"Eating Disorders Do Not Discriminate" - or do they?

It’s eating disorders awareness week, and one of the phrases that I am seeing more and more at the moment is "eating disorders do not discriminate". This might be a part because of a really excellent new book that’s been put together by Dr Chucks and Bailey Spinn, with the same title, which launched last week at YouTube and Google's headquarters in London.

I was really privileged to be asked to write a chapter for this book about my own personal experiences, although at the time, I did not know what the title of the book was. I really celebrate the message of this book and what I am going to write about in this or blog an attack on this wonderful piece of work. A book that sheds light on unheard experiences and a diverse range of voices is exactly what the field of eating disorders needs right now, so go ahead and make sure you get a hold of a copy!

There are however, quite a few problems with the phrase "eating disorders don't discriminate", to my mind. I think that eating disorders do discriminate, in several senses of the word. To discriminate is to mark something out as different - to differentiate - and whilst eating disorders are really heterogenous conditions experienced by diverse ranges of people, to suggest that there is some kind of equity in the way that eating disorders are distributed and experienced is just false.

The data clearly show that some people are more likely to get eating disorders than others. Some people from particular backgrounds are more likely to get eating disorders than others. I’ve seen a couple of posts and presentations this week, which have emphasised that eating disorders impact people from all different kinds of backgrounds, and do not discriminate on the basis of gender, class, race, etc. These posts then go on to say, "for instance, 25% of people with eating disorders will be male!", ironically proving the point that there are key differences in how eating disorders are distributed in the population. To say that eating disorders do, in fact, discriminate doesn’t have to sit in opposition to the fact that eating disorders affect people from all different kinds of backgrounds. Both can be true.

Just like eating disorders are more likely to affect some people than others, eating disorders are also more likely to affect some people more severely than others. This is another form of discrimination, and there are many possible reasons why somebody might perhaps experience a more severe illness. Having an eating disorder with diabetes and having an eating disorder without diabetes will be two very different experiences, for example. This is just one example, but there are many others. People living in poverty, people from ethnic, gender, or sexual minorities, and many more besides. It seems a case of both/and, not either/or, when we talk about diversity. Yes, we are all in this together, but that doesn't erase difference.

I think the language is really important. The phrase "eating disorders don’t discriminate" comes from a really well intentioned place, but I think that it just doesn’t make sense on one level, and on another level is potentially harmful. It really matters that we know who is more likely to get illness. It really matters that we know who might experience illness differently, or more severely, or less severely, and on what grounds. We need to be able to see discriminate in order to target are very limited resources to prevent and treat illness, so this is not a trivial issue.

But just to turn this blog on its head at the end - I do think there is one key way in which eating disorders do not discriminate. It is less, perhaps, that eating disorders do not discriminate - it's more that, conceptually, they can't. I mean this in the sense of performing the act of discrimination - as eating disorders do not have a willpower. They are not some kind of entity that exerts its will upon sections of society or individuals. Eating disorders are not out there in the world, skulking in the corners, hiding in the pages of Vogue magazine, waiting to get your children. Eating disorders are not hiding in the wings, waiting to take centre stage from their own volition. They aren’t seeds flying on the wind, waiting to colonise any patch of land with the right conditions. Of course, many people find it helpful to personify or externalise that eating disorder, and if that works for you then brilliant. But I do not conceptualise eating disorders being a thing with discriminatory willpower.

There is a tendency within discussions about eating disorders to treat eating disorders as an almost top-down kind of entity, rather than looking at them in a bottom-up kind of way. I prefer to think of eating disorders are emergent from many different factors, such as biology, society, prevailing culture, relationships, food, economic structures, the environment, etc. - rather than as an invasive pathogen. It is our environment and our conditions that bring about the differences from which eating disorders emerge - rooted in the diverse contexts within which we live our lives. Maybe we can’t articulate the multiplicity of experiences of eating disorders that a diverse range of people have with such sweeping and generalising statements as we might like to.

We might need to be more discriminating - with our language.