From the Mailbag

Hello Dr. Stacey,
While reading your blog EDNOS, I began to think about the roots of thin body expectations for women. Where did it come from? When and how did it evolve? When was it decided that thinner looked better? Certainly this is a phenomenon that has been around a relatively short amount of time, judging from photos and portraits of women considered beautiful over a hundred years ago. Perhaps you addressed this in earlier posts. I will peruse...

Also, what other cultures are so wrapped up in this obsession? Are eating disorders cross-cultural? What do eating disorders look like in other parts of the world? Do they only exist in developing nations? Of course, many parts of the world do not have enough food and don't have the luxury.

Sometimes I feel incredibly guilty and disgusting for having an eating disorder when I realize so many people don't have enough food to sustain their health. How dare I not eat healthy when others don't even have that choice. I am filled with self and culture-loathing. But then I realize that this thinking, while true, doesn't help me or anyone else. Self-love. Self-love. Self-love.

Thanks for your BLOG and thanks for reading,
Shelley

“Thinner is better” is a relatively new phenomenon, as we see from artwork and archival data. Looking at the sizes of models, movie stars, Miss America contestants, and even Playboy centerfolds, we see pretty sharp decreases in weight during the second half of the 20th century. Even our mannequins have shrunk—here’s some information I found: In 1950, the hip measurement for store mannequins was 34 inches, reflecting the size of the average woman at the time. Forty years later, when heroic chic descended on the catwalk, the average hip measurement for real women climbed to 37 inches, while mannequins’ hips shrunk to 31 inches. If these mannequins were real, they (along with Barbie, who if her measurements were extrapolated to “real” size, would be 6 feet and 101 pounds) would be amenorrheic. So, as real women have grown, our standards have gotten smaller, and as such, the frequency of dieting and eating disorders has increased.

To answer your second question, eating disorders are cross-cultural. Eating disorder inventories have been translated into countless languages and what we see are many studies documenting disorders among, for example, people of various cultures living in Western countries, as well as in women living around the world. That said, what’s interesting to note is that while women around the world may struggle with disordered eating, the relative incidence may vary, particularly when you take into account the culture’s exposure to Western ideals (see above). Some studies, for instance, show that when developing nations are introduced to Western media (i.e., they first get television access), the incidence of eating disorders increases. Anyone who has watched a couple of hours of Western-influenced television may understand why, both from the programming and commercials. From this, one can argue that eating disorders, to some extent, are culture-bound phenomena. Even with exposure to Western media, however, there is usually an accompanying predisposition—in Western countries, not everyone develops an eating disorder (with the same exposure), so a combination of variables is likely present. This describes what we call the diathesis-stress model—the diathesis is some sort of genetic, biological, or psychological disposition and the stress could be exposure to media, family dynamics, etc.

True, plenty of people around the world don’t have sufficient access to food. David Landes, author and professor of economics and history writes: “This world is divided roughly into three kinds of nations: those that spend lots of money to keep their weight down; those whose people eat to live; and those whose people don't know where their next meal is coming from.” While this provides some perspective, I’m not sure, as you indicate that it’s helpful to compare your struggle with others’, as that leads to greater self-reproach (which can fuel the problem). There will always be someone who suffers more than you—what matters, from my perspective, is that we do what we can to understand and support ourselves and that, if we’re so inclined, we reach out to others with fewer resources.