A little over 17 years ago, in my junior year of college, I went on my first diet to try to lose a little bit of weight that I’d gained during a study-abroad program. What happened next is a story that’s probably all too familiar to anyone reading this: the diet quickly spiraled into a vortex of disordered behaviors, including restricting more and more types of food, as well as the overall quantity of food I’d allow myself to eat; bingeing in response to the intense physical and mental deprivation I was experiencing; and overexercising and occasionally using other behaviors to try to compensate for the binges (which I now know just made the bingeing worse).
Soon I developed a whole host of new health problems: irritable bowel syndrome, fatigue, “brain fog,” acne, a missing period, and other hormonal abnormalities. I went from doctor to doctor, trying to figure out the cause of all my seemingly disconnected symptoms—not recognizing that the disordered eating was behind it all. I truly thought my restrictive diet, compulsive exercise, and fixation on weight loss were “healthy,” because that’s what I’d always been taught in the diet culture we live in—and so I was genuinely confused by my rapidly declining health.
My doctors were similarly stumped. They said I was in the “normal” BMI range, so I couldn’t possibly have an eating disorder. They never even asked basic questions about my eating and exercise habits, let alone got me to open up about them.
Today, as a recovered dietitian who specializes in disordered eating, I understand the diagnostic criteria for eating disorders and know that back then my behaviors would have been diagnosed as “Eating Disorder Not Otherwise Specified.” But I never actually got the diagnosis—and that was all because of weight stigma. My providers’ unwillingness even to screen me for an eating disorder (or refer me to someone who could) was the direct result of their weight-biased attitudes about eating disorders. In their eyes, if a person wasn’t “underweight” then they couldn’t possibly have a problem.
So instead of getting help when I desperately needed it, I had to take a winding, decade-long path to recovery that kept me fixated on food and struggling with disordered behaviors for far longer than I would’ve been if it weren’t for weight stigma.
I’ve always lived in a smaller body, so it might seem surprising that I experienced any level of weight stigma in healthcare. And I do indeed have a lot of privilege, in the sense that I’ve never had to endure the pervasive weight-shaming at the doctor’s office—and in virtually every other aspect of society—that people in larger bodies go through every day. Still, although weight-based discrimination disproportionately harms people in larger bodies, anti-fat bias affects all of us, no matter where we fall on the weight spectrum. For people of all sizes, weight stigma is often a barrier to eating-disorder diagnosis and treatment, as it was for me. And those of us who face this barrier lose precious years of our lives—our time, our mental energy, our well-being, and our capacity for joy—when we’re stuck in the vortex of disordered eating. Even people who are at low weights when they receive an eating-disorder diagnosis have often previously struggled unnoticed for months or years because of weight stigma.
We need to end this suffering, and make eating-disorder diagnosis and treatment accessible to people of all sizes (not to mention income levels, ages, ethnicities, and genders). We need to eradicate weight stigma from our eating-disorder-recovery communities, so that people across the body-size spectrum can feel safe and supported as they pursue recovery. And we need to end weight stigma at the societal level, to help prevent disordered eating in the first place.
It all starts with recognition of this issue, which is why it’s so awesome that NEDA is hosting Weight Stigma Awareness Week.
But it can’t end here. In the weeks and months to come, I hope you’ll continue to explore resources devoted to dismantling weight stigma and diet culture (such as NEDA’s ongoing coverage, as well as my podcast and forthcoming book). And as you educate yourself, I hope you’ll feel empowered to start speaking out against weight stigma in your everyday life. Because this is a problem that affects all of us—and it’s going to take all of us working together to solve it.
Christy Harrison, MPH, RD, CDN is an anti-diet registered dietitian nutritionist and certified intuitive eating counselor based in New York City. She offers online courses and private intuitive eating coaching to help people all over the world make peace with food and their bodies. Since 2013 Christy has hosted Food Psych, a weekly podcast exploring people’s relationships with food and paths to eating-disorder recovery and body liberation. It is now one of iTunes’ top 100 health podcasts, reaching tens of thousands of listeners worldwide each week.
Christy began her career in 2003 as a journalist covering food, nutrition, and health, and she’s written for major publications including The New York Times, SELF, BuzzFeed, Refinery29, Gourmet, Slate, The Food Network, and many more. Her forthcoming book, Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating, will be published by Little, Brown Spark in December of 2019 and is available for pre-order now. Learn more about Christy and her work at christyharrison.com.