CONTENT WARNING: DISORDERED EATING
In 2012, Stephen Hawking told an interviewer that what most preoccupied his free moments wasn’t general relativity or artificial intelligence, but rather an entire gender. Women, explained the famous theoretical physicist, “are a complete mystery.” Despite the minor internet kerfuffle this statement caused among feminists, Hawking, whose considerable scientific achievements have earned him the unofficial title of the world’s smartest living person, revisited the sentiment a few years later when, during a 2015 Reddit AMA, he responded to a question about the riddles of science in a similarly uninspired vein: “My PA reminds me that although I have a PhD in physics women should remain a mystery.”
With a few throwaway statements, Hawking illustrates a patriarchal tendency that few people—or few women, anyway—will deny exists: the insistence that women are mysterious, otherworldly, impossible-to-understand creatures.
In this mindset, the woman who is sick becomes doubly enigmatic. Taking on this perspective from the other side in Tender Points, a gorgeous chapbook about living with fibromyalgia, Amy Berkowitz pins down the mysteriousness of “women’s diseases,” and the effect it has on their treatment and diagnosis:
“Fibromyalgia is routinely described in terms of its lack of certainty or credibility… Up to 90 percent of fibromyalgia patients are female, and there is a strong precedent for ‘women’s voices not being heard or considered credible in the male-dominated healthcare system’...While I can’t say for certain how fibromyalgia would be discussed if the condition primarily affected men, I suspect that we would see words like ‘mysterious’ and ‘unknown’ drop from the literature, replaced by the findings—however incomplete—of research done thus far.”
In our culture, so mysterious, insubstantial, and incomprehensible a group as women are naturally suspected of also being literally incredible, even when it comes to their own experiences, pain, and trauma. With Tender Points, Berkowitz joins a long tradition of thinkers who have teased apart misogyny and ableism to lay bare the experiences of women and non-binary people who also happen to be sick. Unfortunately but unsurprisingly, fibromyalgia is not the only disease to have its credibility questioned after years of misunderstanding and dismissal by everyone from the family and friends of patients to the medical establishment itself.
As one of the diseases most strongly associated with women, bulimia is another such affliction—to many, it still conjures up “lifestyle choice,” rather than the gravity of a deadly mental illness. And while its existence isn’t debated to the degree we see with fibromyalgia, the humanity of the bulimic person certainly is. We learn early and well that the Bulimic is not only always female (through a gender essentialist lens) but, paradoxically, not even human to begin with. Even a cursory glance at her disease confirms that she is something bestial: Though a direct translation of bulimia nervosa from the Greek might be “nervous ravenous hunger,” the word bulimia itself is a compound of the Greek words for “ox” and “hunger”—describing an appetite that only an animal could have.
"IN OUR CULTURE, SO MYSTERIOUS, INSUBSTANTIAL, AND INCOMPREHENSIBLE A GROUP AS WOMEN ARE NATURALLY SUSPECTED OF ALSO BEING LITERALLY INCREDIBLE, EVEN WHEN IT COMES TO THEIR OWN EXPERIENCES, PAIN, AND TRAUMA."
But even animals, as cultural figures anyway, are often afforded a complexity of character and spirit that is denied to the Bulimic. Lassie and all her iterations have more dimensions than the army of young white women thrown in as punchlines in the comedies and rom-coms of the past thirty years; the stars of March of the Penguins evoke more pathos than the stupid bimbo, vain cheerleader, or bitter workaholic (almost always straight and white, by the way) who eventually drowns in the toilet of her own vanity.
Though it wasn’t invented—that is, described, codified, and pathologized—until well into the twentieth century, bulimia has come to represent a triple dovetailing of mortification, excess, and gendered baggage, the kind that even professionally forward-thinking people like Hawking still carry, that goes back hundreds of years. While the self-abnegation of the Bulimic fits in perfectly with standards of femininity that are defined by misogyny, it can’t be separated from the gluttony that no “healthy” or “normal” or “desirable” woman would express. To deviate from normative femininity with, for example, the conspicuous overconsumption of food—one-half of bulimia’s defining behaviors—is in direct violation of how women are supposed to be, especially if that consumption results in weight gain. It seems that, no matter how many #bodyposi ad campaigns Dove runs, women are still held—and still forced to hold themselves to—oppressive body standards, especially when it comes to food and eating.
Our contemporary framing of it aside, disordered eating is nothing new. From the legendary vomitoria of ancient Rome, to the anorexia of the medieval European saints, to ritualized starvation across cultures and eras, we have normalized some ways of eating, which means that other ways of eating will necessarily be abnormal. Even taking into account the relative novelty of bulimia as we know it, it seems ridiculous that an illness affecting more and more people of all genders, races, and classes—though underreported—is still so misunderstood.
If there is a reason aside from institutionalized misogyny that eating disorders merit a fraction of the research funding that diseases affecting similar percentages of the population do, it’s hard to imagine what that might be. Figuring out how that misogyny manifests is its own puzzle. Is it the inherent mysteriousness of women and their ailments, or a general apathy about afflictions that don’t have anything to do with cis men’s sex lives, that explains the overall indifference?
If adequate medical recognition is too much to ask for, at least for the time being, then being overly concerned with media representation might seem to be a misprioritization. People are dying—who cares if eating disorders like bulimia and anorexia remain culturally siloed as the illnesses of straight, white women for whom money is of no particular concern?
But media representation of bulimia relates to its status as a disease, and examining this relationship is important, especially as representation continues to evolve. With Emma Watson’s turn as Sam in 2012’s The Perks of Being a Wallflower, Sam’s bulimia is an aspect of her character, not the extent of her role. Recent YouTube-born indie comedies like Binge and The Skinny, both written by and starring women who have actually experienced bulimia, feature bulimic protagonists who are portrayed with a sense of humor and of self, and even more importantly, a future—they don’t have to die to earn your sympathy, redeem their brokenness, or cash in on the tragedy of their trauma (see: Brittany Murphy’s Daisy in Girl, Interrupted), though they do tend toward manic pixie dreamgirlishness.
These examples are certainly more representative than a half-century’s worth of after-school specials that confine bulimia to young, white, female, middle-class perfectionists who are, most importantly of all, thin—but not by much. They’re an inarguable step up from the Bulimic as misunderstood and rarely seen, unless as parody (insert joke about Lindsay Lohan, Tracey Gold, or Princess Diana) or melodrama (catch an episode of A&E’s Intervention or any Lifetime movie about eating disorders), but only slightly so. As of 2017, the Bulimic remains a ghostly figure: She’s a slightly more fleshed out face, or facet, of womanhood (or, as is more likely to be the case, adolescence), somehow almost all the more insubstantial because her caricaturization is so obvious.
This means that even our better contemporary understanding, and more representative depictions, of this serious disease still play out as reductivist at best. Though there is a movement to raise awareness about the diversity of their victims, eating disorders still tend to be associated with the kind of women who could most easily get treatment for them, despite the fact that studies have shown that other kinds of people get eating disorders too—they’re just less likely to get diagnosed.
Which is why media representation matters. With such a limited view of whom eating disorders affect, a feedback loop occurs, resulting in a muddling of causality: We only see this kind of person getting sick, ergo this is the only kind of person that can get sick—a mindset to which medical professionals are as vulnerable as sick people. This misapprehension not only disappears people with eating disorders who deviate from what is supposed to be the “normal” patient (thereby making it that much harder for them to get a diagnosis, let alone treatment), but reduces an entire mental illness to a “woman’s disease”—an excellent way to make sure it continues to be taken less seriously by the medical establishment, especially if that woman’s humanity is perceived as limited by other aspects of her identity, as Berkowitz, Johanna Hedva, Carolyn Lazard, and many others have illustrated.
Of course, we can’t dismiss the fact that there are some diseases that afflict certain populations more than others. Prostate cancer, for example, affects mostly men (though female and other non-male people can also have prostates). (1) The point, however, is that gendering diseases is never objective, and often, rather than increasing specificity—and the power of medical experts to study and treat them—makes them even harder to grapple with on a macro scale. As Berkowitz and many other people with “women’s diseases” have learned the hard way, unless you’re a man, the gendering of disease is tantamount to the demeaning of your value; and on the field of health, and the life-or-death situations it incurs, tantamount to dehumanization.
It’s also worth pointing out that not all diseases are gendered the in same way. Just as gender is informed and shaped by other identities, its effects vary across population, culture, time, individual, and even situation. Though also afflicted with an eating disorder, the Anorexic—in the cultural imaginary, someone almost always characterized as highly disciplined white woman in control of her emotions and behavior—represents the height of femininity. In contrast, though also usually white, the Bulimic is dehumanized by her hunger; worse, and again paradoxically, she is ungendered, because anything that is seen as a failure of normative femininity will also, by the metrics of patriarchy, become precisely unhuman.
"...ALSO IMPORTANT IS THE EXAMINATION OF THE WAYS WE’RE STILL BEING POISONED WITH FALSE NARRATIVES OF GUILT OR RESPONSIBILITY, OR EVEN WORSE, THE IDEA THAT EATING DISORDERS ARE ACTUALLY JUST A SET OF HABITS, BEHAVIORS, OR PREFERENCES THAT ARE DISTINGUISHABLE FROM SERIOUS MENTAL AND PHYSICAL ILLNESS."
Of course, the Anorexic Woman might tell you that attaining perfection, even sainthood, through her self-denial doesn’t feel like equality, or equity, either. It’s impossible to feel human from a pedestal (even one created by a world-famous scientist). This positionality often just feels like a slightly roomier cage, albeit one with a better view. The cultural perspective of anorexia has at least a whiff of personhood—perhaps the remnants of the mortal coil she’s left behind—but not even the Anorexic escapes her gendering. (2)
Much ink has been spilled parsing all the different ways people are addicted to the abuse of food (or lack thereof), and these are not unimportant concerns, least of all to the many people who have eating disorders. But also important is the examination of the ways we’re still being poisoned with false narratives of guilt or responsibility, or even worse, the idea that eating disorders are actually just a set of habits, behaviors, or preferences that are distinguishable from serious mental and physical illness.
This is made most obvious by “the person within” discourse—the idea that inside our body is a better, and often thinner, version of ourself that’s trying to escape; a sad person striving to be understood; a sick person that wants to be well. From thinspo, to fitspo, to well-meaning attempts at kindness, this discourse is leveraged in ways that are meant to be supportive as well as undermining, but regardless of intent, it’s always harmful. How can doctors, family members, and friends say, in good conscience, Your belief that there is something wrong with your body is evidence of your mental illness, when we know that the bodies of even the most privileged women—straight, white, able-bodied, cisgender, middle-class American citizens—are surveilled, policed, punished, derided, dehumanized, and legislated against, (3) are at best dismissed as “mysterious” and at worst treated as inhuman?
If recognizing that eating disorders exist is an uphill battle, recognizing the saneness of eating disorders as a response to a world that despises the bodies of women and non-binary people can feel impossible. It implodes the “the person within” discourse, one predicated on the notion that that we are not, ontologically speaking, our bodies. This discourse is supposed to be an opportunity to dissociate from the challenges of our embodiment, and to encourage us to continue attempting to change our physicality in order to capitalize on the benefits of conformity. You are crazy to think there is something wrong with your body.
But as much as family, friends, doctors, and wellness shills would try to convince you otherwise, there is something wrong with your body, or the world (patriarchy; political regime; white supremacy) wouldn’t be attacking the rights to one's own agency and freedom on the basis of pre-existing conditions, race, class, indigeneity, misogynoir, transmisogyny, or ability. As a person with an eating disorder, your error is not in thinking that there’s something wrong where there isn’t, but that you could find a way to circumvent that wrongness by losing weight. The compulsive abuse of food—addiction, in other words—is your punishment for making such a mistake. The truth is, in our world, many can become more privileged (or rather, better profit from the privileges they already have) by attaining a “better” body, and most women, mysterious and otherworldly though they might be, must face this most corporeal of realities every single day.
We can be hopeful that better representation of eating disorders, slow though it may be in coming, signals a rise in body positivity and fat acceptance. Though media has its part to play (remember the Degrassi: The Next Generation episode where we learn that boys can have eating disorders, too?), we mustn’t forget that the real heavy lifting is done not by very special episodes or corporate ad campaigns, but direct and radical challenges to the dominant narratives about the bodies of women, femmes, and non-binary people by activists and scholars like Virgie Tovar, Nalgona Positivity Pride, and T-FFED, whose work is not only about dismantling the white supremacist cisheteropatriarchy that creates eating disorders, but about humanizing people affected by diet culture in the here and now. These activists recognize that even accurate representation—like the kind that many praise in The Skinny—is still limited by ideas of what eating disorders are and who they afflict (see: Lily Collins in this year’s To the Bone, or Elle Fanning in 2013’s Likeness). They understand that seeing and hearing from a diversity of bodies, rather than sanitized abstractions designed to drive ticket sales and subtly reinforce those oppressive systems, is what’s going to have an impact.
The gendering of eating disorders is only one thread in a much larger tapestry, one voice in the greater narrative that insists there can be “good” bodies and “bad” bodies. (4) Like many gendered illnesses—fibromyalgia and other autoimmune diseases among them—eating disorders resist easy understanding and simple categorization; like women are said to be, they tend to be mysterious. Writing about the grinding toll of her own autoimmune illness, Carolyn Lazard says simply, “These kinds of experiences are difficult to narrativize.”
Tempting as it might be, however, challenging these narratives with more representative media won’t save us: You cannot represent us to wellness. Like other conditions and identities, bulimia shows us that while representation might be a means of resistance, it can never be liberation.
(2) It must be acknowledged that by even making these distinctions, and creating discrete categories for what anorexic and bulimic people attain or don’t, relies on the expectation of thinness, which shouldn’t be taken into account when diagnosing eating disorders for many reasons. The gendering and subsequent dehumanization of fat people, and fat women in particular, is key to this discussion, and many have done the hard work of identifying the connections between fatness and dehumanization, racism, ableism, classism, and misogyny.
(3) Note that this discourse doesn’t apply to fat women with eating disorders, even though “fat” and “healthy” are not mutually exclusive.
(4) That fatphobia is inextricable from racism, transphobia, classism, ableism, and institutionalized lack of access goes without saying.