Eliminating eating disorders and investigating the roots of these issues is a passion of mine. While I have never struggled with an eating disorder myself, I have personally experienced dear friends both die from and overcome these disorders. It is a serious issue that impacts many. As a scientist investigating eating disorders, I hesitate to share that I am also a former fashion professional. However, being a part of these two unique worlds of science and fashion, hopefully gives me experience and insight.
Eating disorders take more lives than all the other mental illnesses , and is a growing epidemic in children through to adults, effecting both males and females. Recently, in the United Kingdom alone, the hospitalisations in one year (2012/13) for eating disorders rose 8% overall, and these types of hospitalisations often result in longer periods of hospitalisation than for all other admissions . Sadly, eating disorders take the lives of females ages 15-24 years, 12 times more than all other causes of death . The underlying roots which propel these disordered eating behaviours forward into dangerous and life-taking habits and illness are still unclear, including the role and impact of body image.
Much of the main focus regarding eating disorders seems to be on anorexia nervosa and the ideals of attaining an emaciated body, which is often blamed on the influence of the fashion and entertainment industry. Interestingly, the most suffered eating disorder for women and men combined is currently binge eating disorder (BED), which affects nearly half of all eating disorder sufferers. BED is characterised by overeating several times a week for over three months with distress. Whilst eating disorders continue taking the lives of people of all shapes and sizes, genders and ethnicities, and both malnutrition and obesity put an incredible strain on the body and lives, the main message has been to understandably eliminate “thin-ideal” and also to embrace the “real” larger body-types, for women in particular.
Within the fashion industry body-size is also a delicate subject, and many who enter the fashion model profession have naturally slimmer frames. Whilst it is necessary to develop some type of guidelines and laws to protect fashion models (in many aspects of their profession), a Body Mass Index limit to avoid unhealthily thin models from gaining employment may also strip the means of earning a living for those who are not able to gain weight easily (in their natural state). Just as some people naturally have a more overweight tendency and body shape, there are others who naturally have the opposite issue.
I will never forget a female fashion model from South America in tears sharing with me the frequent rude comments made about her body size face-to-face, and under her social media photos. Perhaps many felt justified to tear down what they assumed was her goal and the “thin-ideal”, not realising that not everyone is trying to lose weight or desires the “thin-ideal”. This particular model shared that she always struggled to gain more weight, as she came from a culture where curvy is the ideal body type for women, and was brutally bullied growing up as a very slim person. Now this bullying continued, even in a new country, again, for not having a curvier, more voluptuous body type, and it was painful. Seeing many struggle in many ways, brought personal awareness of the importance to consider all different shapes and sizes, in our attitudes, comments, and in how to protect anyone from being bullied for their size. A larger, curvier body, as well as a very slim body does not make someone more or less a “real” woman. Also, women of all shapes and sizes suffer from eating disorders. Assumptions, rude comments, and bullying, should not acceptable whether someone is underweight or overweight or average weight. There is a danger when working with those struggling with an eating disorder to demonise those with body size closer to the unhealthy goals the person may hold. While this may be done with the hope that these goals will be dropped, bringing health and healing, we may be more effective if we each contribute to reducing a spirit of competitiveness, and the “us” and “them” messages, even pertaining to outer appearance. Messages that someone is not “enough”, “real”, or “worthy” because of their size and shape – should never be acceptable. It may be that instead of labeling the “thin-ideal” as the evil to avoid, we all may work to develop an embracing society, which cheers on others beauty (of all sizes), gifts and talents, while also cheering on our own.
It is also important to research the facts behind these issues, so that we may develop the most effective safeguards. My current research focus is investigating these underlying roots. My hope is to help develop more effective prevention and treatments with the goal of saving more lives, whilst supporting more inclusive body messages which reduce victimisation and stigmatisation for all people.
Christina Ralph-Nearman is a former fashion professional, who has an MSc in Neuroimaging and Neuro-Clinical Psychology, and is currently completing a PhD using neuroimaging techniques to research the implicit underlying mechanisms of eating disorders. Contact: LPXCR4@Nottingham.ac.uk Twitter: @CRalphNearman
For more information and sources of support:
 NICE (National Institute for Clinical Excellence) (2004) Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders, Great Britain: The British Psychological Society and Gaskell.
 Health & Social Care Information Centre (HSCIC). (2014). Eating disorders: Hospital admissions up 8 per cent in a year. Retrieved on May 1st, 2014, at: http://www.hscic.gov.uk/article/3880/Eating-disorders-Hospital-admissions-up-by-8-per-cent-in-a-year
 Sullivan, F., 1995, Mortality in anorexia nervosa. American Journal of Psychiatry, 152(7), 1073-4.