce it to under that number over a nine-month period.

Alternatively they will be required to shed 15 per cent of their weight, according NHS Herts Valley Clinical Commissioning Group (CCG) and NHS East and North Hertfordshire CCG. 

Whichever achieves the greater weight loss will then allow them to be considered for surgery.

Patients with a BMI over 30 but under 40 will also be required to reduce that figure to under 30 or lose 10 per cent of their weight before they are considered for surgery.

This decision is yet another discriminatory act against people in larger bodies in the UK, and I’m so tired of it. I’m tired of being told everywhere I look that my body is “wrong”. I’m tired of watching my category of bodies represented by images of men and women with protruding stomachs and their heads cut out of the shots as if they are nothing but  their size (for example right now I typed in “obese patients will not get non-urgent surgery until they lose weight” into Google and the majority of the images are fat people with their heads chopped off – seriously, I’m so done). I’m tired of things like having a “World Obesity day” following the National Mental Health day – which if it wasn’t so revoltingly ironic, would be laughable, without even addressing the fact that there is literally a day to tell us all how bad and unhealthy our bodies are if we are over a BMI of 30.

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Artwork by Frances Cannon

Despite that, I’m someone who exists in a body that is fairly “average”. Even as an “obese” person, I have an amount of thin privilege. I can fit into clothing at regular stores. My friends laugh as if it is absurd when I say that my body fits into the “obese” category. My booty is the UK’s “average” size (although this booty is anything but average, just saying), and my top half is below the UK’s “average” size (and just so you know the average clothing size for women in the UK is a size 16, which is a US size 12, and in the U.S. the average size is between a 12-14, which is a UK size 16-18). I have only had one health professional (physiotherapist) mention my weight in a negative way (AFTER I had told him all about my previous experience with an eating disorder and described to him my active lifestyle and balanced diet. And boy, did he receive an educational six-page feedback letter on eating disorders and health at every size? Yes he most certainly did). The discrimination that I face is significantly less than those who live in bigger bodies than I do, and it can have devastating effects on mental health.

I don’t want to be fighting to be seen as equal to other people because of my BMI. I don’t want to fight for those bigger and smaller than me to be treated the same. I don’t want to fight to get rid of negative associations with certain body sizes. I just want it to BE like that. Right now. I will, of course, keep fighting this fight, but man, am I exhausted of having to argue with at least one person every time I say that to be obese is okay and that someone who is obese can be just as healthy as someone who is not. And now we have our healthcare to fight for, too.

Hopefully, one day, we will all be at peace with our own bodies, and each other’s, and regardless of our weight, shape, or size, we will be treated equally and our health considered individually. Until then, let’s keep being angry, let’s keep speaking up, let’s keep pointing out the evidence, and let’s never give up.

Artwork by Francis Cannon

A Balanced Diet: What Do Those Words Really Mean?

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We hear it everywhere: in order to be healthy, you need to eat a balanced diet. But what does that really mean? I’m scrolling through Google images right now trying to find an appropriate picture to go with this article, and at least half of the images only show “healthy” foods. You know what I mean: your greens; your grains; your fish; your eggs; your cheese; your meats (the latter four tiny splodges at the top compared to the large array of fruits and breads). A large percentage of the pictures are only of fruit and veg. I mean, come on: I have my own “cheese corner” in my fridge, and no one is ever taking that away from me. Especially not a food chart.

For the most part, the food triangle often used to demonstrate balanced eating is a fairly accurate rough guide, and looks something like this:
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It is a rough guide to the way our diet will look if we listen to our bodies (when energy-balanced and healthy in themselves – not in a state of recovery or beforehand) and follow its cues – and we do not have to do any counting or checking or weighing or recording to trust that this is what our bodies will naturally lead us to do. Our bodies are extremely intelligent and I urge you to listen to them over most external influences.

I also like this pie chart, apart from the wording of “treats”, as these types of foods should just be another part of the pie chart rather than being labelled with a word that holds so many negative connotations.

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What I do like about this pie chart is that it shows that 10% of your diet in a day should include foods deemed “unhealthy” by society. Foods like cookies, sweets, chocolate, cake, biscuits etc. Now this chart shows a representation of your daily diet. If you start to think about it, that means that you can eat these foods every day – something that I have seen demonised in countless magazines and online articles. I have often seen or heard advice that you should only eat “treats” a few times a week, and no way am I giving up my daily dose of baked goods, however much you tell me it’s not good for me, Karen.

The thing is, a lot of us believe the words “balanced diet ” to exclude those yummy foods that are so often seen as the devil. The thing is, these foods are an important part of a varied, balanced diet. They are part of our mental health – because we should not deprive ourselves of anything. They are a good, quick energy source for our bodies, and they are especially helpful to our bodies in recovery because of this. Eating a balanced diet means eating bits of everything. It means not restricting any food types or specific food items, unless you have a food allergy, food intolerance, or you have an illness that requires you to cut out certain foods or monitor them. It means varying what you eat and not eating the exact same thing every day (yeah, I’m talking to you, ED). It means eating foods and consuming liquids that you enjoy. It means getting in those nutrient dense fruit and vegetables. It means providing yourself with an adequate amount of carbohydrates so that you have enough energy for the day. It means having that coffee and cake with Ann, and getting takeaway with Heather, and digging into ice cream and popcorn in front of a movie with Sam. It means changing up your routine. It means being flexible. It means trying out new things. It means going back to old favourites. It means hearty meals, light bites, snacks, and puddings. It means not overthinking it and letting your body lead the way.

So often these wonderful foods like crisps, pizza, and cake are associated with feelings of shame, greed, and overindulgence, and there can be judgement from others when eating them. However, this is only because they also have been made to feel those negative emotions when eating those foods themselves. The thing is, food is not a moral issue (and you can read my article on that here). You are free to eat what you want, when you want. You are free to be as healthy or unhealthy as you want – and that is not anyone’s business. And if you want to be healthy, follow the lead of your body (yes, I will repeat that until my death). If you want to check that you are eating a varied, balanced diet, do a quick valuation of what you eat on an average day or an average week, but don’t overthink it, as this can very quickly descend into a spiral of obsession. As long as every food group is incorporated into your diet, that’s a good sign. And when you’re uhmming and aahing in the cafe with Susan, just get the damn cake.

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It’s Summer Soon and Surprisingly, Fat People Get Hot Too

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Art by Jovanna Radic Eriksson

The summer is fast approaching and that means that the weather is cranking up and sweat patches are about to become a lot more common. It also is the season of self-consciousness as those with bodies that do not fit societal ideals feel unable to wear less clothes and therefore sweat in silence as their smaller counterparts breathe a little easier in mini shorts and tank tops.

There are many reasons someone who has more fat on their body than is deemed socially acceptable (or is only deemed acceptable when wearing less revealing clothes) will feel uncomfortable wearing less clothes. It could be the cellulite on their legs; the way their thighs rub together; the way parts of their body jiggle; the belly folds when they sit down; the softness around the tops of their arms; the back fat creasing around their bra strap; the curves of their hips…and the judgement they might receive for having a body that does those normal, natural, absolutely okay things.

This is a perfect time to point out that everyone of any weight, shape, or size, is allowed to feel physically and mentally comfortable in their bodies and in whatever clothing they choose to wear this summer (and any other season). Everyone deserves to feel safe from humiliation and judgement, and everyone deserves respect and consideration, regardless of what their body looks like. If you feel uncomfortable looking at someone else’s body, then you may want to have a good hard think about what makes you feel a certain aspect of someone’s natural body is unacceptable and why it is affecting you personally. If you are someone who makes comments about or towards other people in regards to their weight, shape, or size, you might want to take a moment to reflect on why you think that someone else’s physical appearance is any of your business and why you are treating that person with less respect just because of how their body looks.

If you are someone who does not fit society’s idea of the “perfect” body, and are struggling to know what to do this summer in regards to clothing, then I urge you strongly to…do whatever the fuck you want. If that means that you want to rock a short little number or feel more comfortable covering your curves in a floaty summer dress, then you do what feels good for you. If you want to strut your stuff in a crop top and leggings, or if you prefer to don a baggy t-shirt and harem pants, then you dress yourself in what feels right. If you want to strip down but aren’t at the stage where you feel confident doing so, then it is perfectly okay to cover yourself up, but please start/continue to work towards accepting and loving your (beautiful) body, because you deserve to feel comfortable in your own skin. Whether you want to get your body out or keep the layers on, you deserve to feel good about yourself.

Top tip: if you’re getting your legs out this summer and have issues with chub rub (those gorgeous thighs loving each other so much that it gives you friction burns), then pop some baby oil on your inner thighs before you stride down the street.

Enjoy your summer. It’s going to be beautiful, and you are too.

 

Hidden Behind A Healthy Weight: The Eating Disorders You Can’t See

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Eating disorders are complex illnesses. They are a mental illness that often result in the deterioration of physical health, and there is not one recovery method that has a high success rate as of yet. They have a complicated entanglement of genetic and environmental causation that is entirely individual to each person. There are many different types of eating disorders (anorexia, bulimia, EDNOS/OSFED, ARFID, BED, purging disorder, rumination disorder, pica), and people of all ages, genders, weights, ethnicity, sexual orientation (etc, etc) can develop one. And yet we are bombarded only with images of eating disorders in the form of extreme anorexia: the emaciated, skeletal bodies of those walking the fine line between life and death. The media blasts out the headlines that often scream something like “I WAS 4ST AND ONLY ATE A LETTUCE LEAF A DAY”. They plaster photos of bones protruding across the articles and present to us an “after” photo of the recovered victim: nearly always a slim, beautiful, white young woman.

And there we have it: the damaging stereotype of what an eating disorder looks like and who develops one. This stereotype harms everyone who deviates from the narrative of pretty young white girl who starves herself to within an inch of her life. I’ve never seen an article about anyone black with an eating disorder. Ever. I’m sure that there are one or two articles out there, but the media all but erases the existence of black men and women with eating disorders. It erases the existence of older adults with eating disorders. It erases the existence of men with eating disorders. In fact, the media erases nearly all eating disorders in themselves – the minority of people with eating disorders experience anorexia nervosa, and an even smaller amount have the chronic anorexia that the magazines depict. “Before the latest change in diagnostic criteria, it was estimated that of those with eating disorders, 10% were anorexic, 40% were bulimic and the rest fall into the EDNOS category” (from here). Most of the 90% of people with eating disorders that are not diagnosed as anorexic will be fit into the “healthy”, “overweight”, or “obese” BMI categories. That’s not to mention all the undiagnosed people who are not seeking help and are invisible because of their weight, who are not getting the help and support that they need and deserve.

There are also different types of “invisible people” with eating disorders at a “healthy” weight. Those who have lost lots of weight but come from a higher weight are one set of people. These people are often congratulated for their weight loss, even though it has been lost in exactly the same way  that someone going from a “healthy” BMI to an “underweight” one has – someone who would be diagnosed with anorexia rather than praised for their efforts. We offer treatment to those that lose weight and fall into the weight criteria for an anorexia diagnosis, and pat those on the back that lose the same amount of weight but come from a weight perceived as socially unacceptable (or a weight perceived as “acceptable” but not “desirable”). And what many people do not know, or forget, is that we all have our own natural healthy weights (that can be pretty much any weight, shape, or size), and if people are well below those weights, they are underweight for their own individual body. So if someone is naturally a BMI of 27 and they starve themselves to a BMI of 20, they are severely underweight for themselves, but their eating disorder are often dismissed as “healthy weight loss efforts”. Their illness can be not only hidden, but recognised as something positive, and therefore encouraged and reinforced. Included in this category are those who will never dip below a “healthy” BMI and could remain invisible for any amount of time, and those who will continue to lose weight. At this point society will go “woah, lose weight but not too much weight!” This is when their weight loss will be recognised as an issue, but as it was never noticed before, by now the person will likely be entrenched with their eating disorder.

Another group are people who have eating disorders but find that their weight doesn’t change much, or there are those that gain weight during their eating disorder. Weight is only a secondary symptom of some eating disorders, and it is important to understand that not everyone experiences a change in weight when suffering from an eating disorder. They are primarily mental illnesses.

Another group of “invisible people” at a “healthy” weight are those who are recovering from a low or lower weight and have gained weight to a weight that society deems “fine”. Peoples see them in the street and don’t suspect a thing. Friends stop worrying and family heave a sigh of relief. Those close to the person show less concern and more frustration: they think that the journey is over. You look fine therefore you must be fine. It’s important to remember that this is a mental illness, and that the physical symptoms are secondary. It is also important to remember that the person may still be at an unhealthy weight for their own personal body, and though they may be an acceptable size in terms of society’s standards, they may be underweight still regardless of BMI. Just because you can’t see their pain doesn’t mean that they are not experiencing it. The mental anguish that led them to rock bottom is still there and still needs to be addressed.

People who look fine but have expressed that they are not need to be taken seriously. They need to be supported, and they need to be encouraged to move towards being healthy and happy: whatever that looks like for them. It might not look like your idea of healthy and happy, but you have to put aside your biases, your judgements, and your prejudices in order to help that person achieve the best life that they can for them.

If you are someone who is living at what society says is a “healthy” weight, but you have engaged in disordered habits to get there, or you are regaining weight and are still unwell but people think you “look fine”, then sit those people down that are important to you and tell them. Set your boundaries, let them know what you need, and ask them to support you to get better. Be open and honest. Don’t downplay your struggles. Be assertive when telling them what is helpful and what is unhelpful.  Print off information on eating disorders to support what you are saying and to give them something to read later to help them to understand how pervasive and powerful an eating disorder is mentally. Write a letter if that is easier. Whatever you do, talk. Your voice needs to be heard.