A plate made to look like a scale, with a tape measure draped over it.

The unfair hierarchy of eating disorders

Eating disorders don’t just affect rich, thin, white women, but that’s who the medical field focuses on. Emmeline Clein joins host Krys Boyd to discuss her own struggles with an eating disorder, how she didn’t meet the weight requirements to be considered anorexic, and how we judge people based on their relationship with food. Her book is “Dead Weight: Essays on Hunger and Harm.”

How pop culture teaches women to shrink 

By Sophia Anderson, Think Intern

It’s no secret that women’s bodies go in and out of style as quickly as shoes and lipstick colors. Look at the Kardashians and their legacy of inserting and removing fillers and implants. Their place in popular culture is an interesting one, such that they are victims of oppressive beauty standards while simultaneously projecting these standards onto their audience of millions of young women.  

Author Emmeline Clein examines American diet culture and its roots in racism and misogyny. She discussed her book “Dead Weight: Essays on Hunger and Harm,” on Think.  

She takes note of all the early 2000s heroines who are villainized for having eating disorders but envied for being thin. While Gen Z may better understand how harmful stringent beauty standards are, our mothers likely remember the popularity of models who were “cocaine skinny” or “heroin chic” in the ‘90s. Characters like Marissa Cooper from “The O.C.” or Angelina Jolie in “Girl, Interrupted” were gaunt and ill from abusing drugs, but somehow epitomized glamour and were to be admired, pitied or even imitated. 

“I think we internalize this message young that if we can channel the pain of girlhood and the learned, taught pain of femininity into this type of self-harm that allows us to fit a beauty standard, it will attract a certain amount of attention and affection,” Clein said. 

It is important to understand the nuance between dieting and eating disorders, especially when one can blend into the other over time.  

“I really feel like often teenage girls feel like they’re making an active choice,” Clein said. “When in fact they’re sort of like reading a room that they’ve been locked into where they’re getting messages from all sides in the society telling them that this is the best choice, to ease their passage through the world and to be treated well by society.” 

Dieting is not inherently negative, but in a culture that bombards women with the message that they need to take up less space (literally and figuratively), teenage girls are particularly vulnerable to their eating habits spiraling out of control. Clein emphasized that this is not their fault. 

Bulimia, anorexia and binge eating disorder, which often overlap, are diseases. But the early medical history of these diagnoses is deeply misogynistic, Clein argues. A psychologist first recognized eating disorders other than anorexia at his clinic in the early 1970s. From the beginning, doctors compared patients with anorexia to Christian saints fasting, while comparing patients with bulimia to animals. This false hierarchy still impacts how we talk about eating disorders today. 

In addition to social consequences like pervasive fatphobia, this thinking leads to dangerous effects on the medical field. Clein said that people with larger bodies are rarely evaluated for eating disorders, even though disordered eating results in weight gain as well as weight loss. When weight loss is praised unconditionally and dieting is recommended as the first course of action for anyone with a large body, it perpetuates the misconception that being fat is always unhealthy and being thin is always healthy.  

“I wanted to flip the script and say teenage girls are in fact not stupid and are not making bad choices,” Clein said, referring to young women who are demonized for engaging in disordered eating behaviors or being diagnosed with eating disorders. “They’re making actually an incredibly intelligent choice to find a way to cope with a society that does not, that might not treat them kindly in their natural body.” 

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    Transcript

    Krys Boyd:

    Eating disorders are among the most lethal mental illnesses, especially if people don’t receive early and effective care. But many insurance companies demand that sufferers fit very limited stereotypes of how these diseases look in a ravaged human body. So, the extremely low BMI of late-stage anorexia may qualify somebody for a bed in a residential treatment. Enter, whereas a person whose entire life is controlled by episodes of purging may not look thin enough to be perceived as ill, and someone with binge eating disorder might be given weight loss tips and plunged into a harmful, lifelong pattern of weight cycling. From KERA in Dallas, this is Think I’m Krys Boyd.

    My guest, writer Emmeline Clein, worries we don’t just broadly misunderstand the pathology of disordered eating. We touch moral judgments to the people who suffer and create a hierarchy of disease that may harm more people than it can help. Clein’s new book is called Dead Weight Essays on hunger and harm. Emmeline, welcome to Think.

    Emmeline Clein:

    Hi, thank you so much for having me.

    Krys Boyd:

    You opened by exploring this trope of the sexy, skinny, sad girl in movies and TV shows. These are young women who drink too much. They take too many drugs and they’re emotionally devastated. But because our culture values women in tiny bodies, they’re seen as almost. I don’t know. Enviable in their brokenness.

    Emmeline Clein:

    Yes, yes. Well, I really wanted to unpack and deconstruct this trope that I hadn’t noticed, especially growing up in media, but then, like looking back into high literature or what we consider high literature as well as what we consider is pop culture, just this idea of this sexy skinny, sad girl who I find is either highly demonized or highly glamorized, or some combination of the two, but is rarely treated with empathy and is rarely placed in a more structural contextualization of how did she come up with these coping mechanisms and like who taught them to her? What structures are they benefiting? So, I was sort of thinking of everyone from like Marissa Cooper was like more and more men falling in love with her throughout that show as she wastes away, and abuses substances and drugs and you see the same thing with the hero and Gene Reese novel. And then you both of those figures being all over Tumblr back in the day or TikTok now and having a really big impact on a lot of young girls psyches sort of. I think we internalized. This message young that like if we can, if we can channel the pain of girlhood and the taught learned pain of femininity into this type of self-harm that allows us to fit a beauty standard, it will attract a certain amount of attention and affection. And this narrative can really like pull you out like a riptide and get in your head. And so, I wanted. First, point out that so many of those stories end with the girl dying young. So, is this really what we? Want to consider aspiring to, but also why is this popping up so many times and why is she always understood from a critical perspective, either as a negative portrayal of women as crazy and vain and ill and or as this glamorously tragic figure? And what if instead we found? In the middle and we tried to baby even save her or like, ask her how she got this way or like not trap her on this very shaky pedestal while also taking her off that pedestal because often she fits a very, very racist, misogynistic. Beauty ideal that I really didn’t want to center in my book, and I wanted to talk about how disordered eating appears in all bodies, but I, but I felt like I couldn’t do that. Tell all those diverse stories honestly without first going into the way that this one beauty standard has infiltrated our minds so much like it would be like, dishonest not to notice. That she’s on that pedestal.

    Krys Boyd:

    Yeah. I mean, you make very clear in this book. We need to stop blaming people with eating disorders for their own illnesses. If they have, like, chosen to torture themselves and could stop at any time they wanted. But at the moment this all started for you before it got dangerously out of control. Was there a part of you that felt like you had a choice?

    Emmeline Clein:

    I think that’s an interesting question. I think that yes, it felt like a choice at the beginning to start adopting some of these restrictive behaviors that can very quickly spiral into things that do not feel within your control and feel like compulsive. But I think what’s interesting about that notion of choice what is I wanted to. Demonstrate. Is that what does feel like a choice at first, like going on a diet that you’re reading about in a magazine or seeing on someone’s blog or whatever it is? I really feel like often teenage girls. Feel like they’re making an active choice, when in fact they’re sort of like reading a room that they’ve been locked into, where they’re getting messages from all sides in this society, telling them that this is the best choice to ease their passage through the world and to be treated well by society, right. It is a choice, and it is. At first, and it is a coping mechanism that is also a disease that is developed and thrall to a beauty standard that we’ve all been fed for pardon upon our entire lives. And so, and I feel like girls making that choice are often cast as sort of these, like they and crazy girls making such a self-harming choice even though we have feminism, and we have body positivity or whatever. And I wanted to flip the script and say teenage girls are in fact not stupid and are not making bad choices. They’re making an incredible intelligent. Choice to find a way to cope with a society that does not, that that might not treat them kindly in their natural body, and what we need to do is create more options for more choices by showing them where these choices could lead and revealing all the different. Is from the food big food industry to the diet industry, to the medical weightless industry that are benefiting from them making these choices.

    Krys Boyd:

    There are rampant misconceptions about who’s at risk from these illnesses. I mean, the classic story right is that it’s straight white, wealthy girl somehow warped by the beauty standards of straight, white, wealthy men. But as you point out, the patriarchy affects LGBTQ people at least as much.

    Emmeline Clein:

    Totally the narrative that we’ve been, we’ve been taught to believe about eating disorders and the stereotypical eating disorder patient who is that wealthy white girl that assists and straight that you just described, who’s sort of embodying these constructs of femininity almost like too well, or is actually, like, demographically not who this afflicts. Those like eating disorders affects black women just as much as they affect white women. They affect LGBTQ youth, often in higher numbers than in straights, as youth, and I think that what’s going on. There often is that this narrative is just like, honestly as thin as the body we’ve been taught to want, and in fact, moving through a world that upholds that beauty standard and uphold so many standards about sexuality, it can feel like an almost like assimilationist coping mechanism. To try to hide your early sexual yearning, if it is not straight sexual yearning by kind of like exerting this agency on your body. If you can’t control its appetites in one way, maybe you try to control its appetites in another way or try to make your body. Look, the way you’ve been taught, the heterosexual patriarchy wants it to look to sort of camouflage other yearnings you have. And I I spoke to many people who sort of felt that way.

    Krys Boyd:

    One, I mean horrible consequence of the way culture intersects with illness is that there’s a bizarre kind of hierarchy right to the way we think about and care about people who are suffering from eating disorders for a long time, the only diagnosable one was anorexia. And then early 70s, the psychologist who ran an eating disorder clinic looked around and recognized not all his patients looked like what anorexics were presumed to look like. Talk about how they were different.

    Emmeline Clein:

    Yes. So basically, I for yeah, for a long time, anorexia was the only eating disorder that appeared in the DSM, which is the psychiatrist, like classificatory encyclopedia and. In the 70s, this Doctor Who was running an anorexia clinic, even though the time that anorexia was being talked about as a disease, doctors would notice that many people with anorexia also like had periods where they would binge or where they would make themselves throw up. But they just never really talked about it that much because they just understood that. Sort of like these weird relapse periods, which it makes sense. Of course, your body, if it’s in starvation mode, will eventually rebel and crave a binge. But they weren’t being diagnosed as their own symptoms of the eating disorder. And then. This doctor had a lot of patients who were coming to him and saying I think I have anorexia because that’s the only eating disorder, you know, that they had heard of and they were often starving themselves, but then they would tell them that they were also very often eating in very large quantities and then forcing themselves to throw up after. And he noticed that. The people that were doing that were also often not quite as emaciated as many of his anorexic. Patients and he kind of started constructing from the very beginning this artificial dichotomy between bulimia and anorexia that casted bulimics as like where anorexics are that good girl like perfectionist, femininity, bulimics are like the spoiled girls who want to have it all and he would. Was writing really cruel and misogynistic things like that. They were like, more sexually active and that they were bigger and like. I mean, even the name bulimia nervosa translates to ox hunger. You have anorexics being compared to the fasting Saints of Krystendom. And you have polemics immediately being compared to animals and to this hierarchy is already being set up, which is going to create a diagnostic system that makes it much harder to recover from a disease that. Is shrouded in both like shame around what the symptoms are and also the self blame that both eating disorders are imagined to. 12 and on top of that. I argue in this book that a lot of and we can get into binging to start our next, the fact that we even have all of these different diagnosis is not actually as helpful as we think it is because pretty much it’s very rare to just have one eating disorders like most people I spoke to had had. Some form of. Multiple eating disorders. Whether it’s an anorexic period followed by a bulimic period or an anorexic period that becomes a binge. Period or vice versa, and the scientific studies show that, too. It’s something like almost half of anorexics go on to develop binge eating disorders by siling people off and making them feel like they’re, like in competition for the better diagnosis. We lose opportunities for solidarity between people who are suffering. From the same psychiatric and like cognitive and emotional symptoms, even if the manifestation around the eating is slightly different.

    Krys Boyd:

    You mentioned binge eating disorder, which is a situation which people don’t necessarily purge. And they these folks find themselves on the lowest rung of the sympathy scale because they tend to put on weight, and people who suffer from this disorder turn out to vastly outnumber people with anorexia or bulimia. But they’re almost invisible within the healthcare community. Questions may not even be asked.

    Emmeline Clein:

    Yes, since you disorder was only added to the DSM in 2013 because our society and our medical system is so fat phobic. Often when a person. That is living in a larger body goes to their doctor. One of the first things they’ll be suggested if they have any complaint will be to go on a diet and like see if that helps alleviate problems before they’re given the same types of scans or screening questions as a thinner person with the same complaints that people are not screened for, eating disorders, even binge eating disorder. Even though binging just sort of can lead to weight gain and could be part of the reason that they’re appearing in that they’re living in that body in the. Place. But even still, our notions of what levels of fatness are dangerous are very, very skewed, and the obesity epidemic as an idea has largely been constructed by drug companies that are making weight loss drugs. Obesity itself was only classified as a chronic condition. Also in 2013. Of course, obesity can be very dangerous at high grades, but BMI itself is a very racist and misogynistic metric and a flawed metric of health. But being in the band that’s considered overweight or the band that’s Grade 1 does not actually, if you’re not weight cycling a lot, it’s not actually associated with that many heart problems. Any more than for than somebody who falls into the normal band, but people that are in the very thin spectrum and who are in the larger spectrum but and are losing and gaining weight multiple times, which is often the result of a pattern of extreme dieting that in my opinion is not very different clinically from a pattern of. Extreme restriction and anorexic behavior followed by binge eating behavior. But because it’s going undiagnosed and is actually only being exacerbated in these people by the fact that their doctors are prescribing them diets rather than prescribing their mental healthcare for the eating disorder, it all only gets worse. And then if a heart problem.

    Krys Boyd:

    Does their eyes it gets blamed on the size of their body rather than perhaps the reason their body might be that size in the first place? I mean some people who look fat may well have lost huge amounts of weight in a very short time, and then, as you mentioned, cycle or started all over again. Do doctors tend to ask probing questions of people who have lost a lot of weight if they are still believed to be overweight? Is this ever a subject of concern?

    Emmeline Clein:

    So I mean, I obviously can’t speak for all doctors in general. That is a big part of the reason we have this largely undiagnosed missed epidemic of both anorexia and binge eating disorder often appearing back-to-back. In larger people because when larger person shows up to their doctor’s office and has lost a lot of weight, they are usually just like congratulated and encouraged to keep up the good work. And that message is also being given to them from all sides. They’re often receiving that message from people in their life. That are not medical professionals and I think like one of the things that really needs to shift in our approach to. Eating disorders as an as a epidemic in this country is that these diseases are so deeply prevalent, like one in 10 people will be diagnosed with an eating disorder in their lives, and we make the diagnostic paradigms so exclusionary that that’s a huge undercount of who actually has them. But even with that number, we know that over 10,000 people will die of eating disorders in this country. Annually, so with numbers like that, I really think that pretty much. That in the same way that your General practitioner asks you if you smoke and like if you drink, when you’re at your yearly physical, they should be asking you, and they should especially be asking adolescence like, what is your relationship to food and can you tell me a little bit about your eating? Habits and how they relate to how you mentally and emotionally feel about your body and like those types of screening questions that often are asked young. Adolescent than white girls, but aren’t really asked to anyone else, I think could help people so much earlier in their journey and struggle with an eating disorder because the treatments we have really don’t work and often are counterintuitive in ways we can discuss shortly. But one of the few factors. Eating disorder treatments have some of the highest relapse rates of, like any mental health treatment, and one of the few factors associated with long term remission of an eating disorder is. If you treat it, catch it early, basically, and yet we have diagnostic standards that literally create a situation in which you can’t really get diagnosed until it’s pretty dire, and especially you can’t get your insurance to pay for treatment unless it’s pretty until it’s pretty dire, at which point. It’s much more intractable.

    Krys Boyd:

    So when you first became ill as like a tween around the time of your bot mitzvah, your mom noticed something was going on with you. She took you to the doctor. What was that experience like for you?

    Emmeline Clein:

    Well, so that experience was obviously very terrifying because when you’re in those early stages that you can, I think I felt that it was taking over my life and was something I was thinking about all the time in ways that I really didn’t want to be. But I also. Didn’t want to stop doing it at that time because I felt I was getting external validation from people in my life for fitting a beauty standard that I had not quite fit before. So on top of all of those complicated feelings, then once I got there, what I’ve been referencing when I mentioned those exclusionary diagnostic paradigms is that unlike any other mental illness in the DSM, eating disorders require sort of biometric markers to be diagnosed in many cases. So in order to get an anorexia diagnosis, you do have to hit a weight cut. Off and if you have all of the symptoms, mental, emotional and cognitive but are just not hitting that weight, cut off which many peoples bodies will not hit even when they’re having other extreme symptoms of eating disorders such as like losing your period. Or if you’re anyone like your hair. Falling out like there are a lot of physical symptoms people have without their bodies ever getting small. And also there’s a lot of people who don’t ever have as many of the physical symptoms but have all of the mental, emotional and cognitive symptoms. And so in my case. I was not thin enough to meet the anorexia criteria, so the doctor basically like told my mom to like, come back if it gets worse. And so that is something that happens to people a lot. And that was very invalidating and did allow my sickness to get a lot worse because I felt like, Oh my God, I can’t even believe it. Thought something was wrong? You know, like I can’t believe I even thought I had a sickness, which I think is another problem with the way we talk about eating disorders in this country is that we have this culture around. We’re afraid of saying we’re of, like, overstating our sickness. And we want to hold up this artificial. Binary between like just a diet and a disordered eating, which I think is a very, very blurred line and. That. And in most cases it doesn’t really exist in my. View. Anyway, so it got worse, and then eventually my mom took me to an eating disorder clinic, an outpatient one, where they gave me this. Diagnosis called eating disorder not otherwise specified that has now been changed to the name other specified feeding and eating disorders, but the acronym used to be Edna. So now it’s all fed. But I use edness in the book because I had and that is a diagnosis that. I that was for a long time the most prevalent eating disorder, which really just I think goes to show you how corrosive and artificial that idea that anorexia has to be at the top of this pyramid and has to be so hard to get that diagnosis if we have so many people. You have this diagnosis. That means that you’re having all the physical and emotional symptoms of an eating disorder, but just not without appearing in an emaciated body. If that’s the most. Prevalent eating disorder, then, shouldn’t that be the one we’re trying to do most of the research on, but instead we’re carrying out far more research on anorexia, which then seeds that stereotype into the next generation of research, because you can only be allowed into the studies if you’re hitting that weight. Cut off and we’re doing so much less research on this one eating disorder. That so many more people have because it’s perceived as less serious, and when in fact many people with that disease go on to eventually develop anorexia. Whether that’s because you need they need to, they need to get worse before their insurance will pay for treatment because they cannot. Pay for it out of pocket, which you would often have to do with Aetna’s diagnosis. Or because you feel so invalidated in the treatment center and you feel like there’s competition with the NX because you feel that this diagnosis you’re being told you’re telling people with the disease defined by the dread of not being thin enough that they’re not thin enough to have the disease they think they have.

    Krys Boyd:

    You also discovered in treatment that if, like one sign of being in better mental health, is that you’re no longer obsessing over every mouthful of food you ingest. That is not the experience in a lot of clinics.

    Emmeline Clein:

    I mean, in my imagined utopian world of eating disorder treatment, the goal would be, and I think for many providers, it is. I think there’s tons and tons of well-intentioned eating disorder doctors in this country that are really, really trying to help. But I think that in many of these. Treatment centers, many of which are privately run and highly expensive and treatment centers that are not like associated with a hospital or something, often do a lot of other types of therapy that aren’t proven to work on eating disorders at all. But when you’re in the treatment center. In an ideal world, to me like it would be trying to like teach you to unlearn so much of logic and ethos of eating disorders, which is so often centered on this numbers based self surveillance, right where you’re constantly. Obsessing over calorie numbers and weight numbers and what you’re going to eat next, and it would be a, I think, both cathartic and empowering and liberating. If treatment could be focused on teaching us to unlearn those things and to eat in a way that is just more, just less freighted, and less like scientific and rigid and theatrical and regimented. But instead, in many of these treatment centers, you know you are eating a certain amount of meals and a certain amount of snacks in a very regimented and surveilled way. And you’re doing it around a lot of other people who are eating in the same way, and you’re watching each other and you’re obsessing over what everyone else is eating at the same time that you’re being told that calories and weight are not the most important thing about you. In like the therapy portions of the treatment, you are being weighed every day and as soon as you hit what your insurance deems like your goal weight, you’re kicked out of treatment, and they won’t pay for any more of it. And that is often at the point at which you need the holistic mental health care the most because you’re now living in the body that you were just doing so self, so much self-harm to avoid living in. And then you’re released back out into the world without any coping mechanisms to eat outside of this regimented and theatrical way, and to eat in the context of your own life. And you’re suddenly in this bigger body, so you’re often feeling very overwhelmed, and it often leads to a relapse. But then? Eating disorders because we have this notion of blame and choice around them, your insurance providers will have to understand you the patient, as having failed treatment rather than the treatment as having failed you when you, when you relapse soon after treatment, which can make it harder to access treatment in the future.

    Krys Boyd:

    As you mentioned, there are many people you know professionals in this space who make genuinely care about their patients. There may be people who are having success in these programs. You do notice, though you point out that in your experience, there’s an interesting paradox that happens like people in treatment are coached to understand that. Because they’re not fat, they should not starve themselves, so it’s not the ultimate message that might be received, although it’s incorrect, is not. That weight loss might be potentially dangerous. It’s that only fat people should be compelled to lose weight.

    Emmeline Clein:

    Right. Well, and it’s and this has changed luckily in like recent years and there are eating disorder treatment centers that really emphasize like a health at every size ethos, but it’s just not as pervasively throughout the like eating disorder treatment complex as it should be. So basically what you have going on is a few things that can often. Really reinforce the logic of the disorder accidentally. One very emblematic example I’ve seen is many treatment Centers for a long time and like, not as many do this anymore. This body tracing activity where you would draw an image of yourself on a giant piece of cardboard like the silhouette that you think you look like, and then you’d lie down on top of it and another girl would trace your body, and then you get off it. And you see that the actual outline of your body is smaller than what you think it is, and so they’re trying to show you that you have body dysmorphia, and therefore you’re not as fat as you think you are, so you shouldn’t be trying to lose weight, but that at its core, isn’t inherently, as you said. Mobic. Message that implies that if you were as fat as you thought you were, you should be trying to lose weight, even if perhaps it might be wreaking emotional and physical havoc right on your body, and so that message is being seeded into the minds of people that are in treatment. While at the same time, treatment is also very focused on this very cognitive behavioral therapy infused form of therapy, that is telling you. So that the eating disorder is kind of a false consciousness in your mind, whether it’s the body, just more if you’re part of it, there’s a false consciousness in your mind that’s telling you you’re fat when you’re not. But also there’s a false consciousness in your mind that’s telling you that losing weight is the most important thing in the world, and that the best, most important thing about you is your appearance. And you have to. Understand that false consciousness as one that’s like trying to hurt you, and that is lying to you. And that is crazy or whatever. When in fact I think, and many people I spoke to have felt that it can be much more cathartic and empowering to understand that voice in your head, not as this evil, crazy voice, but as a voice that is trying to help you cope with the world that is giving you messages from all sides. Saying that your life will be better if you’re thinner and so you’re not actually. Coming up with some like crazy ideology because you’re a crazy vain girl. That voice is trying to help you in a way that is unfortunately very harmful. But that is again reading a room. It’s locked into and attempting to come up to read the smoke signals of a society that it didn’t create and come up with a coping mechanism. That is in fact, a disease, but one that, once we see, perhaps, and stop using this somewhat often, it can feel gaslighting messaging around. It’s a crazy false consciousness, and the way isn’t the most important thing about you. And why can’t you just realize that instead say. I’m really sorry to myself and to all the women I love that we live in a society that teaches us that being thin actually will improve our lives in every way, because now that I’ve been living with this eating disorder, I’m realizing that it in fact doesn’t and is wreaking havoc on so many aspects of my life. Is not allowing me to engage in my social life. In in romance, often in jobs, often it can take over your entire life and take up so much of your psyche and sort of saying to that voice. Thank you for trying to help me. Honest, we’re in this together and we’re hurting each other and having that type of conversation with it. And I also think that in many of these treatment centers. There’s no political education whatsoever. It’s all very highly medicalized and psychiatric terminology being used all the time, of course, because it is a medical and psychiatric issue. Everybody I spoke to had been through treatment. Said that, there was no like education on this beauty standard or on diet. Culture on the way that doctors have known since the 50s that the majority of diets do not work and do not cause permanent weight loss and instead we had doctors in the 50s inventing a term called the dieting depression, which is where diets cause a lot of. Emotional symptoms like depression and lethargy that are also eating disordered symptoms and often later lead to binging, and so that cycle has been set up. We have data on it for decades. It’s probably been going back centuries and we’ve known this for so long. And yet the diet industry has still been making huge amounts of money off of upholding an extremely racist and misogynistic beauty standard. That is a big part of many people’s eating disorders. And if we had any kind of education on that in treatment centers. It could be very empowering and liberating in terms of. Making people with these disorders feel so much less self blame and do so much less self flagellation. About why can’t I just get this voice out of my head instead? Being like it makes sense that this voice is in my head, but I don’t want to keep being part of the a part of this machine that’s been oppressing women for so long.

    Krys Boyd:

    And the line I presume you wrote this book at a moment where you felt you were doing relatively well. I wonder if you can talk a little bit about what it feels like to take care of your health now?

    Emmeline Clein:

    I mean another thing that was really important to me in this book was unseating the dominant narrative around recovery, which can also be really exclusionary, which is this linear path to recovery where you achieve recovery and access. This notion of recovery as like a location. Where all of a sudden. Healed and the eating disorder is not a part of your life anymore at all. When I think that’s very rare for most people and in fact recovery is very much. Durational and a spectrum that often involves relapses and also can involve having eating disorder thoughts but not acting on them, or just having the thoughts far less often. And so I definitely was writing this book at a time when I was well enough that the eating disorder was not at all controlling my life. But that’s not to say that I wasn’t still struggling with the thoughts, sometimes on a weekly basis, sometimes on a monthly basis and sometimes on a daily basis. And I tried to. Demonstrate with my tone in the book by writing from a very emotional place many times like that I am coming at this from a perspective of solidarity and understanding how this is a lifelong struggle. But I found for me that what saved my life was not treatment, but was other women. Fictional women I was reading about real women in my life who are my friends. Women I found on the Internet who I talked to, who had been through the. Yes. And I think openly the way I took care of my health then and the way I stay in recovery is only by talking openly about these issues and the pain they cause and. In doing so, finding like communion with so many other women who have felt the same pain and then realizing how much pain this culture has wreaked. I am able to like motivate myself, kind of like out of solidarity, to not want to engage in eating disorder behaviors every time I do. I would be, you know, teaching my younger cousin by accident that my body could look like that without a huge amount of self harm and perhaps leading her into the same type of pain. That that I’ve had for so long. And just the realizations of how powerful this machine that has wanted girls to be in pain in a way that this machine can profit off of for so long, talking about it openly. And realizing just how prevalent it is at both a clinical level and a non clinical level can really be very empowering because you notice that though the machine is powerful, it’s very simple and it’s pretty easy to be the screw that doesn’t turn instead of just a cog in it. And so I find that. Just being reminded that I’m not the only one feeling this way, and that it’s not my fault, and that if I have a bad day with it, I shouldn’t blame myself and that I can go talk to someone about it is really honestly like the way I stay accountable to to myself with with that type of recovery.

    Krys Boyd:

    Have you learned strategies for making good choices about where to go online when you might be seeking community support?

    Emmeline Clein:

    Yes, as much as like I find the TikTok and Instagram algorithms to be like. One of the most disturbing aspects of our culture right now, because they’re really, really, really coded and there’s been a lot of. Amazing reporting on this to uphold that thin white beauty ideal and that is the type of stuff that they’re feeding to young girls on their feeds, even when they’re not looking for it. The Wall Street Journal did a great investigation about this of like if you code a bot as a 13 year old girl and don’t even have her search. Or diets or eating disorder. The. It’ll start showing her diets and showing her, like, very thin women, and it’ll get more and more extreme without her even like liking the content. But if she just like watches it till the end or doesn’t scroll past it fast enough so that is like very disturbing to me. But on the flip side, we also have more and more amazing recovery activists. That liberation activists and people who are talking openly about their disordered eating problems then. And I think ever before and you have amazing online support groups run by places like the Fed Up Collective and Project heel that you can go to for safety and support and open communication at the same time. I think that a lot of the way we talk about pro eating disorder Internet spaces. Especially the ones that existed back in the 2000s and the 20 teens were extraordinarily. Condescending and cruel and positioning teenage girls as the center of this moral panic, kind of in an effort to continue to uphold that artificial binary I was talking about between diet, culture and a culture of of disordered eating, because those were spaces where, like there were these forums. On Tumblr and on other blogging websites that were like called Pro Anna, which is a shorthand for pro anorexia. And they were reported on as though they were in a dangerous cult of teenage girls, indoctrinates at each other into eating disorders. Because like, yes, these girls were posting diets and posting images of very thin people. But they were also just posting. The images that had been published, you know, in fashion magazines and a diet that they saw in a tabloid. And when those same things were were published by a bunch of adults in high rise office. Is then the New York Times and the Atlantic, and publications like that weren’t reporting on them as though they were indoctrinating teen girls into a cult of thinness. And yet, when teen girls, literal minors, posted them from their bedrooms and, like, make a funny joke about it and call it the inspiration, instead of calling it how she lost the weight. And those two things really do mean the same thing. It’s suddenly really dangerous and so I think that that just goes to show we really as a society have this impulse to, like, blame and shame teen girls for having a disease. That is a very logical reaction to the society they live in. And then simultaneously, there was also a lot in those spaces of just people on message. Towards helping each other get through the day and people like helping each other when they were in recovery. Talk about how hard it is to eat a snack. But like let’s do it together or somebody would be like having suicidal ideation and their friend would literally call help and save their life. Like I’ve talked to someone who that happened. To and especially because, as we said, people that are larger, black and brown people are not screened for eating disorders nearly as much as white people. Fat people are not skin nearly as much as thin people. So often people whose bodies did not fit the stereotype and were locked out of getting an eating disorder. Diagnosis only ever felt validated and could only ever access a supportive environment that was anything like group therapy. By going on to these message boards where people would be like, no, I believe you that you. Sick and I don’t think you’re too big to get a diagnosis. And I’m so sorry that you’re struggling. And then because of this, like, moral panic in the media around these spaces, a lot of those message boards were censored and banned and people lost the one place that they had found a supportive community. So I think. I’m also just reticent to, like, demonize Internet spaces that might also not always be best for everyone.

    Krys Boyd:

    You remind us in the book of an almost entirely overlooked eating disorder, one that has only recently started to find its way into headlines, and that is orthorexia. Can you explain that term?

    Emmeline Clein:

    Eating shorter isn’t even yet in the DSM, it’s it’s used by doctors sometimes and and like with patients seldom understand what they’re struggling with. But like it, you can’t get it as like an official diagnosis. It’s sort of like the eating disorder that has come out of the. Era of our Wellness obsession and it’s this eating disorder that begins as an obsession with like health food often and with eating clean but very quickly spirals into basically anorexic levels of restriction of cutting out food groups and. What happens with that is that it’s. Very difficult to diagnose, especially at first because the medical establishment is, of course, reticent to see an obsession with nutrition and eating healthy as disordered, even though it easily can become the. And also Wellness influencers often really fit that thin white beauty standard, and the rise of Wellness I feel like has functioned as a way for people in an era where we’ve now I feel like reached an era when we’ve had body positivity. We’ve learned a lot about the ways in which the beauty standard. Is racist and misogynistic, and many people politically do not want to admit that that beauty standard is something they still wanna aspire to, even though they know they don’t like politically, want to uphold it. And so I feel like Wellness has emerged at this Nexus of feminism and Wellness in disguise. You’re you’re constantly being told as a woman in all these coded ways that being beautiful in this traditional way is very important and will make it easier for you to move through the world. Yet you’re simultaneously being told that you shouldn’t be vain, and that you should be a feminist and should not care so much about you. Their parents and so then Wellness can emerge as like a trap door that allows people to hide their obsession with the way they look in instead, and an obsession with health and clean eating and pure foods. But I also found that in doing my research. Versions of this have been happening for a long time and sort of there was an interesting craze back in the Victorian era where there was like sort of this epidemic of what was called auto intoxication. But it was basically like an early version of what’s now talked about online is like Hot Girl IBS of this idea of. White women having these like very delicate digestive systems that only allow them to eat various specific foods. That basically creates a culture of discipline exerted on women around what they can eat and what is or is not like allowed to go into their body. Presented as due to us demand of health rather than a demand of beauty.

    Krys Boyd:

    And like, have you found a balance between the kind of vigilance that everyone recovering from a mental illness needs, you know, be on the lookout for recurrence of symptoms, that sort of thing, and the kind of obsessive self monitoring that may be characterized your illness at its. Worst.

    Emmeline Clein:

    I think that’s another amazing question. I mean, I think the way I would answer it is that it is again sort of about. In the same way I was saying before about rather than, I’m talking to my eating disorder voice in my head as this false consciousness that is evil and is like trying to ruin my life and is lying to me and is crazy instead. Thinking of that voice as one that was trying to help me in the best way it knew how at the time in a world that was not being kind to it. And so similarly like I have to be vigilant but in a way that can feel at moments, obsessive. But know that that obsession is coming from a place of care for myself, and that even the negative forms of obsession were rooted. In a desire to be seen and loved, and I have just realized that I don’t want to be seen and loved for the reasons that my eating disorder and this culture often wants women to be seen and loved. The people who are only going to see me and love me if I’m in my thinnest body, I don’t want their attention. And so I have to instead channel that obsessive quality of yearning into wanting to be seen and loved by, you know, people and women who share the same like values and have gone through this type of thing. And who are also interested in deconstructing as much as we can this culture so it doesn’t harm the next generation of young women as much as it harmed us.

    Krys Boyd:

    Do you feel like you there are people in your life who may not have had the same experience but with whom? You can talk about this.

    Emmeline Clein:

    Yes, I I do. And I think also like when you talk about it openly, I have found that many more people have had some version of the experience than you would think and that people are actually. Quite eager to talk about it once you create the space for. Because I do think we kind of have a culture of silence around eating disorders that do not manifest just in that one specific, straightforward anorexia narrative way. And so people find it very cathartic to talk about and then realizing that you’re not alone can make it so much easier to fight back against an eating disorder thought in a moment where one is coming at you because you can be like, I’m not the only one who feels this way. I’m not crazy. And this thought isn’t even crazy. This thought is actually rational. It’s just not acting on it is just not going to help me. It’s going to.

    Krys Boyd:

    Emmeline Clein is a writer. Her new book is called Dead Weight Essays on hunger and harm. Emmeline, thank you for the conversation.

    Emmeline Clein:

    Thank you so much for having me.

    Krys Boyd:

    You can find us on Facebook and Instagram and subscribe to our podcast wherever it is you like to get your podcasts or at our website, you can find it. It is at think.kera.org. Again, I’m Krys Boyd. Thanks for listening. Have a great day.