How We – Women, Culture – Justify and Promote Disordered Eating
If you’re new to the “Healthy Not Healthy” series, here’s a two-sentence summary:
I just finished two of years of extremes: stress, exercising, and undereating; which resulted in hypothalamic amenorrhea (HA) (among other things). The “Healthy Not Healthy” (HNH) series discusses the how and why of HA, as well as my mental and physical recovery.
If you want to read the previous three posts, they are:
Quick Diagnosis Update:
I got my bloodwork back from the OBGYN, which confirmed that I do not have Polycystic Ovarian Syndrome (PCOS). I already knew this, but having the hard evidence is validating. Note that my OBGYN did not offer any further suggestions for diagnosis or treating my hypothalamic amenorrhea (HA). While I’m disappointed in the lack of acknowledgement and attention to the two years without a menstrual cycle, I do have a good start on recovery and an amazing support group to help move me forward.
HA (no menstrual period due to hypothalamus shutdown) typically manifests itself with one or a combination of the three factors I listed above – stress, extreme exercise, malnutrition. It is estimated that 69% of woman athletes who compete in sports where leanness is encouraged (ballet, running, etc) experience amenorrhea. Although I wasn’t a professional runner, I trained like one – my workouts and runs were grueling and kind of required for me to feel comfortable in my own skin.
Lies I Told Myself
- I cannot miss a workout. Missing a workout was the equivalent to becoming a fat and lazy slob (worse than death), and I’d shave off the X00 calories from my food intake for the day to make up for it. Illness, traveling, and family schedules were ignored or adapted to accommodate, you know, 8-mile pre-dawn speedwork on Mondays. If I missed a workout, I’d usually work double-hard/long the next day.
- Truth: I was missing out on life – time with my family, joyous relaxation, other activities – in favor of working out (mostly by myself).
- It’s better to not eat than eat unhealthy foods. I love make cookies … for others – not for me. I practiced “clean eating”, which meant no cookies, cakes, ice cream, bread, beans, grains, etc., etc. The exceptions to this rule were: 1) it’s my birthday, Thanksgiving, or Christmas; and/or 2) I’ve burned >1000 calories in exercise that day.
- Truth: All foods can and should be enjoyed. I was increasing my own stress by overthinking everything I ate and restricting my diet to certain “safe” foods.
- Not having a cycle is evidence that my body is super efficient. Not only did I not have to worry about the inconvenience, I thought I was working harder than most other athletes. I told myself I was fine. People said I look super-shredded, so it was “all good.” Nevermind that my fingernails were crumbling and hair falling out.
- Truth: Hypothalamic amenorrhea is a sign that the body is in a starvation and/or fight-or-flight mode. It senses chronic stress and malnourishment, so it shuts down functions that are not absolutely required for survival, eg, a working reproductive system, growing hair and fingernails, maintaining bone density.
- My 40-bpm resting heart rate (RHR) is a sign that I’m in awesome cardiovascular shape. If 60 a beat-per-minute RHR is good for an athlete, 50 or 40 bpm is even better, right? Never mind that sometimes I had tachycardia (heart rate >100) or palpitations for a few seconds, even at rest.
- Truth: Bradycardia – slow heart rate (<60 bpm) – was probably caused by my parasympathetic nervous system trying to conserve energy by slowing my heart rate. It can be evidence of a malnourished, not super efficient, heart muscle. The tachycardia is also a compensatory measure taken by my sympathetic nervous system, in response to long-term underfueling.
Those four are just a few of the lies and justifications I made for my HA and perfectionist lifestyle. I own those 100% – they come from me.
Up next: how external factors feed (pun intended) disordered eating and distorted body image.
What is Diet Culture?
I’ve been reading the term Diet Culture a lot recently, but it’s such a made-up-sounding term to me. Here’s the best and most general definition I have found:
Diet culture is a belief system that focuses on and values weight, shape, and size over well-being.
Sara Upson of My Signature Nutrition
How Diet Culture Promotes Disordered Eating
- Positive feedback and validation of (crazy) habits. Friends, family, and strangers offer affirming comments such as, “I wish I had your willpower” or “You’re an amazing runner.” Health magazines, apps (Noom, I’m looking at you), media in general praise low-calorie diets and food restriction as a blanket “health” recommendation to all people.
- Reality: My eating and exercise habits were rigid, unsustainable, and detrimental to my health.
- Reality: Drastically lowering caloric intake and/or eliminating entire food groups commonly and ironically results in long-term weight gain and feelings of failure. At least for “normal” people.
- Reinforcement that my body is approaching ideal. Everyone from my family to complete strangers commented my leanness, muscular definition, etc. Women especially ask for tips on how to get more defined arms. Images of fit women in the media reinforce that super shredded, no-fat physiques are desirable, achievable, and something to strive for.
- Reality: Almost no one will be as shredded as the images in fitness magazines, because it takes a crazy amount of time, dedication, and self-punishment to do it. Emphasis on the “crazy” here, because getting that lean is not natural for most women. Their bodies will resist and/or start to shut down in the process – no periods, hair loss, etc.
- Reality: The ideal fit woman’s physique, as promoted by diet culture, focuses on extreme leanness and strict dieting. For some women, the only way to achieve this goal is through semi-starvation and disordered eating.
Those of us who have or know someone with disordered eating and/or extreme exercise habits are probably pretty familiar with the mantras associated with such a rigid mindset.
“No missing workouts”, “clean food only”, “my body is a machine”, “unnatural physical symptoms are evidence that I’m super fit.”
These are lies.
In addition, Diet Culture and well-meaning people cheer us on with compliments and reinforcement of our lifestyle.
This is not a healthy reality.
If you tell yourself any of these lies or work yourself silly trying to reach an idealized size/shape, I’m willing to bet that, deep down, you know that this is not healthy. If you read this post and think, “That’s crazy talk” – congratulations – you’re right!
Please post any thoughts and/or comments, as well as any questions. ~Brook
Eating Disorders Review. “Orthostatic Hypotension and Tachycardia in Adolescent Patients with Anorexia Nervosa: A Marker of Illness Severity.” Eating Disorders Review, 27 Aug. 2018, eatingdisordersreview.com/orthostatic-hypotension-and-tachycardia-in-adolescent-patients-with-anorexia-nervosa-a-marker-of-illness-severity/.
“Functional Hypothalamic Amenorrhea.” Wikipedia, Wikimedia Foundation, 27 Dec. 2019, en.wikipedia.org/wiki/Functional_hypothalamic_amenorrhea.
Harrison, Christy. “What Is Diet Culture?” Christy Harrison – Intuitive Eating Dietitian, Anti-Diet Author, & Health at Every Size Expert – Food Psych Programs, Christy Harrison – Intuitive Eating Dietitian, Anti-Diet Author, & Health at Every Size Expert – Food Psych Programs, 10 Aug. 2018, christyharrison.com/blog/what-is-diet-culture.
“It’s Time To Drop Out of Diet Culture.” EDRDpro, 31 Oct. 2018, edrdpro.com/its-time-to-drop-out-of-diet-culture/.
“Low Heart Rate Bradycardia and Anorexia.” Low Heart Rate Bradycardia and Anorexia | ACUTE | Denver Health, www.denverhealth.org/services/acute-center-for-eating-disorders/treatment/low-heart-rate-bradycardia-and-anorexia.
Nazem, Taraneh Gharib, and Kathryn E. Ackerman. “The Female Athlete Triad.” Sports Health: A Multidisciplinary Approach, vol. 4, no. 4, 2012, pp. 302–311., doi:10.1177/1941738112439685.
“PCOS | Polycystic Ovary Syndrome.” MedlinePlus, U.S. National Library of Medicine, 2 July 2019, medlineplus.gov/polycysticovarysyndrome.html.
Patel, Riti, et al. “Cardiovascular Impact of Eating Disorders in Adults: A Single Center Experience and Literature Review.” Heart Views, vol. 16, no. 3, 2015, p. 88., doi:10.4103/1995-705x.164463.
Rinaldi, Nicola J., et al. No Period. Now What?: A Guide to Regaining Your Cycles and Improving Your Fertility. Antica Press, 2016.