Eating disorders in later life: Some of my peers have had teenage weight levels for decades

I read recently that more Irish children than ever are being hospitalised for eating disorders. Most are teenaged girls, but if my contemporaries are any guide, many will continue to be haunted by their illnesses long into later life, relapsing from time to time. Most of these relapses will be invisible, because they look exactly like dieting.
Friends and relatives may be impressed, congratulatory. Such willpower, such discipline. Some have held for decades to the “target weights” set for teenagers, doing whatever is necessary to hold ageing bodies to adolescent numbers. Many are locked in a cycle of restriction and “bingeing” (do you “binge” on air after holding your breath, on water after hiking in the sun, on sleep after a run of bad nights?) We alternate famine and guilty feast, precious energy and diminishing time devoted to fighting the body’s natural and proper need for food and then to regret when those natural and proper needs prevail.
It’s not big and it’s not clever. Eating disorders are complex, multi-factorial. For the last century, even the most ardent pill-pushing psychiatrists have acknowledged a psychological component, often in the form of punitive treatment regimes where patients might be physically restrained, force-fed and denied access to visitors, clothes and books until they comply.
Mothers – of course – have been blamed. Other professionals have insisted that the dance of restriction and craving will end by itself with enough talking therapy, or indeed that that dance is to the music of patriarchy and will stop if only women listen to their own voices instead of trying to obey a society that says you can never be too thin, that nothing tastes as good as skinny feels. There’s truth, of course, in all of these, but none is complete, which is why these diseases are so hard to endure, so hard to treat, so hard to leave behind.
As a society, as a community, there are ways we could do better. Every time we talk about “guilt” in relation to food, we reinforce the idea that eating is a moral failure. If there is guilt related to the enjoyment of chocolate, it should be because of the conditions in which the cocoa and sugar are grown, harvested, processed, shipped, not because it’s wrong to take pleasure in energy-dense food. Cake is just butter, sugar, flour, eggs, and if there’s sin involved, it’s in the production, not the consumption, of those things.
If, like me, you grow up hearing your parents and their friends, your teachers and your friends’ parents, speak of food as “naughty”, “guilty”, “indulgent” you learn that your inevitable desire for these sinful pleasures is a sign of moral failure, a weakness and a shame. You fight your appetite, and your appetite fights back, because bodies want to live.
Obviously not everyone who pays attention to this rhetoric will develop an eating disorder, and obviously for those who do fall sick there are other things at work too, but such narratives help no one. Even if you believe that all weight loss is healthy and all bodies should be small, if restriction, shame and guilt made people thinner everyone would be emaciated by now.
A theological language has come to permeate our cultural imagination of food, every dish either “virtuous” and therefore not really desirable or “indulgent” and to be rejected or earned by self-denial. Then there are the magic “diet foods” that claim, impossibly, to be both and neither, to trick your palate and body into almost-enjoying almost-disguised fibre, protein, vitamins, masked, invariably, by fake sugar. There is disbelief if you enjoy vegetables (everyone knows they’re virtuous) or dislike doughnuts (but they’re indulgent!), as if energy density were the mark of evil.
[ Daughter’s eating disorder showed me that our youth mental health services need a major rethinkOpens in new window ]
Vegetables and doughnuts have their moments and places. One is not innately “better” than the other unless you are concerned with the ethics of food production and distribution, and in which case a locally-made, organic doughnut might well be better than green beans grown with scarce water in Namibia and air-freighted in plastic wrap. None of this can be addressed, much less solved, at individual or even family level, but we could support people who are already struggling and save a few on the edge by refusing to moralise appetite.
The bodywhys.ie helpline is at 01-2107906, or email [email protected]