Battling a Culture

October 2016

She would only munch on carrots and celery sticks, and sometimes, when the ballet class had been too intense, she would allow herself a puffed rice cake with a side of guilt.

16 year-old Leah had become well acquainted to the conniving, destructive disorder. Activating her gag reflex had become easy. She would tilt her head up, put her index finger down her throat, and bend over to let her mom’s spice-rub T-bone steak out. The shower was always running so that her mom and sister wouldn’t hear the wet vomiting sounds. She would pour herself a glass of water, chug it, and start over, and over, until she was sure she had purged every last piece of dinner.

She had become used to the bitter, persistent taste of bile. Sometimes she even craved it. Leah stared at her reflection in the fogged mirror — sunken cheeks, dark circles under her eyes, her face swollen from bulimia. Despite the reflection of her frail frame, “fat and disgusting” was what the voices of her mind repeatedly told her. A statuesque 5 ft.10 Leah had plummeted to just 93 pounds, the lowest she had ever weighed. In fact, she had a BMI of 13, when her normal BMI should have been somewhere between 17 and 25. It wasn’t her first episode, only this time she had hit rock bottom. Before bed, she spent hours browsing the Internet for “thinspiration”, weight loss tricks on superskinnyme.com, skinny girl products, and photos of Victoria’s Secret angels. A year earlier, Leah had been diagnosed with anorexia nervosa with intermittent bulimic episodes.

Leah is part of a troubling generation of pro-ana (pro-anorexia) and pro-mia (pro-bulimia) blogs, “how-to” sites, and social network influencers that glorify ultra thin people, promote false or unreachable ideals of beauty and have turned eating disorders into a “lifestyle.” There is ongoing debate as to whether or not these sites have the potential to cause the eating disorder, but healthcare professionals all agree they certainly are a catalyst.

In Leah’s case, this type of damaging media has considerably reinforced her condition, spiralling her further into the disorder by encouraging dangerous restricting behaviours camouflaged as “thinspiration”, and healthy dieting. “Awesome tips to lose belly fat fast,” and “How to be skinny and look great” are examples of the countless stories in which dangerous dieting methods are feigned as desirable behaviours. “These sites are a double-edged sword,” explains Dr. Alain Lévesque. On one hand, they are helpful in reducing isolation by creating a community of anorexics, but on the other they foster denial and don’t support recovery.” “Just as we all tend to seek advice from who will tell us what we want to hear,” he says, “pro-ana and pro-mia sites create false groups of belonging that stigmatize a false debate, and value poor judgement.” Girls like Leah go to these sites and think, “well maybe we’re right about being 90 pounds.” Dr. Lévesque says that what is most concerning about pro-ana sites “is they bolster the notion of control, inherent to the eating disorder,” by providing girls with even more tools to compulsively restrict their calorie intake and control every single aspect of their diet. An eating disorder is a power trip in a sense.

Years of dancing and circus arts are part of the reason behind Leah’s skinny figure and accordingly, her obsession with weight. She was admitted to the most prestigious ballet school in the province, and even though the earliest warning signs of anorexia had appeared when she was still a child, the unspoken competiveness and constant pressure at the academy had triggered a relapse. “I was always looking at other girls in their tights and leotards,” she says, and it would only reinforce the pressure I felt to lose weight.” Her professor Mr. Olivier would often correct her posture by firmly pressing on her stomach to lower her pelvis. “I don’t want pregnant women in my dance class,” he once told her, referring to Leah as one of the larger girls of the class. This had prompted the bulimia episode and drastic weight loss. She might not have been performing as well because of it, but it had gotten her plenty of compliments from other dancers who started envying her concave stomach, and had gotten her to sign a modeling contract. She could barely manage to get through the day and was so weak she would often pass out. By practicing restrictive eating behaviours, her brain had tricked her into believing she could only eat if she had the possibility to throw up afterwards. She would only munch on carrots and celery sticks, and sometimes, when the class had been too intense, would allow herself a puffed rice cake, with a side of guilt. She had become an expert at professing self-control, thanks to the fasting tricks she had sought online, but it only fuelled her binge eating fire at night.
Leah’s relatives called her out on her weight loss, but she refused to admit she had an eating disorder. Even though the artistic director of the ballet academy suggested she seek treatment, it is only once she started suffering from serious hair, muscle and bone density loss, absence of period, mood swings, dehydration, and was unable to focus that she agreed to finally seek the help she needed, after two years of extreme yo-yo dieting.

“Recovering from an eating disorder literally means reprogramming your brain,” says Dr. Lévesque. Over time, anorexics learn to “only think in terms of calories, numbers, and math, according to an extreme dichotomy of foods, and all of a sudden, boom! They’re told they need to start making choices based on new factors, or they will die,” he says. What makes the transition difficult is that programming is usually done in the tender years; at the same time self-image starts developing, the first symptoms usually appear. The basis of any eating disorder is in fact an identity disorder, so someone who’s been afflicted by an eating disorder for a long time essentially has to create an entirely new sense of self; the disorder has become part of who they are. Dr. Lévesque says the danger with pro-ana and pro-mia websites is that “they make the reprogramming process even harder, and prevent the rebuilding of a new identity that is not solely based on the anorexic or bulimic lifestyle.” Consequently, eating disorders are not a technological problem, but rather a societal one. Technology only exposes and advertises the condition.
Society today is obsessed with food. Whether considered a vital need or simple leisure, food has acquired a mythical aspect. There is a growing social concern about food that translates into a myriad of new restaurants, specialized groceries, cooking shows, cookbooks, new dieting trends, and tons of articles, all of which form our cultural mosaic. Food has become the determining factor by which we identify to a subgroup. “Those are the vegetarians, those are the vegans, those are the anorexics, those are the obese, and so on,” says Dr. Lévesque, and “this creates rivalry.” So it all comes down to which group will be the healthiest, skinniest, and thus the happiest. Dr. Lévesque believes our society’s obsession with food is much more likely to cause a rise in the number of eating disorders than pro-ana and pro-mia sites, and “that is why treating an eating disorder is also about learning how to eat within our social context, again.”

At 18, Leah quit ballet, modelling, and her job, and embarked on the 16-weeklong treatment at the Douglas Mental Health University Institute. The focus of the treatment was precisely to reinstate social eating habits, and defuse the detrimental relationship she had with food, which in turn would allow her to reprogram her brain, and develop a new sense of identity independent of any subgroup. She ate three meals a day with fellow patients, with whom she shared discussions in an attempt to learn re-socialization. “I’ve never worked so hard on myself,” she says, with a half-sorrowful half-happy look in her eyes. “Restriction habits don’t stop overnight, but I’m slowly beginning to figure out who I am, deep down, and its great to know there’s something beyond the bulimia.”
16 weeks have passed and Leah knows she’s in for a hell of a ride. “I’m still adjusting to everything, but I’m learning to cherish my body, even though it’s so easy to fall back into the restriction scheme again.” For Leah, as for many girls in her position, learning to reprogram her brain will be the struggle of a lifetime, especially in today’s social context. Anorexia and Bulimia have become a culture in which technology is used as a vehicle for promoting and enhancing a sense of identity, whether good or bad. While she sometimes still feels a little afflicted by restriction thoughts, Leah doesn’t see herself as fat and disgusting anymore. Rather, she tries to harbour the idea that her body is a work of art that carries a beautiful soul.