I was in Colombia recently and had the opportunity to go to the Botero museum in Bogota. Colombian artist, Fernando Botero, has a style that is unique in its neo-figurative depiction of forms that are rotund and bulging in both girth and exuberance. Men, women, children, and even fruit, are celebrated for their bulk. This joyful abundance is a provocative antidote to the idealization of thinness -particularly for women – that is the sine qua non for beauty images everywhere we look these days.
Instead of dancing and celebrating the miracle of our bodies, too many girls and women have internalized the message that we need to take up less space in the world. Even kindergarteners report feeling fat, and over 90% of adolescent girls diet before high school graduation. The nearly ubiquitous result is that women feel bad about their bodies, and for some, the psychological storm takes shape in the development of an eating disorder.
1. Anorexia, Bulimia, and Beyond. Both Anorexia Nervosa and Bulimia Nervosa are well known and serious eating disorders. They are among the most fatal of all psychiatric disorders. However, most individuals with eating disorders – up to 70% or more – describe a mixture of symptoms that aren’t exactly Anorexia or Bulimia but are nonetheless associated with serious psychological distress and functional disturbances.
2. It’s not just upper middle class white girls. That’s the stereotype, but eating disorders are on the rise globally. And eating disorders are increasingly recognized in places and groups where they were once thought to be rare – like among ethnic minority groups in the US, in Asia, and among males.
3. Why are eating disorders increasing around the globe? It has often been assumed eating disorders increase as a by-product of Westernization. But Patricia Dunne (former student turned colleague) and I suggest this analysis is incomplete. Societal change in the form of globalization, industrialization and urbanization that occur independently from, or in tandem with, “western” influence are critical factors contributing to the rise of eating disorders around the world. We need to understand the diversity and distinctiveness of individual countries and cultures to understand the emergence and rise of eating disorders globally.
4. You are what you eat. In today’s industrialized world, we have unprecedented exposure to readily accessible, high-calorie, high-fat, heavily marketed, inexpensive foods. “Big food” is as bad as “big pharma” when it comes to lobbying and marketing. The result is a “toxic food environment.” Combined with an increasingly sedentary lifestyle, people are consuming more calories and burning fewer calories. At one extreme, we have dieting and eating disorders and at the other end, the public health obesity crisis.
5. Getting Educated; Getting Help. Professional societies and evidence-based treatments are available to help individuals construct healthy attitudes and behaviors around eating and weight, including: The Academy for Eating Disorders, National Eating Disorder Association, and the National Association of Anorexia Nervosa and Associated Disorders.
When we ask, “what does it mean to grow up female?,” high rates of eating disorders around the world tell us that something is seriously awry. Maybe there is a takeaway from Botero that could help change the answer to this essential question.