A piece in Vogue Magazine's April "Shape" issue recently sparked off a lively controversy about the role of culture and family in eating disorders. The author, Dara-Lynn Weiss, was slammed across the Internet, and the article derided as the "worst Vogue article ever" by numerous bloggers. "Weight Watcher," a personal account of Weiss's struggle with her seven-year old daughter's obesity, chronicles the diet she eventually decided to put her daughter on. The Internet frenzy culminated in a swelter of fit and fury when the Manhattan socialite landed a book deal. The National Association of Anorexia Nervosa and Associated Disorders (ANAD) quickly released a statement denouncing Vogue for publishing the piece, calling it irresponsible and urging Weiss to examine her own relationship with food and image.
Both the magazine, known for its iconic, rail thin models, and the parenting style Weiss frankly confesses to--a style inevitably fraught with the author's own ambiguity over food and thinness--have long been in the crosshairs of those wishing to vent their fury over the results of our culture’s collective obsession with both food and image. This twin obsession, so riddled with contradictions, cannot but yield some painful paradoxes. As Weiss herself asks, "I had suffered through my own issues with food. Who was I to teach little girl to maintain a healthy weight and body image?" Armed with Bea's "clinical qualification as obese," Weiss found herself in confrontation with other parents, the school, and even a Starbucks barista over her daughter’s diet.
Though there is much to criticize in Weiss's approach, including a troubling tendency to preference calorie counting over nutrition, she raises some interesting questions that seem to have escaped her detractors’ notice. Noting that her daughter attends a school that bans a common allergen (nuts) she says wryly, "Should she attempt to walk through the door with an almond in her pocket, she'd practically be swarmed by a SWAT team. But who is protecting the obese kids when 350-calorie cupcakes are handed out to the entire class on every kid’s birthday?"
Regardless of what one thinks of Weiss's methods--and even she has times of doubt--the article demonstrates clearly that eating disorders cannot not be isolated from the complex matrix of familial and cultural factors from which the disorder originates.
Anorexia and obesity are both serious diseases that exist within a continuum of eating disorders. They both affect every organ in the body. Anorexia has the highest fatality rate of any psychiatric illness. Obesity is well on its way to becoming a national epidemic, afflicting some 72 million adults as well as making serious inroads into America's population of children. Both diseases open up a host of other health complications. Obesity plays a role in heart disease, blood pressure, and diabetes, and most people who struggle with a serious eating disorder will suffer from life-long health complications.
Though the underlying assumptions informing clinical practice have swung from a view of the family as pathological to a much more individualized focus that excludes or even discourages the family's role, a comprehensive body of research is yielding a more nuanced understanding. But until we can speak about the problems surrounding eating disorders and families with civility and gravity, we won’t even be able to uncover the underlying issues.