Josh Zimmerman, MD, is a general adult psychiatrist with a focus on treating patients with an eating disorder at the Melrose Center. The following is Dr. Zimmerman’s answers to common questions about body shaming.
Does public discussion about women and weight have an effect on your patients?
Any time there is public discussion about women and weight, I see patients picking up on it, talking about it, fretting about it and I see their symptoms spike.
A great example of that is the thigh gap meme which came out two or three years ago. If you don’t know about that, it’s the idea that a woman is supposed to have a small amount of space between her thighs.
I had patients who were melting down over the fact that their thighs touched. They increased purging to try to achieve this body standard that nobody even knew existed before.
Patients have not directly commented to me about recent body shaming statements made in public. But I have had patients tell me that they think they will only be taken seriously in their career or that they will only be seen if they look a certain way or dress a certain way. I believe recent statements deepen the belief in women that they have to appear thin, beautiful, and big chested to get anywhere in this world.
As a therapist, does this make you angry?
Yes. As a therapist, it makes me mad. And as the father of a nine-year-old girl, it makes me mad. I want my daughter to be seen for her sense of humor, intelligence, and personality, not her body. I want my daughter to be able to buy magazines without digitally altered women on the front of them. I want to be able to look at Halloween costumes in a store with my daughter without her being forced to look at options like “sexy nurse.”
Have we been making headway on changing this?
There are things I find encouraging. But the objectification of women is rampant in our society. I am encouraged by the concept of “Plus Size” models. The models I have seen in this category are actually quite a normal size, so the “Plus Size” name doesn’t exactly fit. But I like the fact that it is being looked at. I like the fact that there are pop songs targeting women that reference having a healthy body image. Those songs sell and I think that’s a really good thing. At the same time, I am concerned about:
- Public figures making statements about how women look
- Teasing in school about body image and weight
- Mass media messages about what women should look like, shouldn’t look like, how to lose weight, how celebrities lose weight after being pregnant, how women should be thin again within three weeks after giving birth
Some pediatricians believe that dieting plays a role in obesity and eating disorders. What do you think?
Dieting is one of the worst things women can do from a psychological perspective. I define dieting as changing your behavior to lose a certain amount of weight in a certain amount of time.
Isn’t losing weight a good thing?
Dieting sets up unreasonable expectations for depriving yourself of food and tolerating high levels of hunger. Dieting leads to binge eating because people get so hungry they can’t take it anymore. Perhaps worst of all, dieting can result in positive cultural feedback. People might say, “You look great!” so they start to believe that what everyone wants of them is to not eat and to look thin. The Mediterranean Diet is healthy, but that’s not what we in America think of as a “diet.” The Mediterranean diet is a way of life that is sustainable. It’s not drinking kale juice, running three miles a day and taking supplements. I believe dieting is toxic.
Anorexia is a leading cause of death for teenage girls. Are we making progress in treating it?
Anorexia is the most lethal of all psychiatric conditions. The death rate is probably close to one in three. However, it is a highly recognizable and treatable illness. Early intervention lowers the death rate. There are treatments that work. One is psychotherapy that teaches the whole family how to gain control and establish healthy eating patterns. Melrose Center is doing research that suggests that we can restore nutrition and weight in patients twice as fast as we used to think. Patients can recover better when they are fed faster.
Drug and alcohol abuse is very common with people who have an eating disorder. For example, someone might be abusing pain pills to kill their appetite. We need to treat drug and alcohol addiction at the same time we treat the eating disorder. At Melrose Center we treat addiction and eating disorder at the same time.
I hope that in the next decade or two we can find ways to prevent eating disorders. That can happen if we find ways to stop cultural messages that suggest that women are objects.
Does HealthPartners cover treatment for eating disorders?
Yes. We are lucky that we have a lot of good programs to treat eating disorders in the Twin Cities. HealthPartners covers them including treatment at Melrose Center.
Is there anything you’d like to add?
I encourage everyone to think about what they can do to address the way women are viewed. Parents should never make their child feel shame for what they eat, how they look or how much they exercise. Talk to your children about finding balance with eating and exercise. We can all be a good role model by practicing good habits.
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During each episode of the Melrose Heals podcast, Karen L. Nelson, a licensed clinical psychologist at Melrose Center, hosts honest conversations about the topics near and dear to people and families impacted by eating disorders. We hope you’ll listen and start healing.