Eating disorders are complex mental health conditions that develop from a confluence of biological, psychological, and environmental factors. Diet culture, with its pervasive influence, often plays a significant role in both encouraging and maintaining disordered eating behaviors in many individuals.
Understanding Diet Culture
The term "diet culture" lacks a specific, universally agreed-upon definition, which ironically contributes to its insidious nature. Essentially, diet culture glorifies thin, "toned bodies," presenting them as the epitome of health and the one "true" healthy body type. Achieving this shape is not just encouraged in diet culture but elevated to a moral imperative; it is sometimes considered the most important goal someone can achieve. In this light, diet culture dictates that all aspects of someone’s life and lifestyle must revolve around working on or prioritizing the goal of having a thin, toned body.
This creates a false dichotomy that extends to food as well. Just as diet culture recognizes "good" (or "ambitious") people who try to "stay fit," and "bad" (or "lazy") people who don’t, so too does diet culture designate "good" and "bad" foods. On a cultural scale, diet culture gets a massive boost from long-held beauty ideals, including the thin ideal for women and lean, muscular bodies for men in Western cultures.
Movies, TV shows, advertisements of all types, including the Internet, have long been understood to spread these and other unrealistic beauty standards, which have been directly tied to body dissatisfaction, disordered eating behaviors, and eating disorders. Diet culture presents itself as an antidote to this dissatisfaction, offering a path to achieving the "perfect" body or one that resembles the cultural ideal. In many cases, these messages can be even more treacherous, as they superficially present as being "inclusive," but are still coded with diet culture ideals. In fact they are often delivered by people in "ideally thin" bodies.
While specific diets may be legitimately recommended to be followed by people with certain health concerns, such as Celiac disease or Diabetes, dieting specifically to lose weight or achieve a particular body shape can have many negative impacts on mental and physical health and well-being. When the world is painted in terms of absolutes: "good" and "bad" foods, "right" and "wrong" bodies, it can make every choice or non-choice feel like a moral test and potential trigger. For example, the idea that some foods are "bad" can make someone feel guilty or ashamed after eating them. This is an extremely harmful thought pattern tied to disordered eating and several eating disorders.
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Diet culture promotes itself as championing health, but it often works to normalize disordered eating behaviors, including skipping meals, calorie counting, and other restrictive eating practices. These, in turn, frequently lead to even more problems like low self-esteem, feelings of failure, and the development of increasingly disordered eating behaviors to "counteract" these effects.
One of the most dangerous aspects of this worldview is the undue focus and attention it puts on dieting and body shape and size. A fixation with body image, food, and eating is a key factor in nearly every type of eating disorder. Many conditions are also maintained by the belief that self-worth is directly tied to appearance, a thought often implied by diet culture. The conflation of dieting and moral superiority raises the stakes much more, adding even more pressure for someone to keep these ideas at the top of their minds. It can help create a sense of high personal standards and encourage concern or self-criticism when these standards aren’t met. In the scientific world, those are the same traits that make up “perfectionism,” a characteristic that has long been associated with eating disorders.
On the other side of that coin is the perpetuation of harmful stereotypes that help power weight stigma, weight discrimination, and weight bias. The idea that controlling what one eats and having a slender body offers a sense of moral superiority dates back to the 1800s when European enslavers used the concept as another way to separate themselves from-and hold themselves above-enslaved Africans, who tended to have larger bodies. It offered a shorthand way for the ruling class to point at a Black person in a larger body and say they were lazy, amoral, or inferior.
On the gender divide, diet culture has long targeted cisgender women, though people of all genders are undoubtedly impacted by widespread images of "ideal" bodies. The cultural "lessons" largely passed on to cisgender women, however, is that their worth is intrinsically tied to their appearance-and particularly, their weight. As awareness around the specific concerns of the LGBTQIA+ community has expanded, so have realizations that this community, too, is deeply and negatively impacted by diet culture. Statistics suggest that members of this community are more likely to experience disordered eating behaviors than their cisgender heterosexual peers, though more research is needed in this burgeoning field.
The Problems with Diet Culture
Even when presented sincerely or unknowingly preached as health-promoting, diet culture is loaded with several problematic or objectively false ideas that can be dangerous if internalized.
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Equating Health with Thinness
One of the central tenets of diet culture is that a thin or toned body is the only "healthy" type of body. But this notion is patently untrue. Health is multifaceted; it exists on a spectrum of physical, spiritual, emotional, and mental well-being, and countless factors influence it. Health also means different things for different people, depending on everything from their physiology, age, and medical history to their cultural and religious beliefs. And overall, people can be healthy in a variety of body shapes and sizes.
Unfortunately, even medical community members have difficulty avoiding diet culture messaging. Weight stigma has increasingly been reported in the medical community by doctors and patients alike. These attitudes, whether active or subconscious, can impact a doctor's medical recommendations, influence how they perceive a larger patient's health, and even, in some cases, affect a doctor's willingness to help their patients.
Promoting Dangerous Ideas
Aside from the concept that there is only one way to be healthy, diet culture pushes additional false and unhelpful ideas around food, diet, exercise, body weight, and physical well-being. In many cases, diet culture will promote restrictive diets to achieve or maintain a particular look. These can include dietary restrictions around limiting caloric intake, limiting types of foods, or even an entire food group. Adhering to these types of rules and ideas around food and eating can lead to adopting extremely rigid eating patterns and enforcing an unhealthy relationship with food.
Diet culture is rooted in anti-fat bias and also perpetuates fat-shaming, outrightly or subconsciously pressuring people in larger bodies to lose weight. Through the types of ideas pushed by diet culture, many people have come to associate higher-weight bodies with laziness, immorality, and a lack of health. This can contribute to weight stigma, which is extremely damaging and contributes to physical and mental health problems, including eating disorders.
Encouraging Problematic Thinking Patterns
Diet culture often explains, out loud or through insinuation, that certain foods are "good" while others are "bad." This kind of black-and-white mentality can extend beyond the concept of food and impact the feelings of worthiness of the person eating the food. The reinforcement of this false dichotomy and the idea of the world as a place of "good" or "bad" choices-and, therefore, "good" and "bad" people-can contribute to the way people talk to or think about themselves, their bodies, and their eating habits. They may believe that "bad" food choices are made by "bad" people and feel guilt or shame about their preferences or decisions.
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For example, if the idea prevails that all desserts are bad, full stop, someone may be more likely to punish themself for eating something deemed "bad food." The mentality is dangerously close to that which often drives the compensatory behaviors in eating disorders and can also contribute to worse low self-esteem and poor body image that usually works to maintain or develop eating disorders.
Diet Culture and Eating Disorders: Overlapping Traits
The thinking behind diet culture overlaps with the thoughts that drive eating disorder behaviors in many ways.
Idealizing Certain Body Types
The overall philosophy of diet culture can cause people to believe that they don’t have value or worth unless they have the "ideal" body-often considered thinness for women; lean, muscular builds for men; and thin, curveless versions of androgyny for nonbinary people. When people don't have bodies that meet these arbitrary standards, they may feel ashamed, guilty, or angry. These feelings can contribute to negative body image and poor self-esteem, as well as mental health conditions like depression and anxiety, which are frequently considered major maintaining factors for disordered eating behaviors.
Promoting Disordered Eating Behaviors
Disordered eating exists on a spectrum, describing a wide range of detrimental eating habits and behaviors that sit somewhere between adequate eating and eating disorders. However, diet culture often promotes many behaviors that meet this designation.
Some research has argued that all diets are a form of disordered eating, as they impose certain rules and restrictions around someone's otherwise natural hunger cues, enjoyment of food, or adequate eating behaviors. Other studies have concluded that dieting may cause more harm than good. Some people who engage in disordered eating do meet the criteria for an eating disorder, while others may not. But these habits can lead to full-blown eating disorders eventually. Frequent dieting, in particular, has been identified as a risk factor for developing binge eating disorder (BED).
Connections with Low Self-Esteem
Both diet culture and eating disorders are often perpetuated by low self-esteem. The connection is so strong that some researchers have posited chronic low self-esteem as a prerequisite to developing an eating disorder of any kind. Diet culture can also work to lower self-esteem further.
Social Media's Role
With increasing eating disorder prevalence, attention has turned to the growth of social media. The rise of social media has amplified the impact of diet culture, particularly among young people. In 2020, social media reached 49% of the global population. Recent reports reveal that 91% of UK and US adolescents use social media, with over 50% checking these at least once per hour. Users can choose who to follow or message, what content to engage with or upload, what to highlight or conceal. What is posted and well-received is not coincidental-it is dynamic, shaped by broader social and cultural ideals related to beauty. Body image dissatisfaction and eating disorder pathology amongst young people is rising. According to a recent UK Government report, 95% of under 18’s report that they would change their appearance, and body image was one of the top three anxieties amongst Australian youths. An estimated 13% of young people experience an eating disorder by the age of 20, and 15-47% endorse disordered eating cognitions and behaviours. Despite this, the association between social media, body image and eating disorders remains relatively unexplored. However, with 41.9 million neglected cases of eating disorders in 2019, combined with unprecedented social media exposure amongst young people, this issue warrants further review from a global health perspective.
Social media usage is a plausible risk factor for the development of eating disorders. Evidence from 50 studies in 17 countries indicates that social media usage leads to body image concerns, eating disorders/disordered eating and poor mental health via the mediating pathways of social comparison, thin / fit ideal internalisation, and self-objectification. Research from Asia suggests that the association is not unique to traditionally western cultures.
Fitspiration and Thinspiration
The fitspiration trend, while seemingly promoting health and fitness, can also contribute to body image dissatisfaction and disordered eating. Some individuals feel extreme pressure to "eat clean" or exercise to excess, with subsequent bingeing and disordered eating outcomes. Similarly, the #thinspiration trend glorifies "emaciated people" and "bone-thin girls", promoting starvation as a lifestyle choice instead of a symptom of mental illness.
Statistics: The Scope of the Problem
The impact of diet culture on eating disorders is reflected in the statistics. In the United States, 28 million people will suffer from an eating disorder at some point in their lives. The most common eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder. Eating disorders are a group of heterogenous, disabling and deadly psychiatric illnesses that severely impair daily psychological and social functioning.
Eating disorders incur an estimated 6-10% increase in years lived with disability. Outcomes range from cardiovascular disease, reduced bone density, to comorbid psychiatric conditions, namely depression, anxiety, obsessive compulsive disorder and specific phobias. Amongst young females, eating disorders are one of the leading causes of disability, often preceding amenorrhea, reduced fertility, and adverse pregnancy and neonatal outcomes. The cost of eating disorders at a health systems level is significant, fuelled by increased hospitalisations and the significant burden placed on primary and outpatient services.
Despite perceptions of eating disorders as a culturally bound syndrome of the West, they affect individuals worldwide. Estimating global prevalence, however, is challenging. Nationally representative data are scarce, the disorder tends to be omitted from national health surveys, and multiple changes to classification have confounded existing global data. Despite this, the most recent Global Burden of Disease study calculated that in 2019, approximately 13.9 million people suffered from Anorexia or Bulimia. A subsequent review highlighted an additional 41.9 million overlooked cases of OSFED and binge eating disorder, indicating a total global prevalence of 0.7%. However, since many cases never present at formal health services, actual prevalence may be much greater. Whilst females still represent the largest proportion of cases, the greatest increase is amongst males, athletes, those with obesity, and sexual and gender minorities. Most eating disorders begin in adolescence but tend to persist throughout adulthood.
Combating Diet Culture and Promoting Healthy Relationships with Food
Recovering from an eating disorder is a difficult journey in any case, and it can be even harder in a society so fixated on diet and physical appearance. One of the best ways to confront diet culture is to meet it where it primarily lives: online. Combing through your social media is a great place to start. You can also take some proactive actions.
Strategies for Change
- Practice intuitive eating: Intuitive, mindful eating involves learning to listen to the body’s hunger and satiety cues and using those cues to discern when to eat, how much, and what to eat. It's about trusting one’s body to know what is best for it. For people recovering from an eating disorder, more structure might be necessary at first to help them address nutritional deficiencies or establish a more regular and adequate pattern of eating. However, many recovery programs aim to help introduce skills that can facilitate eating more intuitively. Intuitive eating is not accessible to everyone due to various physical, psychological, financial, and logistical barriers. Still, many alternatives to diet culture can enable more positive and sustainable relationships with food.
- Engage in joyful movement: Diet culture associates exercise with punishment for eating something deemed "bad" or marks it as a necessary chore to maintain the ideal body weight and shape. But it doesn’t have to be that way. Movement can-and should be-a joyful experience that can help improve the mind-body connection. If it is safe for you to engage in movement and you are interested in doing so, you can explore many kinds of movement that may be pleasurable for you, including dancing, playing a sport, or practicing yoga. It’s also important to remember that rest isn't a sign of failure or giving up but rather an essential aspect of growth and part of the natural cycle.
- Embrace body neutrality: Body neutrality involves having a neutral perspective about one’s body. In other words, it asks people not to think about their bodies as good or bad but as something to care for. Many proponents of body neutrality prefer to focus on meeting their body where it is and figuring out how to care for it, whether or not they like how it looks. Appreciating ways that bodies can support us, including allowing us to heal, spend time with others, or engage in things we enjoy, can be a source of happiness. Thinking of the body this way can help cultivate gratitude and care for having a body rather than focusing on the negative mindset of what it "should" be.
- Curate your social media: Start following accounts that promote inclusivity, neutrality, size diversity, attentive self-care, intuitive eating, joyful movement, and other helpful practices-but remember to be careful, as many "wellness" accounts still peddle many of the same toxic ideas associated with diet culture.
- Expand your sense of self-worth: Working to expand your sense of self-worth beyond your weight or appearance is another way to quiet the harmful ideas of diet culture. Start by identifying goals that align with your morals, then work toward achieving them. The same technique can be used for new hobbies that are good for you and make you feel good. And values work can also be helpful.
Seeking Professional Help
A therapist or other mental health professional can help you with these strategies and offer different approaches and types of support that can help you cultivate a successful recovery journey. Treatment can occur in a number of settings, including inpatient, residential, intensive outpatient, partial hospitalization, outpatient, and virtual venues. And each level of care offers its own benefits for patients struggling with all kinds of conditions.