The Social Contagion of Eating Disorders

The canon of Western philosophy can be summed up in one sentence: in the end we are all alone. From that first self-aware moment, the first realization we all are going to die, this truism seeps into the zeitgeist of our humanity to become the one balm to ease our panic. But how true is it really now? With the unlimited ways of staying in touch, can anyone feel alone in this day and age? The existential crisis of modern life pits the alone hypothesis against our growing interconnectivity. It all leaves me hopelessly confused. What I do know is that the study of human social systems and group dynamics makes the isolated philosopher a dated creature. The age-old academic stance on the human condition needs an update.

I'm aware that this is clearly a big leap for a psychiatrist. But when it comes to understanding how eating disorders have spread like wildfire, the logic of this post will become clear.
The first point of business is to reconcile the isolated individual with the breadth of humanity. Until recently, any one person's world remained fixed and small. No one could easily travel or keep in touch with the world around them. A life was led in a small geographical area amongst family, friends and neighbors. The larger scope of humankind was a heady concept, an abstraction in need of a theoretical framework. Instead, the nature of pre-industrialized civilization led inward. Living a relatively isolated life, the intellectual focus was on our individual existence and the inherent loneliness of experiencing the world behind the filter of the mind. The juxtaposition between the unique human gift of self-awareness and the universal prison of our own minds occupied the best and brightest minds for centuries. The result is a compendium of philosophical transcendental and religious treatises that solve nothing and ignore a basic, equally important fact of being human.
We have conquered the world through sheer mass and numbers. Our consciousness and self-awareness distinguish us from other animals, but let's not fool ourselves. The sophistication of our individual minds is only as powerful as the community, society or nation we belong to. The lone peacock may spread its plume to attract a mate, but no one cares unless the peacock clan survives. The brain development and capability of humans matter only because the complex social forces--no different from the lion or elephant herds--shaped history as it did. The philosophical truism, enlightening as it is, missed the forest for the trees. To ignore the magnitude of social forces in our own daily lives is akin to the blind spot in anorexia: you can't survive without food.
The social forces behind the eating disorder epidemic are incontrovertible. No one in this country can ignore the mass media pressure for thinness and weight loss. For each eating disorder recovery forum, there is a website schooling the budding anorexic in how to lose weight faster, or the bulimic in purging tips. Even mainstream eating disorder programs, clearly intent on promoting recovery, have to clamp down on underground education for the new generation of anorexics and bulimics. An ambivalent group of patients without clear guidance is as likely to egg each other into illness as into recovery. And the conflicting, powerful forces proceed unabated.
But recognizing the social forces at work in the proliferation of eating disorders only scratches the surface. It is the precious few who still read and follow any guidance from philosophers. We may be trapped in the human condition but are too distracted by the interconnected world to care anymore. In the modern era, it's hard to find a spare minute to reflect on our individual fate. Each moment is steeped in the enormity of the broad scope of humanity and reinforces our small place in that vibrant mass of life. The overarching mantra of the modern era has left behind internal reflection and instead revolves around the philosophy of food and weight. The combination of willpower with the right number on the scale equals salvation. The burden is off the lone philosopher charged with explicating our suffering. Now philosophy 101 is taught in the mass media and celebrated in pop culture. The slow, inevitable reach of distorted food thoughts can feel like our modern-day consumption. Just instead of the image of the philosopher coughing incessantly and wasting away, we all starve, and suffer the consequences.
The obvious examples of the disordered eating contagion abound, but one less obvious choice is the severe calorie restriction movement. I remember vividly the blinding media coverage of the starving rats in the mid-1980's. In a quick summary, rats fed half the normal rodent diet lived significantly longer than their unstarved brethren. In an interesting turn of events, starvation as an elixir of youth and longevity was too tempting an offer for an already deprived society to refuse. No one seemed to feel sorry for the poor, listless creatures. Instead, everyone marveled at the extraordinary discovery. The lure of a guaranteed century of life, no matter how miserable, hungry and food-obsessed it might be, was like a carrot to a bunny. And carrots, along with other vegetables and fruit, are the mainstay of a calorie restrictor's diet. How else to survive on such a paltry sustenance? The steps from lab discovery to philosophical movement to an eating disorder aren't hard to follow. We have all seen it before from Weight Watchers and Atkins to Bariatric surgery.
The real concern is that antibiotics might have eliminated consumption but it's much less obvious what will make us eat again. Stay tuned for the next post.

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