I am a native New Yorker - Brooklyn born and raised and Manhattan life as an adult. I love my city. Having the luxury of being a professional in this City has been a mixed bag. The plus is that making it in NY is an accomplishment. My professional life is wonderful, especially now that the City recently got some strong talent to join the professional ranks - that is, those who understand and treat eating disorders from integrated and well-informed approaches. Many of the newer talent who specialize in eating disorder accept the premise that relationships are key in understanding what can contribute to and/or maintain the symptoms of an eating disorder. This is thrilling and offers hope to those suffering, most of whom have eating disorders that are complicated and complex. We need more solid and competent professionals not only in NYC, but also across the nation and globe.
The down side to being an expert in eating disorders, especially in a town like NY, is that the role of observer never ceases. I still cannot turn my head away from the number of waitresses, bakery counter personnel and patrons in restaurants that I encounter and have encountered over the years that have eating disorders – their emaciation or protruding parotid glands (chipmunk cheeks) are often giveaways. The therapeutic head is always engaged. NYC as a playground and cultural Mecca is routinely curtailed by the reality of the stressors that underlie it. Body image distortion or negative body image is rampant and very public. We negatively thrive on body complaints, and magazines provide us with solutions about how to improve our bodies. More rare are the articles about how to love the body you were genetically programmed to have. We can, however, sculpt our bodies through surgery and lose weight through dieting. Neither of these is bad or wrong as a solution to fix and feel better. The issue is that we appear to never be satisfied with the result. Does the culture make us crazy? Like politics, talk about body size and shape are routine topics of conversation. Is anyone really ever satisfied with his or her politicians or their body?
Negative body image perception, preoccupation with weight and obsession with food are part of most cultures, especially in major western cities like NY. Surface image is often more important than emotional and relational health. Media drives the bus in terms of cultural dictates regarding weight, body and food. No matter how healthy a child was brought up, it is virtually impossible to not be affected or influenced by cultural expectations and dogma. In this regard, no one is protected. Our senses, sensibilities and cognition (judgment & perception, in particular.) are under constant assault. If media bombards us with body image dictates, then the culture typically actualizes and adopts it as truth, regardless if it is good or bad for us.
A recent study in the International Journal of Eating Disorders (Kollei, I. et al. January 2013.) concluded that Body Dysmorphic Disorder frequently goes hand in hand with the diagnoses of Anorexia or Bulimia. “Body Dysmorphic disorder (BDD) is characterized by an excessive preoccupation with a perceived defect or flaw in physical appearance that is either unobservable by others or appears to be only slight.” (DSMIV. 2000) Often, more than one body part is involved. Body dissatisfaction is considered a risk factor for the development of Eating Disorders. However, BDD symptoms are often not revealed by patients with eating disorder due to feelings of shame.
So, is culture responsible then for the Diagnosis of BDD? Families may have relational or psychological issues that contribute to eating disorders, but it is harder to convince me that BDD is NOT culturally determined. Yes, there are families who are critical of their children’s bodies and shroud their own body dissatisfaction under the guise of wanting their child to fit in. i.e. if their child can only lose weight on their stomach or some other body part they (the child? Or rather, the parent) will be happier. Eating disorders develop in households where food is normal as well as in households where mealtime is the battleground for lots of familial conflict. Body image distortion can be a risk factor for eating disorders from childhood and from the culture. One can have body image distortion without an eating disorder, but usually with an eating disorder comes body image distortion.
Culture does not cause eating disorders, but culture sure is the lynch pin in the development of BDD. Changing culture requires the media changing. HA! The mountain (media) is not about to find its way to Mohammad (culture.) Why should the media change; it is not economically sound to do so. If sponsors will pay for a spot on one of the many reality TV shows that deal with body image, then what would compel the TV show to stop producing these shows.
All politics are local. It is ultimately up to the individual or parent to create a separate reality. Two “simple,” but impactful choices to make: Don’t subscribe to magazines that portray women and men with unhealthy bodies. Don’t watch most reality TV. You might just find that the voice in your head supporting body image dissatisfaction actually lessens. We can get by, and even prosper in life without their influence.