Kathleen M. Pike, PhD

Fat and Happy

I am in Sydney for the Eating Disorders Research Society Meeting, an annual and global convening of leading scientists in the field. Having arrived a day before the program opened, I had the opportunity to spend a few hours walking along the famous stretch from Bronte to Bondi. As serendipity would have it, I got to enjoy not only the natural beauty of this famous coastline, but I happened to be there for Sydney’s annual Sculptures by the Sea.

As I made my way around one of the coves, lo and behold, Mu Boyan’s “Fleshy, Obese Man” commanded a position of prominence on the promontory that really made me pause. Throngs of passersby surrounded this work of art, posing with delight in the grandeur and adiposity of this larger-than-life sculpture of a seated man. His folds of fat and contented face harken back to the iconic images of Hotei and Happy Buddha. If only we were all so comfortable with our bodies.

1. Body dissatisfactionWay back in the last century, 1989 to be exact, I graduated with my doctoral degree in clinical psychology having completed a dissertation that examined individual, family and community factors associated with risk for developing eating disorders among high school girls. What has become clear over the ensuing decades is that “body dissatisfaction” is a proxy for low self-esteem, dysphoria and self-loathing among girls coming of age. Young women, and now women across the lifespan, suffer from all kinds of “fat talk” and body dissatisfaction. It is so common that it has been dubbed a “normative discontent.” This body dissatisfaction sets many on a path to developing eating disorders. It is the canary in the coal mine for young women at risk for eating disorders.

2. Body dissatisfaction and eating disorders. Body dissatisfaction figures prominently as part of the complex set of issues associated with the development of eating disorders for most individuals. A characteristic vicious cycle of body dissatisfaction leads to dieting (that most often fails), which triggers dysregulated eating, binge eating, purging and other desperate attempts to lose weight. Across the continuum of eating disorders – from anorexia nervosa to bulimia nervosa to binge eating disorders, and including variations on these disorders – body dissatisfaction most often plays a central role in both the cause and perpetuation of the disorder.

3. Size 0. This brings me to a topic that can really get me lathered up. I find it beyond disturbing that women have been brainwashed to think that we should take up less and less space – so much so that young women today who wear size 0 think they have achieved something special. Of course, there are some among us who are naturally petite. However, should they really be a size 0? Often referred to as “vanity sizing” size 0 today is equivalent to a 2001 size 2, and is larger than a 1970 size 6 or 1958 size 8. Why the shifting measurement? What is the unspoken message to young women? Google “zero”. The synonyms are: nought, nothing, cipher, nil.

4. Body image around the world. Beauty ideals vary across time and around the globe. Larger sizes and more voluptuous shapes are prized in certain countries even today. Take, for example, the fattening rooms of Nigeria where young women are prepared for womanhood. This ancient practice reflects the traditional idea that fat is a sign of prosperity, fertility and beauty. Young girls are taken to the fattening room during puberty and their ability to gain weight is a measure of the extent to which they possess the above-mentioned qualities. Although certainly not the whole story, at least part of the truth is that beauty ideals represent that which is difficult to achieve by the average citizen. As societies industrialize, food becomes more abundant and life becomes more sedentary. With more calories in and fewer calories burned, industrialized societies are experiencing ever accelerating rates of overweight and obesity. In the United States, for example, over 60% of the population is overweight or obese. Normal weight is difficult to maintain, and thus, being thin has become the holy grail. Especially for women, but increasingly for men. And even in places like Nigeria the trends are moving in this direction.

5. New images on the horizon – or at least on the runway. After the death of Luisel Ramos from anorexia nervosa in 2006, Madrid Fashion Week banned size 0 models. Later that year, the Milan fashion show took a stance on what constituted too thin and banned five models with a body mass index (BMI) of 18 or below. More recently, Italian fashion labels Prada, Versace and Armani have all banned size 0 models from their shows. And in 2012, Israel banned underweight models from its runways. Clearly there is much more to do to shift public perceptions, but these are all steps in the direction of promoting a healthier relationship to one’s body. The positive cascade could be reduced rates of eating disorders over time.

Mu Boyan’s “Fleshy, obese man” is fat and happy. His corpulence fills the screen as passersby pose for photos and selfies with him. Definitely not a size 0, he challenges the thin beauty ideal that plagues so many with eating disorders. Of course, obesity carries health costs of its own, and clearly, the antidote to the thin beauty ideal in reality is not obesity. But together, the art and the reality invite us to ponder how we might all live in our bodies in ways that bring us real health and happiness.

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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