Ana
Dieting causes eating disorders [1]. And it’s not even necessarily the cultural aspect: Biology has a lot to say before we even consider culture. Anorexia is highly hereditable, [2] and anorexia has been observed throughout history in different cultures, most famously as anorexia mirabilis [3]. The evidence [4] suggests that there is a “famine protocol” built into our brains: If you experience caloric restriction intense enough for long enough, and you will begin to think about food constantly (so as to get ahold of any food you can), but also will be afraid to eat (so as to not burn through what little food you may find). Additionally, you’ll experience a drive to move (to encourage you to move to areas with more readily available food). In times before agriculture, this would’ve been very helpful. In extremely abundant societies like the United States, it is almost always harmful.
It is 2022.
I had heard about intermittent fasting and how it has helped others lose weight, and having been hovering just over a standard BMI for a few years, I figured I’d give it a shot. I began to spend a few of my work days eating only one large burrito bowl all day, at lunch. It was difficult, but I was mostly successful. More than anything, I struggled with the logistics of maintaining my quality of work in a restaurant when I wasn’t eating enough. One day, though, I sat down to eat my single meal of the day, and the thought went through my head:
You shouldn’t eat that. It’ll make you fat.
Of course, I knew that was ridiculous, and I knew that thoughts like that were a fast track to a disaster. I immediately shoved it aside and abandoned the intermittent fasting plan. No amount of weight loss was worth an eating disorder.
It is widely-accepted wisdom that being skinny and eating in certain, controlled ways are healthier for you. Eat this, not that; make mindful substitutions; avoid eating sinful things by filling up on other, morally praiseworthy things. There’s a grain of truth behind it. Highly processed meals seem to be worse for you than less processed meals [5]. Of course, nutrient deficiencies don’t do you any favors either. And, controlling for things like smoking habits, particularly high weights seem to be causally connected to poorer health [6]. I don’t actually think that’s the origin of diet culture, though. Most unfavorably, it can be linked to classism and racism: Once upon a time, only the wealthy could afford enough food to gain substantial fat stores, and so fat was associated with wealth. But once abundance became the norm, and the poorer folks began to gain weight, the upper-classes switched positions so as to maintain that clearly visible marker of status: To be skinny was to be well-mannered, even-tempered, controlled, and kingly, while to be fat was the be boorish, common, and a sign of a lack of self-control. More favorably, diet culture might be seen as a consequence of the food disasters of the 19th and 20th centuries. Before the FDA and the National Labeling and Education Act, food was regularly adulterated with poisons and labeled in ways that were misleading [7, 8]. In that environment, it’s no surprise that people became worried about what they were putting in their bodies. There’s truth in both perspectives, and with it things to be learned from and reasons to be suspicious of the modern approach to nutrition.
It is 2023,
and I had just read Dr. Peter Attia’s book Outlive. It was a game-changer for me. I always had worries about my own physical health, and it both provided me confirmation of this and productive ways to respond. Poor cardiovascular health? Focus on increasing your VO2 max and decreasing your resting heart rate. Want to live longer? Grip strength is closely linked to that, for various reasons, so bump that up. But what was really interesting was the section on metabolic health. It was very thoughtful about a lot of things. Diets tend to fail, so don’t put much stock in doing them, and many overweight people are more metabolically healthy than some normative-weight people, so don’t lean on weight loss unless you have other reasons to suspect it’d help your metabolic health. But it paired that with guarded suggestions: If you can, consider eating this, not that, because studies indicate it stunts the growth of cancer. If you can, consider eating this much, not that much, because animal studies show some longevity benefits. I read this and thought, I can do that. And I did. Some foods became off-limit; others became safe. And I began to consider my caloric intake for the first time: I’ve already had so many calories today, so I can’t eat tonight, no matter how hungry I am. I’ll skip this meal.
On any given day, about 15% of America is actively dieting [9]. There are various reasons for this. Some people diet because they believe it’ll make them healthier. For many, it’s about the aesthetics: They want to look skinny, and therefore conventionally attractive. And for others, dieting is about control. Diets are often started during stressful life transitions: Weddings, new jobs, moves. They can be a way to take back control over a life that is often chaotic, unpredictable, and stressful. After all, that is the core of the diet mindset: If your will is simply strong enough, then you can control what you eat and shape your body to your will. A failure to diet is considered a failure of control. No wonder, then, that anorexia is associated with perfectionism and an overcontrolling personality. When life fails to conform to your designs, it is tempting to put a stranglehold on something close at hand.
It is 2024,
and everything is falling apart for me. My college plans have crumbled. I’ve been struggling with mysterious bouts of nausea that interfere with my life and my work. A loved one had a serious medical emergency resulting in many months of emotional and financial stress. Nothing seems to be going right. I’m often so stressed that I don’t get hungry. My weight plummets in response. I reach the lowest weight I ever had in my adult life. Even though it wasn’t intentional, this brings me a modicum of satisfaction. Everything else is an unrelenting, ongoing disaster, but at least the number on the scale is decreasing. Even as months pass and the stress begins to let up and things begin to stabilize, my eating doesn’t return to normal. I was able to make it without eating normally, and the result was I was finally in the standard BMI range; why would I go back?
Eating disorders are more common and more dangerous than many people think. 9% of Americans, or 28 million people, will be diagnosed with an eating disorder in their lifetime [10]. Even when “mild,” they can be physically and psychologically devastating. Just focusing on restrictive eating disorders, the consequences are terrifying. The body doesn’t like to let go of fat, so a lot of weight loss will come in the form of muscle and water, making the individual weaker and reducing their caloric needs, creating a potential spiral metabolic spiral [11]. When constantly run at a deficit, the brain gets shorted on energy, causing brain fog and damage [12]. Memories can fail to form properly, and normal cognitive processes are disrupted. The gut flora, the healthy bacteria that help you digest what you eat, begin to struggle from a lack of food [13]. Hormones get disrupted, and you lose your natural hunger cues that keep your body fueled [14, 15]. This can all happen even if you aren’t underweight, and even if the restriction doesn’t seem that bad. In fact, eating disorders are notorious for ambivalence: Those suffering from them often don’t really want to recover all that much, no matter how awful it is. They struggle to believe how dangerous it is. By the time they realize how dangerous eating disorders are, they likely have already sustained permanent damage to their body and mind and will carry lingering issues with food for the rest of their life.
It is early 2025.
My husband is worried about me. He’s noticed how much weight I’ve lost, how tired I am, and how I keep skipping meals. He asks me directly: “Do you have an eating disorder?” With full confidence, I tell him no, of course not. I’m not that hungry and it’s healthier for me, anyways. This doesn’t convince him, but he doesn’t press further. It isn’t for another month or two that one of my college classes leads me to the National Eating Disorder Association’s screening tool. Out of curiosity, I took it, and it said that I was at high risk for an eating disorder. I didn’t know how to feel about that. I keep the result open in my tabs for a few days before finally showing my husband. We begin to research what needs to be done. I set up an appointment with a therapist that specializes in eating disorders and a nutritionist, because that’s what I am told needs to be done for people with eating disorders, and I also aware that eating disorders are bad. It doesn’t feel that bad, but that’s what I’m supposed to do, so I do it. All the while, I don’t actually change anything. Is it really that big of a deal? I’m not underweight, and I’m eating super healthy every day, so why change anything? I begin working with my team, all the while not really being convinced that I need a team in the first place. The thoughts come back, telling me, You’re doing so well! Keep going! I bet you can lose way more weight if you keep it up. My restriction continues to get worse.
Food has a spiritual undertone to it. Dietary rules are prevalent in many major religions, and fasting is commonplace. The Buddhist monk Thich Nhat Hanh taught a meditation with tea, treating the tea as if it was the axis around which the world revolved; in drinking it, you find your center both in yourself and in what you are doing. These rules and restrictions have a fundamentally different purpose than the morally-tinged discussions of food in modern diet culture, even as modern diet culture uses terms and phrases like “sinful” to describe rich foods or “I’ve been good” to justify eating something pleasurable. Where religious dietary rules connect you to something bigger, secular diet culture teaches you to obsess over yourself. Instead of remembering that you are reliant on things outside of yourself, you devote your limited higher resources and short life to controlling what you eat. Diet culture is a perverse, inverted religiosity that does little but destroy life by turning its pleasures into its sins and desperately grasping at whatever power might be found, even if it’s a manifestly false hope. After all, most diets fail [16]. And yet we cling to them anyways, returning like a penitent to confession.
It is the middle of 2025.
I don’t actually remember much of what happened. I remember more of 2024’s Pride than 2025’s. I remember clearly my college assignments in January; even though I took Summer classes, I struggle to remember anything that I learned. I know that things got worse before they got better. I know that I couldn’t pray or meditate anymore. I know that I lost my desires, my personality, my hobbies. The thoughts got very intense, berating me for eating anything, telling me that I am a pathetic failure for eating at all. Every meal became a nightmare. My life for many months revolved around food, and alternating between avoiding eating and figuring out how to get myself to eat. Days, weeks disappeared where I thought about almost nothing but food. The turning point came after I told my therapist I had a breakdown over a grilled cheese sandwich. I laughed about it. She asked why I laughed; I didn’t know what to say. Her question haunted me for weeks, until I realized that I wasn’t comprehending how bad things have gotten. I began to imagine one of my close friends describing their life being exactly how my life was, and I realized how alarmed I’d be. I still couldn’t accept that it was really that bad, but it was a place to start. The final breaking point came when my therapist told me I met the criteria for anorexia. That shocked me into reality. I began to try a little harder, work a little more intensely, learn a little more about what I need to do to get out of this hell. It took several months before my mind began to clear. It wasn’t until August that I could pray again.
We would never accept a pill that has the failure rate and risks of dieting. We can do better. We know that intuitive eating—the process of learning to listen to and trust one’s own body when it comes to food, and only supplementing it with what we’ve learned about exercise and nutrition—is more sustainable and has better health outcomes. We can look around and see with our own two eyes how we make each other miserable with fat-shaming and diet culture. We can wash our hands of it. We can recognize how common eating disorders are and encourage each other to develop a healthy, natural relationship to food and to our own bodies, instead of a hateful, adversarial one. It doesn’t have to be this way, and fortunately, it starts with us. We don’t need to burn down any buildings, elect the right people, or convince people of our bespoke philosophies. We can start, right now, to trust ourselves, listen to our own bodies, and refuse to engage with self-hatred and shaming. Each time one of us makes that decision, it makes the lives of everyone around us better.
It is late 2025.
My personality is coming back. I’m writing again. My mind is overflowing with ideas and things I want to learn. I have the energy to do the things I want to do, and sometimes meals are even easy to eat. My weight is restoring, too, which is in turns distressing and motivating. I’m not healed yet, but I’m getting there. It’s incredibly stressful. Restriction was how I coped with the world for over half a year. As my mind emerges, so do my emotions, and I’ve lost my main coping mechanism. I’m building new ones, ones that don’t destroy my body and my mind. Recovery has been, without a doubt, the hardest thing I’ve ever done in my life. It’s also been one of the most valuable, because it’s taught me where I’ve gone wrong. I can’t control everything, and I shouldn’t try. It’s good to care about my health, but it’s possible to go too far. My body isn’t perfect, but it’s still very smart and works very hard to keep me going. It’s a good thing to seek out and enjoy the little pleasures of life. I’m building a better life than I had before, but it’s been very hard, even though I know that many others have gone through a lot worse. I hope that in a few years time, I can share my story and it be a message of resilience and growth. I hope that I might be able to convince even a few people to take the short route to a better life.