Dr Vivienne Lewis is a Clinical Psychologist and Assistant Professor at the University of Canberra. She specialises in eating disorders and body image in her clinical and research work.
Recently Vivienne wrote a fascinating article for The Conversation website busting some of the myths about why people develop eating disorders. BroadAgenda editor, Ginger Gorman, had a chat with her about that…and plenty more!
When it comes to eating disorders, what do we misunderstand OR what do we need to think differently about?
I work with young people and adults with eating disorders and we know that a person’s relationship with food is complex and can be very anxiety provoking. A person with an eating disorder feels that their body weight, size and shape is an important part of their identity and this influences how they feel about themselves and cope with emotions.
When a person doesn’t feel happy in their body or their ability to cope with their emotions feels strained, this often leads a person with an eating disorder to either restrict their intake, binge eat and engage in behaviours to try and control or change the body in some way. A person with an eating disorder finds eating distressing a lot of the time.
There’s often a misconception that a person with an eating disorder should just be able to ‘eat normally’ and not worry about food. But this is precisely what is challenging about having an eating disorder, there is immense fear around eating. There’s also a misperception that a person with an eating disorder looks a particular way.
For example, thinking of the stereotype of an adolescent female with anorexia that looks extremely thin. But majority of people with an eating disorder don’t fit this myth. Eating disorders effect men as well and people of all ages. As well, you don’t have to be thin to have an eating disorder. For example, I have treated many middle aged women who are in a healthy body range/size.
What factors influence eating disorders and a person’s attitudes to eating, food and their body image?
V: Most of the influences on our eating come from our upbringing. So what we learn from our parents and carers and our peers. I speak to a lot of parents about the importance of positive role modelling around body image and eating. For example, being respectful of all body types, talking about food for its function in the body, not labelling foods as good and bad, not using food as a reward or punishment.
A healthy relationship with food comes from eating a variety of foods, eating when hungry and stopping when full, having enough food for your own body’s needs, being able to eat without anxiety, and feeling positive about your food choices.
We learn so much rubbish in the media about what foods we should and shouldn’t be eating and how they affect our body weight. That’s how eating disorders often develop, where we learn to feel bad when we eat certain foods or have a certain body shape or weight. Or when we are brainwashed in to thinking we should lose weight and associating being thin with admiration which is often the case with celebrities.
How does gender play into it? I know more men are presenting with disordered eating. But it’s still predominantly women. What can you tell me about this?
Yes, you’re right it’s still more of a female issue. This is mainly to do with the portrayal of ‘idealised’ figures in the media which are a thin female figure.
This is more significant for females than males (males often have a more fitness, strength and leanness focus). As well, there is far more advertising around dieting targeted at females then males. This has been the case for many years. However, it is becoming more and more of an issue for males.
1/10 people with an eating disorder are male. I have treated many adolescent boys and men with eating disorders. So by no means is gender a protective factor. Males receive the same unhealthy messages around the negatives of certain body weights and shapes and eating certain foods as females and there’s a lot of emphasis in the media about males being trim, fit, muscular and toned and shame attached to being overweight for example. You only have to turn on the TV or follow social media to hear about the latest diet or fat blaster or man shake.
Why do people develop aversions and sensitivities (and how does this relate to eating disorders)?
People often develop aversions to foods because they have been ‘taught’ that they are ‘bad’ for you. This comes from the media, upbringing and observing others. For example, when a person is dieting to lose weight or change their shape they are taught (usually incorrectly) that certain foods are bad and shouldn’t be eaten if you’re trying to lose weight.
But this just sets someone up to feel bad about themselves when they do eat these foods. There’s a lot of guilt attached to food and it is these emotions that we try to avoid. So if we avoid these ‘guilty pleasures’ we often feel better about ourselves and then the reverse if we do indulge. All foods are good foods. It’s about their function in our body.
Our bodies need a balance of sugar, fats, carbs etc to function well. Just like only eating sweets makes our bodies not function the best, just eating carrots has the same effect. We need variety and to enjoy a range of foods.
What’s the issue with treating some food as “good” foods and others as “bad foods”?
Labelling foods as good and bad makes us attach emotions to foods. Such as feeling good about oneself because you’ve eaten something ‘good’ and negative about yourself if you’ve eaten something ‘bad’.
All food is good food. It’s about listening to our bodies and being truly in tune with our body’s needs rather than eating foods because we’ve been told (often my advertisers trying to get us to eat their diet food) to eat them.
And what about the idea of food as a reward?
All food is good food. When we use certain foods as rewards for good behaviour for example, we learn to associate that food with being ‘good’. So that means we can’t have it unless we’re good.
This often leads a person to eat certain foods in secret, such is often the case in binge eating conditions, because a person doesn’t perceive they are ‘good enough’ to eat it in front of others. Using food as a reward with children also teaches children that certain foods are nicer or better than others. All foods are good foods and when a person eats a variety of foods and doesn’t deprive themselves, they often have a healthier relationship with food.
How can we treat some of these issues or approach them better?
As a parent it’s about modelling a positive relationship with our bodies and foods. Speaking about our body and other’s respectfully. Also, not labelling foods as good and bad. And stop dieting! Dieting is one of the main causes of the development of eating disorders because it teaches us to restrict and ignore our hunger signals. Think about food for its function.
If I need to concentrate, what sort of food do I need? If I want to sleep well, what sort of dinner do I need to eat? Where we feel we can choose what we eat based on our body’s needs, and truly be in tune with our hunger and fullness signals, we set ourselves up to have a better relationship with food and our bodies.
Is there anything else you want to say?
If you feel that you or someone you know may be suffering from an eating disorder, the first point of call can be to discuss with a General Practitioner, counsellor or psychologist. The Butterfly Foundation has some great resources for individuals, parent/carers and professionals.
[Editor’s note: Dr Lewis has also written a book called No Body’s Perfect, to help parents and Positive Bodies: Loving the Skin You’re In, to help individuals with body image and eating issues.]
- Please note: The picture at top is a stock image.
Ginger Gorman is a fearless and multi award-winning social justice journalist and feminist. Ginger’s bestselling book, Troll Hunting,came out in 2019. Since then, she’s been in demand both nationally and globally as an expert on cyberhate and the real-life harm predator trolling can do. She's also the editor of BroadAgenda and gender editor at HerCanberra. Ginger hosts the popular "Seriously Social" podcast for the Academy of the Social Sciences in Australia. Follow her on Twitter.