Eating Disorders Do Not Discriminate. Neither Should Feminism. Or Recovery.
Despite the myth that eating disorders only affect straight, white, thin, adolescent girls, women and men of all sizes, skin colors, and sexual orientations develop eating disorders. I remember one African-American client (details changes for confidentiality) I saw who was struggling with an eating disorder. She was a bright young woman who struggled with severe bulimia that could not get her family to support her in her recovery because “that’s a white girl’s disease.”
Here are just a few statistics:
African-American girls aged 11-14 consistently scored higher than white girls of the same age on all Eating Disorder Inventory (EDI) scales measuring features commonly associated with eating disorders except for body dissatisfaction and drive for thinness (Striegel-Moore et al, 2000).[i]
A study conducted by Robinson et al, found that among the leanest 25% of 6th and 7th grade girls, Hispanics and Asians reported significantly more body dissatisfaction than did white girls. [ii]
Chamorro & Flores-Ortiz (2000) found that second-generation Mexican-American women-those born in the US to foreign-born parents-were the most acculturated and had the highest disordered eating patterns.[iii]
Acculturation can be defined as the shifting of values from host culture from culture of origin (Kemp & Thomas). This can be one of many intersecting factors in the development of an eating disorder. One woman I worked with in an eating disorder treatment center was a first generation bilingual immigrant. Because her mother didn’t speak English, she had to spend her therapy time translating for her mother. This repeated the dynamic of being “the hero” for the family, and kept the burden of parenting
her mother on her, not allowing her to get the care and attention she needed to heal from her eating disorder. Although the mental health team I worked with attempted to find a translator to lift this burden from the client, we were unsuccessful. Another “miss” in treatment and recovery for eating disorders is the shortage of bilingual therapists and therapists not trained in cultural competence.
Eating Disorders have complex etiology and don’t occur in a vacuum. There is a cultural context in which they occur. I often explore with clients what was going on in their own life, in their family, and in a larger cultural context during the time they developed an eating disorder. There is a reason that eating disorders DO affect many adolescent girls: this is the time during which they are developing into a woman! When we look at how the rite of passage of becoming a woman is held culturally (OR NOT), this make sense. Mary Pipher, PhD in her 2005 book Reviving Ophelia explores the phenomena of how girls entering womanhood begin to collapse inwardly against themselves in a culture that doesn’t support their rite of passage into womanhood:
Why had these lovely and promising human beings fallen prey to depression, eating disorders, suicide attempts, and crushingly low self-esteem? Crashing and burning in a “developmental Bermuda Triangle,” they were coming of age in a media-saturated culture preoccupied with unrealistic ideals of beauty and images of dehumanized sex, a culture rife with addictions and sexually transmitted diseases. They were losing their resiliency and optimism in a “girl-poisoning” culture that propagated values at odds with those necessary to survive.
Similarly, when other rites of passage (pregnancy and postpartum, midlife, coming out as bisexual, lesbian or gay) are not welcomed, there is a cultural compost heap fertile for eating disorders to develop. Eating Disorders do NOT only affect straight women and the research is beginning to reflect that (All research stats from the National Eating Disorders Website, NEDA.org):
- Beginning as early as 12, gay, lesbian and bisexual teens may be at higher risk of binge-eating and purging than heterosexual peers.
- In one study, gay and bisexual boys reported being significantly more likely to have fasted, vomited or taken laxatives or diet pills to control their weight in the last 30 days. Gay males were 7 times more likely to report bingeing and 12 times more likely to report purging than heterosexual males.
- Elevated rates of binge-eating and purging by vomiting or laxative abuse was found for both males and females who identified as gay, lesbian, bisexual or “mostly heterosexual” in comparison to their heterosexual peers.
- Gay men are thought to only represent 5% of the total male population but among men who have eating disorders, 42% identify as gay.
At the intersections of misogyny, racism, homophobia, and classism are implications for where we can become curious and fierce about advocating for women – and men, and transgender people – in their recovery and their rights. Feminist theory has a history of, among other intersectional misses, not addressing the experience of women of color. Intersectionality addresses how, when more than one aspect of discrimination intersects, something else altogether emerges that is missed.
“Intersectionality simply means that there are lots of different parts to our womanhood,” Brittney Cooper, an assistant professor of women’s and gender studies and Africana studies at Rutgers University, explained. “And those parts — race, gender, sexuality, and religion, and ability — are not incidental or auxiliary. They matter politically.”[iv]
Many people, including myself, believe that this intersectionality is the next wave of feminism– and recovery.
[i] National eating Disorders Association (NEDA) website
It’s National Eating Disorders Awareness Week. And the theme this year is “Let’s talk about it.” Talking about eating disorders isn’t necessarily comfortable. Or pretty. Last week I wrote about women having all of their feelings, including anger, and having the right to assert their boundaries. This means a woman has the right to say no. She has a right to say no to unsolicited comments about her appearance and her body size.
When women aren’t allowed to directly express these boundaries or when there is trauma such as sexual assault, an eating disorder can become unconscious expression. For example,
- Binge eating or starving can become I’m going to make my body sexually unattractive so I can be protected from ever having to go through the trauma of sexual abuse again.
- Bulimia can become I’m going to take this food in, in a violent, self-harming way, and then I can get rid of it. I can get the trauma and the pain of the assault out of me.
- Anorexia can become I’m going to show you that you CAN be too thin. I’m so thin that I’m smaller than the 12-year-old girls on model runways that your culture says are sexually attractive or coveted.
At the most basic level, women have the right to say no to abuse and feel safe from sexual and physical assault. But when a woman’s right to say no is laden with cultural ambivalence and minimizing, abuse and rape occur at an alarmingly high level. And rape culture thrives.
No Means No.
Violence against women is still frighteningly common. Here are just a few scary statistics:
- 22% of surveyed women reported they were physically assaulted by a current or former spouse, cohabiting partner, boyfriend or date in their lifetime. (National Violence Against Women Survey, November 2000).
- Approximately 1.3 million women are physically assaulted by an intimate partner annually in the United States. [i]
- Of the American women surveyed who said they had been the victim of a completed or attempted rape at some time in their life, 21.6 percent were younger than age 12 when they were first raped, and 32.4 percent were ages 12 to 17. [ii]
I see many of these women in my practice. (No, not all women recovering from eating disorders have a history of abuse. Eating disorders have a complex and multifaceted etiology.) Sexual assault among women is very common though more common than you may think. Among my colleagues, we talk about how the statistics are more likely to be one in three women.
One in Three
Due to survivors being reticent to report it, the statistics reported are often much lower than the actual numbers. The shame of the abuse is still often carried by the survivor. When assault perpetrated against a woman is blamed on the woman, or not believed, or minimized, there is little incentive to speak up. We need only look at the news of the past few weeks to find evidence for this. And when convictions for three sexual assault felonies, such as in the 2016 Stanford rape case, get reduced from 14 years in state prison to 6 months in county jail, there is little incentive for survivors to pursue legal action.[iii]
If one in three women has been sexually assaulted in their lifetime, that means it is highly likely that you, your spouse, your sister, your mom, your child, your friend, or your colleague has been sexually assaulted. The experience of sexual assault is not limited to women of particular socioeconomic status, ethnicity, or religion. I am probably preaching to the converted here, but just to name a few basic educational points about sexual assault:
- Sexual assault is an act of violence, not sex.
- Sexual assault is not caused by what a woman wears, drinks, or doesn’t drink, or whether she is “in the wrong place at the wrong time.”
- Sexual assault is not consensual. If a woman is unable to consent, that is non-consent. If a woman says stop, then that is non-consent. If a woman has said yes in the past, but is saying no now, that is non-consent.
- Sexual assault can leave long-lasting impact of the survivor, including but not limited to Depression, Anxiety, PTSD, Flashbacks, Self-Harm, Suicidality, Eating Disorders, STD’s, and unwanted Pregnancy.[iv]
I could go on and on about the work to be done in healing “rape culture.” I am grateful for the education and advocacy work[v] being done currently. And I am grateful for the January 2017 Women’s March “Pink Pussy Hat” movement reclaiming women’s bodies and rights as their own. I am grateful for every survivor doing their healing work. I am grateful for every woman and man who says “No, this is not ok” to rape culture. And I am grateful for 19-year-old Nina Donovan writing her “I Am a Nasty Woman” poem and Ashley Judd reading this poem at the Washington DC Women’s March. In Donovan’s poem she writes:
“I am not as nasty as racism…homophobia, sexual assault, transphobia, white supremacy, misogyny, ignorance and white privilege.”[vi]
Feminism today is being called to become intersectional, addressing the places where misogyny, racism, and socioeconomic status intersect, and where they don’t. Stay tuned for the next post on how eating disorders do not just affect straight, white, adolescent women. And, in the meantime, what can you do? You can be an ally. You can talk about it. Talk about eating disorders and that recovery is possible. Talk about how rape culture is not okay. Be an ally: for yourself, for others. Healing is possible. You are not alone.
[iii] “Telling the Story of the Stanford Rape Case” by Marina Koren, The Atlantic, June 6, 2016
[iv] RAINN.org RAINN stands for the Rape, Abuse, and Incest National Network and is the nation’s largest anti-sexual violence organization. RAINN operates the National Sexual Assault Hotline 800-656-HOPE
[vi] Ashley Judd reciting Nina Donovan’s “I Am A Nasty Woman” poem at the January 2017 Women’s March https://www.washingtonpost.com/video/politics/ashley-judd-recites-i-am-a-nasty-woman-poem-at-march/2017/01/21/93205bc6-dffd-11e6-8902-610fe486791c_video.html