Dying to be Perfect

Originally published in ‘At Home with Lorraine Kelly’ magazine.

Being alive in the world as human beings of necessity means living-in-a-body. However living happily in our own body can be a challenge. For many women it is a constant source of dissatisfaction and distress. Men do not experience and have to live with the same degree of bodily scrutiny, analysis, competition and comparison that women do.

In our modern society the relentless promotion of the idealisation of thinness has put women of all ages under intense pressure to strive after the attainment of body perfection. In pursuit of the cultural myth of the ‘thin ideal’ they manipulate their body shape and form through extreme dieting and excessive exercising and subject themselves to an increasing array of cosmetic body modification procedures.

Young women seeking a sense of self-esteem, self-identity and confident femininity are more vulnerable to society’s seductive messages suggesting that in order to be worthy, sexy, successful, powerful and happy they must pursue the perfect body at all costs. They look up to and emulate female role models for direction about how to live as a woman in our society. Unfortunately such role models are often dysfunctional media stars and icons. Mothers also provide powerful role models for their daughters and their personal attitudes and behaviours regarding body shape and eating patterns can have a huge influence for better or worse.

Acquiring healthy self-esteem which is not based predominantly on body shape and weight is critical for lasting emotional and physical health. Any childhood experience such as bullying, repeated harsh criticism or sexual abuse can damage growing self-esteem and increases a young person’s vulnerability to developing an eating problem and trying to use it as a way to boost their low self-worth and regain a sense of control over their lives.

The media, advertising, fashion and cosmetic industries are all part of the propaganda machine promoting the myth that in order to have real value in our culture women ought to be constantly motivated towards the attainment of physical perfection.

These powerful influences serve to fuel a sense of personal and almost infectious collective body dissatisfaction amongst women and have contributed to the rise in the use of eating disorder behaviours such as obsessive dieting, calorie counting, overexercising, self-induced vomiting, diet pill and laxative abuse.

It is estimated that 1.1 million people in the UK suffer from eating disorders. The majority are young women aged between 12 and 24 years although women of any age can develop a problem.

In addition increasing numbers of young men are presenting for help with anorexia and bulimia. This may be linked to a blurring of gender roles and as men have increasingly adopted the cultural values and beliefs about body shape, thinness, dieting which were previously held almost exclusively by women.

Eating disorders commonly develop insidiously and the causes are a combination of genetic, psychological and sociological factors. Going on a prolonged diet, excessively calorie counting, cutting down on carbohydrate foods, hiding food on the plate at meal times and making excuses for not eating with the family or even skipping meals entirely are among some of the early warning signs. More apparent weight loss occurs as the young person becomes progressively preoccupied with food and weight, and the distressing feelings and visual misperceptions of fatness she experiences which are out of proportion to how family and friends view her.

Sometimes weight loss is camouflaged by wearing baggy clothes and explained away by transparent justifications for obsessive activity and overexercising. As weight falls menstrual periods become irregular and then are lost altogether. The sufferer is often in denial that they have any problem at all and becomes increasingly reclusive and socially avoidant. In bulimia the person looks normal weight and is likely to be older, employed and in a relationship. On the surface they may give the impression of leading a normal life. Binging and vomiting are secretive activities and associated with a sense of shame and can go undetected for years. In some forms of obesity the person also binges or compulsively overeats but without vomiting afterwards and so gains excessive weight.

Depression, alcohol and drug misuse, anxiety, obsessive rituals, self-harming and shoplifting are often part of the bigger picture. Physical complications such as infertility, osteoporosis, heart and kidney problems can develop and deaths occur as a result of starvation, cardiac arrest and epileptic seizures.

It is important to seek help as early as possible before the illness gets a grip. So, speak sympathetically with the person you are concerned about, consult your general practitioner for advice and source information about eating problems through the internet and organisations such as the national eating disorder association . Effective treatment involves a combination of restoration of physical health, dietetic management and a wide range of psychological interventions.

Specialist eating disorder help is now widely available and always remember recovery is absolutely achievable.

Dr. Alex Yellowlees