National Eating Disorders Association
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20 Years Later: How Princess Diana's Legacy Continues to Help People with Eating Disorders

Anna Sundquist, Communications Intern

On the 20th anniversary of Princess Diana’s death on August 31st, 1997, her legacy is still prevalent in the mental health community. This influence has been dubbed the “Diana Effect,” and is a result of the courage she had to share her story. 

In many cases, trauma can be a trigger for an eating disorder. The Princess of Wales was involved in a complicated marriage with Prince Charles. This, combined with the intense pressure of the media, marked the beginning of the Princess’ struggle with bulimia. 

Although the family was aware of Diana’s bulimia, she struggled with the illness for many years, not seeking treatment until the late 1980s. However, this fact was not revealed to the public until 1992, when Andrew Morton published a book about the Princess of Wales. 

After the publication, there was a sudden spike in the number of reported cases of bulimia, and many people came forward to receive the treatment they needed. Because of Diana’s openness and honesty about her struggles with her eating disorder, countless people were empowered to also be open and admit their own, similar struggles. Her influence on the community increased public awareness about bulimia, creating the “Diana Effect.” 

Princess Diana was brave to speak up about bulimia during a time when discussions around mental health were stigmatized and rare. Nevertheless, the number of people who also admitted to their own struggles in the years that followed spoke to the fact that eating disorders were always quite prevalent. 

Recently, Prince William spoke about his late mother’s eating disorder. He expressed his admiration and pride for her courage to speak up about her struggle with bulimia, and how this courage inspired many others. He also spoke about the importance of discussing mental health. “We need to normalize the conversation about mental health,” he stated, emphasizing that “mental health needs to be taken as seriously as physical health.” This was the first time that Prince William spoke about mental health specifically relating to his mother. The prince, as a well-known international influence, sets an example for the importance of mental health advocacy. 

Since the princess prompted a discussion about bulimia, our society has become more aware of its presence. However, bulimia is still often dismissed in the discussion of eating disorders. While anorexia is often thought of as the most common eating disorder, in reality, bulimia affects more individuals, yet is still discussed less frequently. According to NEDA statistics, up to 4.6% of males and females will develop bulimia, while up to 2.0% will develop anorexia. 

Additionally, bulimia can be especially dangerous because it is more likely to go unnoticed, as the person can maintain a “normal” body weight, yet be causing detrimental damage to their health. The medical consequences that may arise from bulimia include tooth decay, stomach rupture, and electrolyte imbalance, which can lead to irregular heartbeats or heart failure. Bulimia often co-occurs with depression, anxiety, and substance abuse, which create even more complications. 

If you believe that you or a loved one might be struggling with an eating disorder, there are a variety of resources available at NEDA. You can take a short screening to determine if you are at risk for an eating disorder. You can also contact the confidential Helpline at NEDA, either by phone (800.931.2237) or by chat to speak with a trained volunteer for support, resources, and treatment options for yourself or a loved one. 

Anna is a recently-retired ballerina, trying to use her experience to bring awareness and help others. She is excited to work with NEDA as an intern after her own recovery from an eating disorder. Anna is currently pursuing a degree in psychology.