*****************************Content warning – discussion of eating disorders & BMI.***********************************
This wasn’t my planned next post. I had one lined up, all ready and rearing to go. But here we are yet again commenting on another tragic loss of life to the monstrous beast that is eating disorders.
I spent a lot of time yesterday thinking about the tragic passing of former Big Brother contestant Nikki Grahame, who sadly passed away following a life-long battle with anorexia. Like so many who have survived or continue to face this illness, news of her passing was significantly triggering. I likened it to a loved one as if I were finding out that the person who held me prisoner for nearly 4 years of my life, but who I miraculously managed to escape, had instead taken someone else. Nikki’s death is a stark reminder to us all of the painful truth that anorexia remains the deadliest of all mental illnesses, with one in five of it’s sufferers not surviving it. Nikki’s story is sadly all too common.
For me, it serves as an awakening reminder some key issues.
Firstly, the NHS must do more, and perhaps more importantly, they must be provided with the necessary funds and resources to do so. It feels almost sacrilege to criticise the NHS in the current climate but eating disorder diagnosis and treatment remains one its scandalous failures, time after time. Nikki has sadly joined a long line of names of those lost before their time. From Libby Rose to Averil Hart. It is not good enough.
For anyone who doesn’t know, many eating disorder services across the UK limit their treatment to those who meet a strict set of criteria, with the decision to treat often coming down to whether someone’s BMI is low enough. Too many are refusing, and I mean outright refused, treatment because they are not yet classified ‘sick enough’ as their BMI does not fall low enough. And I’m not talking about just being medically classified as within the ‘underweight’ bracket here. Often criteria is set so low that someone would need to be a good few points underweight before they will even be considered for help, despite this being in direct contradiction to the NICE guidelines. But unfortunately, drastic underfunding coupled with particularly poor eating disorder awareness amongst General Practitioners has made this the reality across the country.
All this I say from experience. I was outright told by my GP I would need to lose an additional ‘X’ in weight before I would be eligible for treatment, despite showing all behavioural symptoms of anorexia to a textbook extent, having already lost a significant and dangerous amount of weight, being within the underweight BMI bracket and downright begging for help. At this stage I had already been sick for over a year, and with each passing day the grip of anorexia was becoming harder to escape. Essentially, we are told to get sicker before we can be helped. At the time I was unwell Cosmopolitan ran a vastly overlooked campaign comparing this tactic with asking someone who had found a lump in their breast to coming back when it was the size of a football, which always seemed particularly apt.
Perhaps more dangerous, is the medical professions obsession with such an outdated measure of health; BMI. There is a gut-wrenching irony that Nikki passed away on the very same day the House of Commons Women and Equalities Committee recommended the scrapping of BMI altogether alongside the issuing a a stark warning of the dangers of using BMI as a measure of someone’s health. Despite the wealth of professionals, including doctors themselves, recognising the endless flaws in this outdated equation, to put it simply it remains the case that a math equation from the 19th Century created as a statistical population model (might I add a model based exclusively on a small majority of white male samples) may be the very thing that stops you getting help for the most deadly of all mental illnesses. Seems fair.
Nikki’s death highlights yet again the continued importance to raise awareness of and challenge diet culture and weight stigma. Now, I do not profess for a single moment that this could have do much to save Nikki’s life in the end. Anorexia, at such a stage, is a beast to be reckoned with and her battle appeared a particularly arduous one. But perhaps we can all do more to help prevent the next Nikki from entering such into such a warzone.
It may sound odd to suggest we all have a responsibility for preventing eating disorders but we all need to check ourselves. To push ourselves to be better when it comes to the way we speak about ourselves, others, our food and our bodies. When was the last time you referred to a food as ‘bad’ or ‘naughty’; ‘junk’ or ‘clean’? When was the last time you caught yourself saying “Gosh, [s]he’s put some weight on!”, “[s]he’s let themselves go”, “[s]he’d be pretty if they lost some weight’?
One of the biggest fears in the anorexic’s brain, or certainly at least in mine, is the judgement of others. The fear that the compliments that so quickly came when we lost weight – ‘God you look AMAZING!’, ‘How do you do it?!’, ‘I’m so jealous of you, you’re so tiny” etc. will be replaced with judgement, critique and condemnation once our weight is restored, even if these judgements go unsaid. We will sacrifice it all, health, happiness, relationships, sanity and more to avoid this.
But even beyond the world of eating disorders, we all have a broken relationship with our food and bodies, largely sold to us by the diet and beauty industries who created a problem so as to sell us the solution at a massively inflated price.
To pretend our cultural obsession with thinness and diets has nothing to do with the growing number of eating disorder referrals would be nonsensical. We need to look no further than the observational research undertaken in Fiji for proof of this. Again, for anyone unfamiliar with this a study was conducted in Fijian adolescent females once Western television was introduced to the island. In 1995, without television, girls in Fiji appeared to be free of the eating disorders common in the West. But by 1998, after just a few years television 11.3% of the girls reported they had had purged at least once to lose weight and markers of disordered eating had increased significantly throughout the population (Becker et al. 2002; Becker, 2004).
Too many of us normalise and rationalise disordered eating and obsessive exercise day in day out, often under the guise of ‘wellbeing and/or wellness’. Regardless of whether it have been packaged up as Bootea, Keto, XLS Medical, Step Challenges, WW, Slimming World, #fitspo, low-calorie meals, 5:2…(the list is endless!) it will always be nothing more than the symptom of a marketing trick, selling you the concept of self-hate in one hand whilst offering you a magical solution in the other (in exchange for our hard earned cash, of course). Just remember, it’s estimated that 95-98% of diets (yes, that includes the one you think is ‘different’) result in you rebounding to the same weight as before or more – you wouldn’t take the COVID vaccine if you knew it was that unlikely to work, so just eat the damn doughnut already.
It’s time to regain control and end this Billion Dollar Brainwash (as once coined by Naomi Wolf in her book, The Beauty Myth). We need to take a stand against diet-culture and it’s equally evil twin weight stigma. We need to challenge ourselves to do better, to see through the shiny packaging and smiley sales reps and see it for what it is. And we have a duty to our next generation, and the generation after that, to not let them be fooled by the same tricks we’ve now seen through.
So, in honour of Nikki’s memory I want to challenge you. Here are some simple ways we can all stick it to diet culture, and be a little kinder to ourselves:
- Next time you go to critique someone’s body (including your own), please don’t.
- Next time you go to refer to food as ‘bad’, ‘rubbish’, ‘junk’ ‘good’, ‘clean’, please don’t.
- Next time you’re beating yourself up for eating that damn doughnut, please don’t.
- Next time you’re tempted to try that latest ‘lifestyle choice/wellness plan, fitness regime’, please don’t.
- Next time you find yourself wishing your body was smaller, please don’t. (Try to remember all the amazing things your body allows you to do every single day).
- And this last one is a biggie….Next time you go to compliment someone on their weight loss, please, just don’t – you might think you’re being kind, but you never know what you might be reinforcing.
If you feel as angry as I do, or are simply interested in learning a little more about eating disorders, weight stigma, Health at Every Size or the anti-diet culture movement here are some of my favourite resources (along with the humans who made them) on the topic:
Beat – (The UK’s Eating Disorder Charity)
Books (and the amazing people writing them):
Megan Jayne Crabbe – Body Positive Power – How To Stop Dieting, Make Peace With Your Body and Live (don’t let the cover deceive you, this is a well-researched, incredibly educated piece)
Dr Joshua Wolrich – Food Isn’t Medicine
Naomi Wolf – The Beauty Myth
Laura Thomas PhD – Just Eat It
Michelle Elman – Am I Ugly?
Caroline Dooner – The F*ck It Diet
Willing to be Wrong – Dr Joshua Wolrich speaks to a range of people linked to the topic of weight stigma & eating disorders, including Megan Crabbe & Callie Thorpe
Made of Human – Sofie Hagan in conversation with a range of people linked to the topic including Laura Thomas PhD, Pixie Turner & Jameela Jamil
Under the Skin – Russell Brand in conversation with Megan Crabbe