by Chiara Palmeri
TW: Eating disorders, anorexia, bulimia, mentions of self-induced vomiting.
In our society, there is a strong misconception that eating disorders are predominantly associated with one gender. Whether due to cultural biases or lack of awareness, there is a misguided belief that it is more acceptable for women to exhibit symptoms of an eating disorder than it is for men undergoing the same challenging experiences. In honour of the Eating Disorders Awareness Week (26th February – 3rd March), the stories of two individuals named Charlie and Alex (fictional names used to safeguard their privacy) will unfold through a series of questions they were asked. The disclosure of their gender will be reserved until the end, allowing readers to engage in a guessing game as they skim through the answers and attempt to understand who the male individual is and who is the female.
Surprisingly enough, J. A. Silverman declares that, despite the widespread belief that men do not usually suffer from eating disorders, one of the first documented cases of anorexia nervosa in 1689 involved a male teenager (1997). Nevertheless, contemporary medical discourse tends to label eating disorders as a “female illness”, as most of the patients admitted to psychiatric hospitals for such conditions are women. An explanation, according to R. K. Støving, might be that “men are less subjected to socio-cultural and media pressures to diet and to be slim, and are instead typically portrayed as being concerned with physical fitness” (2011). Typically, young boys do not contemplate dieting until their teenage or adult years, while many girls become self-conscious about their bodies as early as the age of 8, this is exacerbated by the excessive abuse of social media and contemporary role models whose posts are saturated with filters, presenting an unrealistic, unattainably slim body image.
Is it solely a matter of the stark contrast in the way each gender is brought up? Smith affirmed that knowledge about eating disorders was more common amongst young girls than young boys (1986). Exactly how young boys are not taught by their mothers to scream “fire” if somebody is attacking them, or caution against wearing overly revealing attire to avoid unwanted attention, little girls are taught that in order to be beautiful, it is necessary to be slim. The notion that occasional self-imposed starvation as acceptable is instilled in them as a means to achieve this perceived ideal. In reality, many boys undergo similar challenges through peer interactions, where those with slim bodies and well-defined muscles attract attention and forge friendships effortlessly, whereas boys who are overweight often are subjected to bullying. Moreover, many boys deal with muscle dysmorphia: they see themselves as too slim and they over exercise, pumping up their muscles to look good. Fortunately, contemporary television series are increasingly portraying boys with eating disorders, offering representation and awareness for the new generation. Examples include “Heartstopper” (Netflix, 2022) featuring a main character struggling with anorexia, and “Tiny Pretty Things” (Netflix, 2020) which depicts a character engaging in regular self-induced vomiting.
The initial interview highlighted is with Charlie, a resilient survivor of anorexia who has not only overcome the challenges, but also aspires to assist others in their journey towards recovery from anorexia. As previously stated, all indicators revealing Charlie’s gender will be omitted.
Can you share how your journey with anorexia began?
I am a very insecure and perfectionistic person. When I was 12, like most children in that phase I started getting a little chubby. It was the period when people around me started getting into puberty, so I was often left outside of the group, and that felt really bad… I felt really lonely. And then a year and a half later I started growing rapidly and lost a lot of weight, I was becoming more popular and loved in school, getting more friends and attention, and I think that set off the toxic loop in my head, where I thought the only way that I could get positive attention was being skinny. That’s what ignited the first spark in my journey with anorexia.
How has your experience with anorexia influenced your perception of body image and self-worth?
It has definitely made me become more aware of it. It shaped my idea of the importance of loving your body the way it is, and appreciating the body of others the way it is. But it has also made me aware of the danger that exists in attaching too much value to your self-image because it’s really not all that important; there are so many more important parts to a certain person.
In what ways has recovery affected your daily life, relationships, and overall well-being?
It has been almost exactly 10 years since I started my road to recovery, so it has been a while. When I had anorexia, I was basically on the verge of being admitted into a clinic and staying there 24/7, so it was impacting my life back then in almost every single aspect. I started getting into puberty again once I recovered; before I started going to school again, my parents were also really scared that I was going to die, so they were also really happy to see me recover.
What were the key factors or turning points that contributed to your recovery?
Of course, I did not recover in one day, but I guess the biggest thing that pushed me was that I was so far gone I was really at a point where either I was going to be admitted to a clinic 24/7 or I was going to die. My physical condition was so bad, and my bone density and heart rate were so low that I had to choose either for the anorexia to win or for myself.
Were there specific support systems, therapies, or interventions that played a significant role in your recovery?
I went to a specialised therapist for this, and I definitely recommend it. But I think it is very difficult, because I think eating disorder is the kind of disorder where an intervention does not really work, because whether you are being forced to eat or stop exercising, it is combating the symptoms but what’s happening inside your head doesn’t change. So, my therapy was very focused on me building up the confidence and the strength to do this on my own, and I think that is ultimately what helped me the most.
What advice do you have for individuals currently struggling with an eating disorder?
One thing that I realised is that the key part of the eating disorder is the fear of getting fat, and that your life if you get fat will be so incredibly bad that you cannot bear it. The irony is that life with an eating disorder is a million times worse than life if you’re a little fat. What you are experiencing in the moment when you have an eating disorder is a hundred times worse than the life that you are afraid of if you let go of it.
How can friends and family best support someone in their recovery?
It is individual, but for me the best type of support was just giving me a shoulder to cry on when I needed it, supporting me with eating, also acknowledging when I was struggling and not forcing me to eat or do anything. Just being there with me was enough.
Have you ever experienced relapses in your journey, and how did you cope with them?
I would not say relapses really, but of course I did struggle every now and then. What helped me was realising where I came from, and that I knew that I had experienced that the life without the eating disorder that I was so afraid of was actually not as bad. It is just that realisation that helps me stay on track.
Did you discover aspects of yourself during recovery that you were not aware of before?
That is kind of double-sided, because the eating disorder made me work out obsessively, but at the same time that requires a lot of discipline, and I never knew before that I had discipline in me. I would say that really contributed a lot to my studies later on and to me pursuing hobbies that I like.
How do you think social media impacts perceptions of body image and contributes to eating disorders?
Yeah, I think it’s a no brainer, because one particular body type is idealised, and many people strive for that body type even though Photoshop is used a lot. It definitely negatively affects body image, and people who try to achieve that body by dieting or overexercising, and for some individuals that may be the start of an eating disorder.
In your opinion, how do cultural and societal pressures contribute to the development of eating disorders?
The pressure around you makes you feel bad, and then again, you get positive feedback if you do lose weight. The positive feedback loop that I experienced contributed to it in a negative way. I think that is more relevant for women than men. I think that a woman is a lot quicker criticised whenever she is overweight, whether it is a cultural or societal point of view.
The upcoming interview will feature Alex, an individual brimming with strength, intelligence, and untapped potential, currently contending with the ongoing challenges of anorexia.
Can you share your experience with anorexia and how it currently manifests in your life?
I have a huge fear of gaining weight. I totally dislike my body when I gain weight and I am just so scared of experiencing this feeling like I am trapped in my body if I ever get too big. I completely obsess over the calories that I consume. I count everything. I count all the calories that I burn in a day. So basically, I just calculate what I eat, and if it is more than I should have, I panic. Then I have to compensate.
What challenges or difficulties are you facing on a day-to-day basis?
Currently, I am trying to work on recovery, so a huge challenge is sticking to the diet that the dietitians gave me, eating bread for breakfast and lunch, and having like whole meals. I also really have to weigh myself every two weeks at my treatment facility, and it really makes me nervous. I am very focused on the way my body looks and I am scared of weighing myself, but I do measure myself a lot.
How has your support system (family, friends, professionals) been involved in your journey? And what kind of support has been the most helpful?
I have a really good team of therapists, a dietitian and a doctor who are there to support me. And I have my family, and friends. It has been a much greater support lately, but that is also been because I have opened up more about what I struggle with. I think that is a very important part, like you can struggle with an eating disorder very much in your own time when you are lonely, without anyone noticing. So that has been very helpful.
What misconceptions or stigmas about eating disorders do you think are prevalent in society?
I think one very strange stigma is that people only imagine this very underweight girl, when actually it is only about 7 to 10% of people who have eating disorder who are actually underweight. That has been such a crazy realisation to me because I go to the treatment facility every week, and I just run into all these people in the waiting room, and I am like: this person has an eating disorder? They are just people that I would walk past on the street without thinking anything of it. So yeah, that is a very prevalent stigma and also pretty dangerous one, because people make remarks about people’s weights assuming that they do not have an eating disorder.
What barriers, if any, did you face when seeking help for your eating disorder?
I told myself that I was not worthy of treatment for a very long time, because my BMI was still at a healthy point. It was at the lower end of the healthy BMI, but it was still healthy. So, I thought that I was not worthy of it, partly because of that stigma that you have to be super thin to have an eating disorder, even though my eating was absolutely all over the place and disordered. So, it was mostly admitting that even though I was not at that, like, deadly low weight, I was still really ruining my own life with my eating habits. That was the greatest barrier for me.
What improvements or changes would you like to see in how society addresses eating disorders?
In society, it is very important that we start recognising the huge varieties of eating disorders. So, how many different types of eating disorders there are, how they would manifest differently in people’s psyches and in their bodies is vastly different. And I think that should also be a point of focus in treatment, because in a lot of facilities they still just give you this list of stuff that you have to eat. They are like: “okay, go ahead and eat that”, when really there is quite often a lot more to it to actually make that step, and trauma to get over! And there is so many underlying things, so there should be more attention to your individual complexities.
How do you think we can better raise awareness about eating disorders and foster understanding in society?
It is important to show different people that actually deal with eating disorders and how different those people can be. It is also very important that we just keep talking about it in media, on social media just have an open conversation about it. There should be a conversation between people, like people who do not have an eating disorder and people who do, further mutual understanding. There are so many people who still make hurtful remarks.
Can you describe your typical daily routine and how your eating disorder affects it?
That’s a tough question, especially since I’ve been struggling with it my entire adult life at this point. Quite often, I have very little to eat for breakfast. For lunch too. Just like just enough to not make people around me suspicious if I’m eating with other people. I am also counting with a step counter how many calories I am using, as I have this boundary that I cannot eat over certain number of calories. It used to be 600, now it has gone up to 7-8 hundred, but it has also been 500 sometimes. If I go over that, I panic and I have to do physical exercise before dinner. Basically, like tiny breakfast, tiny lunch, counting the calories. I usually am so hungry that I eat a lot when I am cooking and then I feel super guilty about it when we get to the table and for the rest of the night. Since I feel guilty, I have a small breakfast again the next day. It is a vicious circle I am trying to break.
Are there specific triggers or situations that intensify your struggles?
I mean, for part, social media. It is videos of “what I eat in a day”, it is seeing photos of people with very good figures, it is seeing people commenting on, for example, celebrities’ weights., I have applied filters to all of my social media, just to sort of shut that out. It is also just remarks from people in real life, of course.
How do you communicate with your friends and family about your eating disorder?
I used to not communicate about it at all and just suck it up. I would be completely closed off and just get lost in my own head. And at this point I have started to just describe to my family and friends how I feel. And that’s been helping a lot, even though sometimes my family would not know how to respond properly, because it is obviously a difficult emotion to deal with.
Can you share any positive moments or achievements in your journey, no matter how small?
What I really appreciate is starting to feel that my body has had enough food. You just feel that your body is a lot more relaxed. What I have also noticed is that when you eat more during one meal, you are also less likely to snack on little things. For example, while cooking for dinner, I notice that nowadays I do not snack as much anymore because I eat more throughout the day.
How do you envision your life beyond the struggles?
In a way, I feel like it is never completely going to leave me. It is always still sort of going to be with me. But what I do envision and hope for is that I can just enjoy the important moments, at least with my family, with my friends, have a drink every once in a while, go out for dinner spontaneously and just completely enjoy that because those are the moments in life that are just so precious, so I hope that those are going to be things that I can completely enjoy in future.
In case you have not guessed yet, I will now reveal the participants’ genders to you: Charlie is a man, while Alex is a woman. As you may have noticed, their emotions and the struggles they shared as patients with eating disorders are in fact very similar, proving that such disorders do not have a gender. While I am immensely proud of Charlie for recovering and sharing his experience with all of us, I will stay by Alex’s side until she recovers, because I know she will. I believe in her. I believe in all the people who have started their journey through recovery right now: you are loved, and you are understood and supported.
Chiara Palmeri, born in Italy, is an English Language and Culture student at Utrecht University. She pursues a blogging and editing career in her free time, dealing with themes such as international student life, mental illness and feminism.
Raffia 