Body image and eating disorders – on the same track?

Body image and eating disorders – on the same track?

A keynote speech on body image at the annual conference of Australia’s peak body for eating disorder professionals left me wondering, ‘are we on the right track?’ If we are, which deserves most focus, the body image or the eating disorder?

No offence to the vibrant speaker, UK psychoanalyst Dr Susie Orbach, who describes herself as ‘a clinician talking politics’, but eating disorders are biologically-based brain disorders. This explanation makes sense to me.

I am not a clinician. I am a person who developed Anorexia Nervosa at age 11, living on a farm in the early 1960s – without electricity or television – where ‘body image’ was unheard of. I don’t have letters after my name but I do have 50 years of experience in living with an eating disorder.

When I attend professional eating disorder conferences, I get most interested and excited when speakers talk about the brain, because this is where it all happens. Insights into how our brain works, what happens when the eating disorder develops and what skills we can learn to help ourselves recover – this is what is most helpful to me.

But here I was, listening to Dr Orbach discuss “The politics of the body and the body politic” in her keynote speech to the 11^th annual conference of ANZAED (Australian and New Zealand Academy of Eating Disorders) in Melbourne.

Dr Orbach has written extensively on how the multiple pressures of modern visual culture, family life, and the industries that profit from making us feel unhappy with our appearance have combined to leave us in a permanent state of body anxiety.

Dr Orbach told the audience of more than 300 at the eating disorder conference that our body has been targeted for profit for several decades by the:

• Style Industries
• Music and Fashion Industries
• Big Pharma
• Cosmetic Surgery Industry
• Fitness Industry
• Diet Industry and
• Food Industry.

Self-awareness of the highest order is required not to get sucked in and, perhaps without even knowing we are doing so, contribute to these industries.

The anguish that we have come to feel as we try to manage the multiple assaults on our bodies and eating practices is, Dr Orbach said, palpable. The body has become a personal and political battleground over who owns and controls it. Pre-occupation in defining our body has become, for most of us, very confusing. We don’t know what to eat and when.

By age nine, 50 per cent of girls have been on a diet, Dr Orbach said.

“From age three to old age, we are all worried about what we are eating,” Dr Orbach said.

Worse, from age three we start to hate our bodies.

This is sad, and definitely we need to do away with diets. But do diets cause eating disorders? If they did, we would all have one. Every person who has experienced Anorexia Nervosa, for instance, will know that fear is the biggest problem. It is not something ‘out there’ in the big wide world that scares us, it is the voice or message screaming in our brain.

I don’t think the advertising ‘plague’, aimed at making us feel uncomfortable about our body image, causes eating disorders any more than it causes cancer. Zilch.

Certainly, when on the recovery path, the in-your-face fashion, food, cosmetic, diet and fitness advertisements can be confusing and triggering. This is why we need to learn coping and self-awareness skills, another topic I like to hear discussed at eating disorder conferences.

“The world has gone crazy about bodies,” Dr Orbach said. She showed graphic examples of eyelids, legs, noses and private parts all being operated on, so ‘we all look just the same’.

The body is seen as something to be worked on – the advertising industries create insecurities so that we will go out and buy products to give the companies commercial profit.

So, pull off the blinkers, and what do we see? What happens if we look at our bodies as a body?

The essence of being human, Dr Orbach said, is human culture.

Our personalities are formed in relation to our circumstances, and in the way our bodies relate to others. What is in the parents’ world will be in their baby’s world. Mothers, particularly, influence the child.

“The person who makes the child is the mother,” Dr Orbach said. “The way a mother relates to her body, the way she feeds and comforts, is how the babe will relate and be.”

Dr Orbach drew on examples from her clinical practice to highlight the ways in which our bodies have become both an elusive object and a trouble, but rarely the place we contentedly live from. She said the widespread incidence of body disturbances and practices from eating problems to self-harm, and to cosmetic surgery, were alerting us to a more complex need to understand how we get a body and the terms in which it is made.

Up to 90 per cent of women refuse to do activities because they do not feel good about themselves.

It is time, Dr Orbach said, to fight back against this body tyranny and free women from body hatred.

We need to help girls think it is okay to go outside and play at the ages of six and seven.

We need to influence trainee teachers. We need to empower girls to help shape their culture.

How do we build body love instead of hatred?

Start with mothers and start even before their baby is born. Help the mums feel comfortable with their appetites, body and baby.

And address poison elements that interfere with mothers’ efforts to raise their babies (for example, it is okay to be proud of your mummy tummy – it is no longer the ‘in thing’ for you to starve and exercise it flat within a week of giving birth).

Bin the BMI (Body Mass Index). Hear, hear, to that one! (Toss out the scales, too).

Make body hatred so last season.

Make body love so this season.

Love your body – you’re already perfect.

Join the resistance – love your body.

I don’t have a problem with all this, but again wonder, what has this got to do with the eating disorder illness?

Nudge of agreement from a mother sitting next to me. She scribbles on my notepad:

My daughter is the least body conscious adolescent I have ever seen – she won’t even wear makeup – loathes media images.

Yet this daughter developed Anorexia Nervosa. The mother continued:

Conflating body image with eating disorders actually stigmatized the eating disorder as she was worried she would be seen as vain.

At question time, a clinician in the audience backed this mother’s evidence of experience, asserting to all that “body image problems are not the cause of many, many people who develop eating disorders, and we have a huge shortage of funds in researching for the cause.

“Inpatient treatment does not work for many people with Anorexia Nervosa and Bulimia Nervosa. Why aren’t we focusing on this need at this eating disorder conference?”

My point exactly.

Prof. Susan Paxton, commented, that for many sufferers of Bulimia Nervosa, body image is very much a problem, and it is important to keep everything in perspective. Indeed.

Sigh. To conclude I share a pearl of wisdom from an interview with Prof. Daniel Le Grange: to prevent an eating disorder, we first need to find the cause.

Let’s hold on to hope and stay on track in seeking and sharing answers, both culturally and medically. Together we WILL find a cure.

* Dr Orbach’s research interests have centred around feminism and psychoanalysis, the construction of femininity and gender, globalisation and body image and emotional literacy. Her numerous publications include the classic Fat is a Feminist Issue, Hunger Strike, What Do Women Want (with Luise Eichenbaum), The Impossibility of Sex and her latest book Bodies. She co-edited Fifty Shades of Feminism, to be published this year. The fight to reject the ‘mining of our bodies’ by big business has led to the creation of various activist groups. Dr Orbach described her work as an expert member of the steering group of the British government’s Campaign for Body Confidence and has been a consultant to the World Bank, the NHS and Unilever. She is a founder member of ANTIDOTE, (working for emotional literacy) and Psychotherapists and Counsellors for Social Responsibility and is convenor of Endangered Bodies the international organisation campaigning to challenge the pernicious culture that teaches women and girls to hate their own bodies.