Updated: Apr 29, 2020
Having had an eating disorder is a significant part of my identity. I wish it wasn’t. I wish that I had never believed that my worth was tied up in my body size or appearance. I wish that I had never been taught to be ashamed of or to hide parts of my body and experience. That I had never fallen prey to the idea that the only way I could take up space in this world was to shrink myself. I wish that I could wave a magic wand and take away all eating disorders from those who suffer from them. And, while I’m at it, wave that magic wand, and secure a reality in which none of my 3 daughters (or any of your children) ever experience body oppression or experience the belief that their body is wrong.
But I cannot. I do not have a magic wand. I do not have a 10 day fix, a 5-step program, a perfect model of recovery, or a magic recovery pill. Believe me, if I did, I would find a way to hand them out on every street corner.
This isn’t to say that I suffer from my eating disorder in the same way as I once did. I no longer engage in the type of behaviors I once used as a means to survive my own traumas and pain. I do not spend exorbitant amounts of my day preoccupied with body and food thoughts. I do not see food in black and white categories any longer and do not feel the pressure and obligation I once felt to make myself smaller or to feel bad when it isn’t smaller. When I’m hungry, I eat. When I’m full, I stop. When I eat past fullness or satisfaction, I don’t berate myself or tell myself that I am bad or deserving of shame. When my body changes, I support the change. I buy new clothes. I learn how to move in my changing body. I don’t rush to fix it. When my body wants to move, I move it. When it wants to rest, I rest it. When it wants to be challenged, I challenge it. When it wants to be comforted, I comfort it. For the most part, I live my life unencumbered by the restriction of diet culture I once experienced. But I will always be active in my recovery and hope that you can be too.
My recovery is an ever-evolving process because my body continues to change and the environment in which I live continues to change. My eating disorder didn’t *just happen.* It evolved over time and was promoted by strong forces around me. I believe my eating disorder was a normal, adaptive, resilient response to an abnormal, unhealthy, disordered environment. I believe our culture is disordered and that disordered eating and body oppression have become so normalized in such insidious ways, that we have mistakenly learned to place the problem within bodies, instead of where the problem resides.
You are not the problem. Your body is not the problem. Your experience is not the problem. Your adaptive strategies for survival are not the problem. The problem is a culture that places a disproportionate value and social capital on some bodies over others and forces individuals into adopting survival strategies that may not be health-promoting long-term.
If we could take a person with an eating disorder, give them the best treatment available, extract them from our diet culture and place them on Mars, where we could establish a new social order, in which ALL bodies (Black bodies, Trans bodies, Fat bodies, Disabled bodies) were viewed and regarded equally, then perhaps, individuals could achieve full recovery.
But what does full recovery even mean? Much of this may simply be semantics. I affirm every individual’s autonomy to self-identify using whatever words make sense for his/her/their individual experience. If you identify as Fully Recovered, I genuinely mean it when I say “Good for you!” However, when I hear individuals say “Full recovery is possible” or “I am fully recovered,” I can’t help but notice that it is almost always White, smaller women who are speaking. This makes me wonder if the concept of full recovery is really accessible for all people and if a goal of full recovery might be restrictive toward marginalized individuals. If we’re operating from the premise that our culture has the disorder (which, y’all, it does) and that the bigger root of the problem resides in the culture than in individual bodies, how can we even expect individuals to be able to achieve full recovery until we have a culture that doesn’t other individuals, that doesn’t pay women less, doesn’t criminalize and jail certain groups disproportionately, doesn’t limit civil rights to some groups of people, doesn’t promote exclusive, restrictive, and marginalizing policies and norms. Can someone access full recovery if they are being paid less than the opposite gender or than someone with a different skin color? Can someone access full recovery if they live in fear that their Black son might be shot at the playground? Can someone access full recovery if there are laws in place that restrict their ability to exist in their body’s gender identity or restrict their access to equitable healthcare in their body? I believe the concept of full recovery (without significant changes in our society’s social equality and justice) has the potential to be restrictive toward people of color, trans individuals, fat individuals, individuals with disabilities, and others of marginalized identities.
It is a privilege to even entertain the idea of full recovery. I, as a White, cisgender, able-bodied, small-fat individual, with access to healthcare and financial stability, do not have the same barriers to recovery that someone with other identities might experience. I do not live in the same oppressive, dangerous world that a woman of color or Trans man or undocumented immigrant live in.
Full recovery is exclusive and not available to every Body at all times. My Black friend, who accidentally left something at my house and didn’t feel safe retrieving it from my front porch when I was not there, for fear neighbors might think she was stealing, does not have the same access to full recovery that I have. My Black student who told me her Mom always told her to get a plastic bag, no matter how small her purchase was (even if all she bought was a chapstick) does not have the same access to full recovery that I have.
Intuitive Eating & Health At Every Size are incredibly useful tools for helping individuals heal their relationship to food, body, and movement and are the primary approaches I utilize in my practice. But, for some individuals and groups of people, these approaches are not accessible because the individuals’ first order needs are of safety, security, shelter, and food. In low-income areas where access to a variety of fresh food (or food of any kind) is much more limited (i.e., food deserts), the very concrete and present experience of food insecurity trumps the higher order, more abstract idea of listening to one’s body cues and giving oneself permission to experience body liberation. A mother or father who is working 60 hours a week for a minimum wage salary without benefits, who perhaps is facing racial trauma, fat discrimination, or whatever barriers may be present, is going to have a more difficult time accessing full recovery. Not only may IE and HAES not be accessible (or at the very least, not accessible in the same ways), they could potentially be experienced as harmful mechanisms of furthering shame and structures of oppression if the individual’s lived experience is not considered or contextualized into treatment.
One of the most insidious aspects of diet culture is how it turns the oppressed into their own oppressor. The oppressed individual internalizes the oppression experienced and becomes the oppressor of themselves and of others. Some individuals are more vulnerable to becoming their own oppressor. In the realm of body oppression, the folks who are most vulnerable to this are folks who are genetically larger sized, who may have grown up in a family or environment where their body was not affirmed as it was, and who may have other overlapping experiences of oppression. If you are a fat individual living in a culture that values thinness over fatness, then you are automatically more vulnerable to experiencing oppression from others and, thus, of taking that oppression on and beginning to oppress yourself (i.e., through dieting and body hate). Some individuals are privileged to escape this. There is a privilege in not becoming your own oppressor, that is not always recognized or named, even within HAES communities. If you are a genetically thin person, you are much less likely to experience the body size oppression that those in larger bodies face.
Saying “I’m proud I never dieted” or “I’m anti-diet” may inadvertently communicate a message of being proud you were never oppressed and of being anti-the-strategies-individuals-adopted-to survive tremendous circumstances and multiple levels of oppression. I want to be clear: I think diets suck, are destructive, and soul-draining. I would never suggest one to someone. The majority of my life’s work is helping individuals break free from them. However, many groups of individuals, especially individuals of multiple marginalized identities, turned to diets as a means of surviving their circumstances. It is harmful to shame people for doing what they have accessible to survive and an individual who is not steeped in fat activism or HAES/IE clinical work may receive an “anti-diet” message as an attack on their means of survival, even if that was not the message intended. As providers, instead of marketing and identifying ourselves as anti-diet, we should lead with what we ARE for. One way of doing this is to identify and market ourselves as Fat-Positive.
In the same way that it is important to neutralize binging ED behavior in the healing process, it is important to neutralize dieting ED behavior. When we do this, we can help individuals be open enough to explore what is behind the behavior, what the function of the behavior is, what they are getting from the behavior, and perhaps to consider what it might be like to let go of the behavior. We must find ways to meet people where they’re at in their process of recovery and I believe rigid, dichotomous recovered-or-not-recovered models that have the potential to shame individuals still steeped in dieting, may make this more difficult to do. If we continue to apply frameworks of recovery rigidly, we’re going to leave out some of the individuals that have faced the most significant levels of body oppression and who are in most need of the core messages of HAES and IE.
This is Carolyn Costin’s definition of Recovered:
“Being recovered is when a person can accept his or her natural body size and shape and no longer has a self-destructive relationship with food or exercise. When you are recovered, food and weight take a proper perspective in your life, and what you weigh is not more important than who you are; in fact, actual numbers are of little or no importance at all. When recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size, or reach a certain number on a scale. When you are recovered you do not use eating disorder behaviors to deal with, distract from, or cope with other problems.”
As a person in recovery and as an eating disorders therapist, I find this definition to be a wonderful ideal that I truly wish ALL individuals could be able to access. I am so grateful for Carolyn Costin’s work. I also find this definition incredibly problematic as it centers the problem within the individual and does not consider the multiple levels of oppression an individual may face, including even within medical and eating disorder communities, which still cater to a White, small-bodied patient profile. An individual living in poverty may have not have the privilege to “not compromise their health or betray their soul” because the racist, classist system around them is doing it for them. A fat individual whose healthcare providers refuse to provide care until he/she/ze loses weight, may not have the luxury of accepting his/her/their "natural body size and shape." An individual who is facing tremendous racism and violence may not be able to access other coping strategies to “deal with, distract from, or cope” with what they are facing.
Recovery is hard. Period. Recovery in a culture that promotes disordered eating and inequality of bodies is even harder. But the recovery process is worth it and it is a lot more fulfilling than what diet culture leaves us with. We need to make the recovery process more accessible to more individuals. We need to do away with rigid ways of defining recovery. Recovery does not have to be a race with a set finish line one must cross. It is okay for individuals to weave and zigzag as they go, especially as new body and food challenges present themselves throughout life and especially as individuals are simultaneously doing the best they can with what they have accessible to actively live with multiple levels of oppression and hardship. It is okay for recovery to look different for different individuals. It is okay for one person’s “finish line” to be set at a different point than another’s. As Amy Pershing, LMSW, ACSW teaches about trauma (which body oppression and diet culture promote through disordered eating), some things we heal, some things we manage.
Both are okay.