on Naomi Wolf

There is much to say and more to come on the NEDA conference, but I'm going to start with the Keynote address. The speaker was Naomi Wolf, author of "The Beauty Myth."

For those of us who believe the body image distress and body dysmorphia associated with eating disorders are symptoms of the brain disorder and not a dose response to environment, the choice of Naomi Wolf as star speaker for an eating disorder conference was disheartening. If you think that the obsessive thoughts and compulsive behaviors of eating disorders are closer to OCDs than to Oprah, this choice of speaker sets a tone several octaves away from your preferred range. As a feminist, it feels like splitting the baby to say anything negative about what I ardently desire: an end to sexist and misogynist thinking and marketing.

I actually considered not attending the speech, just to keep my blood pressure even and my mood from sourness so early in the events. But I went, and encouraged others to go, and I'm glad I did. It was not the talk I expected. It wove the usual themes - of the objectification of women's bodies and the economic drivers of these damaging social messages - but added a few unexpected strands: genetics, and a very well-put statement about the lack of food making you crazy rather than the other way around. The mixture didn't go well, however, as the logical loop was not achieved. It was muddled and I had the sense not completely thought through (she actually said, parenthetically, that she had learned some of what she was saying four days before the conference).

Picture this: whenever Wolf said something about it not being parents' fault, or about genetic vulnerability, or about dieting being the primary trigger, I clapped while much of the audience was still. Then the usual themes of 'mommy, you're doing this to your kids' and eating disorders being caused by society's pressures would shut my hands up while the majority of the audience clapped. It was a disorienting experience for everyone, I think. I wonder how many people were truly satisfied by it. I know that many I talked with were disappointed and some infuriated, and several of us wandered into the light saying "well, it could have been worse." Others were quite happy, but I sensed it was for particular themes rather than a complete message.

The mainstream eating disorder advocacy world has largely moved away from overt parent-blaming and is now pretty happy to acknowledge a biological element to eating disorder causation. But the train failed to stop there and has now steamed on to the media as Enemy Number One. We've been there before, people. Naomi Wolf is, as many said at the conference, an icon whose star is again rising in the ED world. Gloria Steinem, who will be speaking at the Renfrew Conference next month (as am I, as a small type contributor), is also being dusted off as a beacon in the fight against eating disorders after a period of neglect by the field. The question is whether this is a return of a pendulum or a move forward - or back.

It struck me that a lot of people in eating disorder advocacy really don't know that there is an incongruity here and they don't get why some of us are dismayed. I wish they'd ask.

Here is my challenge to the eating disorder world: slow down. Give this some thought. Do we need a bad guy? Do we need to have an external "reason" for eating disorders that explains their virulence? Why can't eating disorders be serious and deadly and urgent because they are, not because of external events? Does depression require a reason to be real? Anxiety? Do we treat depression by getting rid of sad events, or anxiety by ridding the world of spiders and high places?

I'm for everything that Naomi Wolf stands for, except that external influences explain eating disorders. I refuse to reject feminism, but I also refuse to use feminism as an arguing point of why we need to treat eating disorders seriously. Too easy, too smugly satisfying, and as far as I can see without scientific merit.

I talked with Wolf afterward, as I know at least one other F.E.A.S.T. parent did. I implored her to familiarize herself with the science and make her message about it coherent and internally consistent. She said "I'm not a doctor." I said if you talk about eating disorders to the public you need to understand the science, too. I asked her to consider that her message did to the male patients and their families in that audience what we reject doing to women: exclude and marginalize. She agreed to consider men more, and to read further in the biological issues. I hope she does.

I hope the eating disorder world can, too.

**be sure to check out Carrie Arnold's piece on Wolf, too.


  1. I'm glad you've posted about this too Laura - and I like this post, just as I liked Carrie's post. I commented on Carrie's post so I'll try not to repeat the same thing here...

    I think the issue is complicated for a number of reasons. First of all, many people who develop EDs look for an external reason for their ED. An ED rules the mind in such a dominant manner that it's difficult to understand why. The natural thing to think is that something caused or is causing it that is within the external environment and not within the body's internal environment or brain. Sometimes there IS a definite set of triggers that provoked/increased anxiety and/or depression and the person believes that their ED helps them to 'cope'. But often the person simply doesn't know why they are thinking and behaving in the way that they are.

    For those people who become obsessed with weight and shape while eating disordered, a lot of comparison with others' bodies seems to occur. When they view other thin people or images of thin people they say they feel 'triggered'. But I would suggest that this feeling is a SYMPTOM of the illness rather than the cause, and that the cause lies within the brain. I know a number of women with AN who say that they only found thin images triggering AFTER they had become sick.

    Now, I never had body image issues while anorexic. The internal 'meaning' I attached to my AN was different. For me it felt to be about control - of anxiety and my existence (but NOT control of other people). In fact, no-one ever suggested to me in my teens that anything in the external environment had caused my AN. I was just told to eat, gain weight, and later prescribed antidepressant and anxiolytic drugs. Furthermore, I developed AN in the mid 1970s when our culture was much less body image obsessed, and I had never read a glamour magazine. I was 11 yrs old when I started to restrict food and was more interested in reading kid's cartoon comics like 'Beano'. Perhaps if there had been glamour magazines around I would have 'blamed' them for my AN, especially if someone had told me that these magazines or the media in general caused EDs?

    I know a number of women with EDs or a history of them who say that taking courses in 'women's studies' helped them to understand themselves better and to overcome their ED. Perhaps they felt empowered by the feminist issue and that empowerment enabled them to eat more - and eating more helped their brain to recover from AN?

    As we all know, AN has been documented over 100s of years, long before the media. It has different personal meanings to different individuals but is still the same illness.

  2. And so I will add to my comment above - that:

    1. I think that some clinicians and researchers can put ideas into some ED patients' heads - that cultural 'pressure' to look a certain way caused their ED;

    and, vice versa -

    2. I think that some ED patients can put ideas into some clinicians' and researchers' heads - that their ED was caused by cultural 'pressure' on women, or men, to look a certain way.

  3. You wrote:
    "Why can't eating disorders be serious and deadly and urgent because they are, not because of external events? Does depression require a reason to be real? Anxiety? Do we treat depression by getting rid of sad events, or anxiety by ridding the world of spiders and high places?"

    Why? Because people don't *reward* you for being depressed or afraid of spiders, but society does reward thinness. Even at a low anorexic weight I was praised and told I good I look, and told how jealous people were. People told me how beautiful my body was and how "lucky" I was. That didn't make me sick, but it sure as heck made it hard to get well (I also said as much on Carrie's site.) It's hard enough to get over anorexia without people encouraging you to stay their with strong words of praise for being thin. When I gained back the weight to a normal weight - not overweight at all, just in the middle of the "guidelines." And two people suggested to me that I start an exercise program because of this weight gain. I cried for days, and went back to starving. Was it their fault? No. Did it influence the relapse? Yeah, maybe it did. I would have at that time been "sick" and thin but accepted and praised then be "healthy" and told I didn't look good anymore and I needed to work out to get the weight back off. Society doesn't cause e/d. My siblings don't have one (and my mother was "disordered eating" and exercise addicted but not anorexic.) But it definitely plays a role and makes recovery all that much more difficult. Even fully weight restored I eventually run back because I hate my body. It's not always just anxiety or the e/d revving up for no real reason. Other people could deal with the criticism/lack of praise. Not so easy for an anorexic who too easily falls into the dieting/starving trap and doesn't know how to "diet" in a healthy manner (if such a thing exists.) When I return to my feminist books and readings it *does* help me battle the e/d. It doesn't cure me, but it helps my thinking enough to sometimes give me some fuel for the fight.

  4. I was actually pondering this the other day. . .

    I think the environmental pressures do have some causal nature in the development of AN. I think that it is important this is not forgotten as we begin to understand the biological nature of the illness -- because AN cannot develop in a vacuum, we MUST consider what factors may perpetuate the illness.

    I wouldn't just isolate the culture of thinness as the culprit but also everything that goes along with it --> the pressure within society to be thin, intelligent, independant, ambitious, educated and talented. We value those who stand out and we admire those who excel -- thinness is simply one related aspect of this domain.

    If one has a predisposition for AN (perfectionistic, anxious, low self-esteem, vulnerable), trying to fit ANY aspect of this mold would very likely increase the chance of development for AN. . .

    Given this, I am not surpised rates of EDs are rising. It may be due to increased awareness/diagnosis (and changing diagnostic criteria!) but I think more people WITH the genetic predisposition are being "triggered" into development than would have happened if they had lived 300 years ago.

    Does anyone know if genetic predisposition for AN is graded in terms of "severity"? Are some people more prone to developing AN regardless while others are less prone but still vulnerable?

    That said, I don't believe there is any excuse for Naomi Wolf (who I have never heard of. . .) not to be up to date as to the science of the disorder. I would wonder how you can accurately give a talk on an illness when you don't fully understand it.


  5. Bravo Laura! Well said. Thank you for speaking with Naomi and asking her to consider brushing up on the science before speaking further.

    The clapping was likely those psychologists who have been taught for many many years that parents do indeed cause eating disorders.

    I completely agree that we need to stop wasting precious time looking for and placing blame - there are many serious illnesses for which we have no explanation as to what on earth is causing them. We can carry on and treat them the best we know how and continue to do research to find out what else helps move people toward recovery. Some of that research may include exploring causes, hooray for that but it cannot be the only focus.
    Becky Henry

  6. I agree completely with Anonymous. Just because culture doesn't cause ED's doesn't mean that it doesn't have a big impact on them.

    The way I think of it is that some people are gentically pre-disposed to ED's. But just having the genes doesn't necessarily mean it will manifest.

    There needs to be some kind of trigger. And yes--once the genetics are there, pretty much anything will serve, just like with addiction. You don't need to have had a horrible childhood to be an alcoholic, but there will have been something that you took badly as a child, or similiar.

    Our culture doesn't cause ED's, but it does trigger them. It does encourage them, and glamorize them, and make them seem like almost the Right Thing To Do.

    I agree completely with the fact that ED's are mental disorders and not just a cultural phenomenon. But I also think that to say that cultural influence is not an impact is to swing too far in the other direction.

    Our body-critical culture is the lit match; a person without ED is an empty barrel; a person with ED is a barrel full of petrol. Only one will explode when you drop that match in--but how much longer would it have taken to explode without that match? Would it even have had cause to explode so violently at all?

  7. I recently wrote a blog (http://www.kartiniclinic.com/blog/genetics-anorexia) about my changing views of triggers-- ("What if there is no trigger?")-- based on new research and assessment and presented in an article called "Re-thinking Mental Illness" by Insel and Wang of the NIMH.

    As a mental illness (=brain disorder) anorexia nervosa, like other mental illnesses such as schizophrenia, may well have its origins in prenatal life.

    I agree with you Laura, and then some, about the Naomi Wolf/Gloria Steinem keynote speaker issue. Sigh. When will we move on from asking feminist philosophers (or any other kind) to guide us when thinking about the etiology of biological illnesses? If Ms Wolf "is not a doctor" and "not familiar with the science", why ask her to speak when she is waaaay out of her depth--unless we are content to stay in the shallow end of the pool?

  8. I'm just so tickled that people are talking about this issue - here and many places. It is refreshing and it gives me hope.

    We may not all agree, but we're talking!

  9. The statistics on anorexia nervosa cited by Naomi Wolf in her book The Beauty Myth were analyzed in a scientific journal. The conclusion was that 18 of the 23 statistics are inaccurate and overdone. Schoemaker, "A Critical Appraisal of the Anorexia Statistics in The Beauty Myth," Eating Disorders, Volume 12, Issue 2 (2004) For example, Wolf wrote that 7.5% of American females suffer from anorexia nervosa. The best available epidemiological data, however, shows that the correct figure is closer to 0.5% to 0.7%

  10. ?? The "eating disorder world" ?? Many organizations, NEDA and others, provide excellent scientific and biological information on their websites and at their events for both public and professionals, and have for years. I give them a lot of credit. NEDA spotlighted leading researchers from the US and the UK in an unprecedented way this year. Kudos to them for that.

    Perhaps they haven't excluded people or discussions you would like them to, but there are other perspectives out there. I think anonymous makes an interesting point about how these issues complicate recovery. Cultural factors may play are a larger role in eating disorders other than anorexia nervosa. Some studies suggest that bulimia and binge eating (which are much more prevalent) are more socially influenced than anorexia.

    And yes, scientists do look at the contribution of life events to the development of depression and other mental illnesses, though this does not mean they "try to get rid of sad events." http://www.nimh.nih.gov/science-news/2009/much-touted-depression-risk-gene-may-not-add-to-risk-after-all.shtml

  11. Laura, just as a general question about your outlook on eating disorders, I was wondering, would you argue that eds are 100% genetic/biological?
    i personally am an advocate for the "genetics load the gun & enviroment pulls the trigger" argument, and thus think that having a speaker like Naomi Wolf is helpful because, although we can't do anythig about our dna, we can do someting about the world / society we live in, as to make sure that the trigger gets pulled less and less often.

  12. It seems to me that, other than weight loss, there may or may not be other triggers for any particular individual. It is certainly not usual for someone to be born with an active eating disorder. Any triggers, likewise, may or may not be interesting to us to ponder. Discussing a few of these triggers (real, imagined or 'rationalised' after the fact) while missing out others, and discussing them in the absence of that elephant in the room, biology, the one universal factor for those who find themselves with an ed, would seem to be missing the point entirely. Why do that at an eating disorders conference in 2010? There is research and evidence, why not do some homework?

    Laura, as always, you have your finger on the main pulse. Ms Wolf's message absolutely needs to be 'coherent' and 'consistent' and she cannot plead ignorance of the science as an excuse not to mention it if she is to take a public platform on eating disorders - she owes it to her audience, whoever they may be and whatever other points she wants to raise.

    As always, I applaud your ability to stand up and be advocate for the rest of us - I hope that she is really able to listen and to learn for the next time .

    Erica (EB)

  13. "It is certainly not usual for someone to be born with an active eating disorder."

    EB -- could you give me the source to this statement? Nothing I have read in the literature by W. Kaye, Treasure, etc suggests that someone is born with an active ED.

    Rather, individuals are born with a predisposition for an ED manifested in different neurobiology which makes them more sensitive to stress, food restriction, anxiety and harm avoidance. These traits, in and of themselves are NOT an ED.

    Eating disorders in childhood (ie. infants and toddlers) can be very different and may be a factor of failure to thrive or swallowing phobias -- they are not related to AN/BN (although there has been some discussion of combining them in the DSM V)


  14. This is an excellent question: "I was wondering, would you argue that eds are 100% genetic/biological?"

    I don't think anyone knows, myself. What I do think is that the mental illness is largely mechanical, but that disordered eating can be influenced by a lot of things. I think a lot of people do disordered eating without having the mental illness and that people can have the mental illness without currently engaging in disordered eating, if that makes sense.

    Disordered eating patterns seem to trigger the mental illness for some people - those with a predisposition. Some people need a LOT of disordered eating/stressors to get tipped over, some are like the fairy tale where the princess is fated or driven to find the trigger. But once over into the mental illness I think the process is largely biological and neither reachable nor usefully explained by logical or psychological means.

    That's why I don't think the psychological arguments have much relevance. If you can become deathly ill from an eating disorder from a pinch or a whollop and the way in isn't the way out...

    I think it is insulting to those trying to recover from an eating disorder to mistake their anguish and bravery with the garden variety body distress that we (cruelly and wrongly) experience in most of society. It's qualitatively and quantitatively MUCH worse and not even comparable, in my opinion.

  15. Erica (EB) writes

    Sorry A:) - the quote is my own and may have been ambiguous. I meant by it that people may be born 'pre-disposed' to an eating disorder (but not 'with' one) - the triggers, as we all seem to be agreeing, come afterward and, for some, the trigger may be simple weight loss, without other explanation or external factor.

    The psychological arguments don't have much relevance for me either in general terms (although I do believe they may (or may not) have relevance to any given individual) because discussing them and speculating on them does not advance our cause. It doesn't help us in educating those 'to whom it may concern' (governments, health providers, insurance institutions, schools, workplaces, friends, relations, humanity in general, etc etc) to have the biological message mixed up in the inevitable muddle that is caused by attributing one or other possible trigger as having more or less relevance - the triggers are myriad, some are speculative, most sufferers will have had (many) more than one; the only trigger that I believe to be universal is some degree of weight loss.

    We may be able to do something about the triggers but, simpler still, we may be able to leave someone in a world full of potential triggers and with a pre-dispostion to an eating disorder (if we can't somehow find a 'cure' for that) but also with the knowledge and the tools and the support for the switch not to get tripped and so to live free of the symptoms if we can first put over the fact that the biology, which may to some degree be inevitable, is also treatable.

  16. There are two things that stand out and which I very much agree with in your last comment Laura:


    "But once over into the mental illness I think the process is largely biological and neither reachable nor usefully explained by logical or psychological means."

    From a personal perspective I was very anxious and depressed before I started to over-exercise and restrict food as an 11-yr old - and I more-or-less knew why I felt so depressed. In terms of anxiety... well, I had a long history of OCD, panic attacks/meltdowns (etc.) from being a young child. However, despite the above, once I started to restrict food and to over-exercise I got 'stuck'; the physiological/metabolic/neurological processes took over. I felt completely unable to eat more or exercise less - because of panic, anxiety and the threat of terrible meltdowns. So, in that way, the AN took on a life of its own. When I started to be treated by the psychiatrist who has treated me for 5 years he made it very clear that I couldn't hope to recover without gaining weight. However, he did promise to help me work through the psychological difficulties I knew I had had for a long time and which existed pre-AN. It was not a case of 'once you're heavy enough your treatment's finished'.

    Second, you write:

    "I think it is insulting to those trying to recover from an eating disorder to mistake their anguish and bravery with the garden variety body distress that we (cruelly and wrongly) experience in most of society. It's qualitatively and quantitatively MUCH worse and not even comparable, in my opinion."

    Thank you. So do I. Some say that 'every woman has an eating disorder'. No; every woman does NOT have an ED. They might dislike their bodies or they might yo-yo diet (etc.,) but unless they get totally stuck in a pattern of destructive eating and associated behaviours (restricting, bingeing, purging, exercise dependence..) that they are absolutely unable to break without being terribly mentally unstable then they don't have an ED.


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