In light of the Facebook whistleblower events that have taken our society by storm this month, I have simple words to share: we’ve known this all along. In the eating disorder field, we’ve known for over a decade that social media has harmful, harrowing, and preventable effects on young people. We’ve known that the mere act of holding a phone – which most young people do for more than 7 hours per day – exposes young people to toxic messages and images steeped in harmful diet culture that can lead them to tailspin into serious, and often secretive, eating disorders. I should know because I developed anorexia at 10 years old after the experience of watching my babysitter diet.
Frances Haugen’s testimony and whistleblowing is a gift that our society should never have needed to receive. Social platforms should have always been held accountable, since their inception, for keeping their users safe.
We’ve known that while eating disorders have the second highest mortality rate of all mental illnesses and 30 million people will have one over their lifetime, less than 5% get treatment that works. The status quo treatment options (largely residential treatment centers) are cost-prohibitive for most, and we don’t know much about their clinical outcomes. Research shows that having an outpatient multidisciplinary care team measurably enhances recovery outcomes, but very few providers are trained in evidence-based treatments for eating disorders, and only a small fraction of them take insurance.
Now that our cultural gaze is held on eating disorders and young people – and social platforms are being called to re-evaluate their policies – we must first and foremost turn our focus on ensuring that everyone with an eating disorder has access to affordable and effective eating disorder treatment.
Barriers abound to making that a reality – from pervasive weight stigma and harmful stereotypes to lack of geographic access and affordability. While the trope of a white thin cis-gender woman with anorexia permeates our media and healthcare system, we know that eating disorders affect people equally across races, ethnicities, body sizes, genders, sexual orientation, socioeconomic status, and abilities.
And we know what needs to be done to unwind these systemic challenges. Evidence-based care like Family-Based Treatment needs to continue to be pulled out of academic circles; telehealth needs to be accepted as a key solution to significantly closing access gaps; insurance companies need to continue taking note and reimbursing for innovative, effective care models; and historically marginalized folks need to receive culturally humble treatment.
There’s sizable work that still needs to be done by our health system and by all of us, in bringing these conversations to bear. For now, a few simple but profound changes in your everyday life can make an impact: pay more attention to the children in your life and the cultural messages they consume; reach out with a loving hand and ear to a friend who makes self-deprecating comments about their body or image; challenge your healthcare provider’s unsolicited weight-related commentary; read up on weight stigma and fatphobia; and encourage loved ones in your community to learn about the evidence-based eating disorder care and to ask for the help they deserve. It’s what we have deserved all along.
1. Sidani, Jaime E et al. “The Association between Social Media Use and Eating Concerns among US Young Adults.” Journal of the Academy of Nutrition and Dietetics vol. 116,9 (2016): 1465-1472. doi:10.1016/j.jand.2016.03.021
2. Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders: A Meta-analysis of 36 Studies. Arch Gen Psychiatry. 2011;68(7):724–731. doi:10.1001/archgenpsychiatry.2011.74