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How I Learned the Mainstream Myth About Eating Disorders Was Wrong

A new awareness campaign once again ties eating disorders directly to body image. The reality is much more complex.

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A longer version of this piece originally appeared on Autumn Whitefield-Madrano's Open Salon blog.

For National Eating Disorders Awareness Week—which starts today—the Renfrew Center, one of the best-known eating disorder treatment facilities in the United States,is sponsoring a new campaign. Called  “Barefaced and Beautiful,” it’s encouraging women to post photos of themselves on various social media without any makeup. The point is to … well, they sort of lost me on that. I think the idea is to display pride in one’s natural, unadorned self, the idea being that … you don’t need to … adorn yourself … with an eating disorder?

I’m being intentionally dense here. Obviously the idea was to touch on the role of appearance dissatisfaction in eating disorders, using something plenty of people wear — makeup — as an entry point for talking about the larger issue. (Certainly it’s more on target than  cryptically posting the color of your bra on Facebook for breast cancer awareness.) And for something like a week designed to raise awareness about eating disorders, you need a campaign that’s simple, accessible and attention-grabbing. But not only does the no-makeup rally willfully ignore the myriad reasons women wear makeup in favor of a one-dimensional shame-based explanation, it treats bodily dissatisfaction as the  cause, not a  symptom, of eating disorders. And if we keep the focus of eating disorder conversations on women’s bodies, we’re doing exactly what women with eating disorders do to themselves.

We should be wary of conflating body image and eating disorders, because they’re not nearly as connected as they’re made out to be. It’s not like she who has the worst body image develops the worst eating disorder, or that people whose body image is average are immune from eating disorders. (I have yet to meet a woman with an active eating disorder who has a goodbody image, but then again, I don’t know tons of women with a good body image to begin with.) I’m baffled that Renfrew chose the makeup hook for its NEDA campaign, unless the idea really was just to raise awareness of the  existence of eating disorders. (“Anorexic” has been a coverline of enough celebrity magazines that I don’t think we need any more awareness of that elementary sort.) Yes, makeup is deeply tied to our ideas of self-presentation. It’s also a method of controlling the way you’re seen, and eating disorders are rooted in control. But none of that shows up in the Renfrew campaign; instead, it’s all about appearance dissatisfaction, as though that alone can set off a disease that ravages one’s life.

Eating disorders are complex beasts, with not-great recovery prospects and the highest mortality rate of any mental illness. We don’t entirely know what causes eating disorders, but last year  when I interviewed Sunny Sea Gold, author of “ Food, the Good Girl’s Drug“ and a recovered binge eater herself, she broke it down nicely:

Therapists pretty much agree that there are three main causes of eating disorders, and most of us who get them have a combination of the three. One is your genetics. Second is your physiology, like the biology of your actual brain — your personality…. The third thing is environment. Environment is broken into two parts: the environment of your home, what your mom and dad said to you, the behaviors they modeled. The other part of environment is culture. So about one-sixth of eating disorders can be blamed on cultural environment, like the pictures we’re shown… If we magically were able to suddenly change the images we see in order to be diverse in all ways, gradually that part of the pressure would relieve itself. But it wouldn’t relieve that need of a girl to control her food intake because she can’t control her life.

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