The ‘War on Obesity’ and the Battle Against Anorexia

The news is pretty inescapable these days, and it’s likely you will by now be aware of the governments plans to add calories to menus in the ‘war against obesity’.

Perhaps, as an anorexia sufferer still in treatment, I am hyper aware of these kinds of stories, but I’m not sure that is the case. The ‘war against obesity’ and ‘fighting the fat’ is nothing new, and has been a hot topic for many years. This battleground language we use implies that people’s bodies are to be fought against and conquered, only winning the war when they become thin, no longer a ‘burden’ on the NHS and it’s already pressured resources.

But what impact is this policy change going to have on the issue at hand? Evidence suggests almost none whatsoever. Nutritional information has been on food packaging for over a decade, yet obesity rates continue to rise. It’s almost as if it’s a more complex issue than calories in vs calories out. Obesity is inextricably linked to poverty, stress and mental and chronic illness. The argument that a lettuce is cheaper than a pizza is nonsense, because you can’t feed a family on a lettuce.

However, try telling that to my anorexic brain. Try telling me last year at the peak of my relapse that I needed more to sustain me than that, because I wouldn’t have listened. I didn’t listen when I was too ill to work, or when I was in a hospital bed on a drip, or when I was so physically and mentally compromised that I had to join a day patient programme because outpatient care wasn’t enough any more.

The idea that adding calories to menus is going to help people to manage their weight when none of the other issues that lead to obesity are being addressed is nonsense. But it’s not only useless, it’s actively harmful to people with eating disorders, yet the government have completely ignored calls to consult with eating disorder charities and researchers and those with lived experience when devising this ill thought out plan. The cost of eating disorders is thought to be over £15m per year for the NHS. Yes, being overweight has links to increased chances of diabetes and heart disease for example, but anorexia is not without risk. One in five people with anorexia will die from it, a number far exceeding that of those who measure as obese on the BMI chart, which was never meant to be a measure of an individuals health in the first place. Anorexia causes organ failure and electrolyte imbalances, and even those starting recovery can experience refeeding syndrome which can be deadly.

So why implement something that is useless for the group of people you are trying to target, but actively harmful for another? It’s just more evidence that the government doesn’t care about mental health, and that the empty words spouted every mental health awareness day are nothing more than performative rubbish.

Calorie counting can be completely debilitating. I have never, in the years since nutritional information was introduced, been able to turn off the calculator in my brain. No matter how far I have got into recovery, I still spend my days mindlessly adding and subtracting in the back of my mind, always working out what equation I need to do that day in order to avoid my biggest fear: weight gain. Yes, the quantity I allow myself is higher now that I am in recovery, and the amount I try to purge from my body by any means necessary is less. But that doesn’t mean I can switch off that running commentary of numbers that plagues me every minute that I am awake.

And how, as sufferers and survivors, can we overcome that fear of weight gain when we are bombarded with messages that gaining weight is morally wrong, shameful, burdensome? How can I stop seeing calories as evil when they are demonised everywhere I turn? Our bodies needs calories. A calorie is a unit of energy, not an enemy – we literally need them to survive. Our bodies are burning calories all the time. It’s how we digest food and pump blood and breathe and do all the other amazing things that it does while we are just going about our lives. You even burn calories while you are asleep.

When people are malnourished their bodies gradually start to shut down – and yes it is absolutely possible to be malnourished in a bigger body. This is why people with anorexia die, eventually our organs can’t take it anymore. Not enough calories doesn’t always equal weight loss, but it can equal death. We shouldn’t be living our lives in a calorie deficit, because that means living a life of fatigue, hunger and low mood, all things caused by starvation. The amount of energy each individual needs to maintain homeostasis is completely variable person to person – we all have our own set points.

There is also mounting evidence that diets do not work and can actually lead to weight gain over time. Diets don’t work, but chances of developing an eating disorder as a result of dieting are high. And that’s not just anorexia. Periods of restriction are the biggest contributor to binge eating, which gets people stuck in weight loss/weight gain cycles for their whole lives. Evidence shows that doing this can be worse for your health than being statically overweight. Someone with a BMI of 27, considered overweight, statistically has better health outcomes than somebody with a BMI of 19. We need to review cause vs correlation when discussing weight and poor health.

These new measures could be an absolute disaster for people either suffering with eating disorders or attempting to recover. I have been a healthy weight now for two months and do not consider myself to be anywhere near full recovery still. Every time I think I have moved a bit further along and made a little more progress, the world seems to throw something else at me that makes it just that little bit harder. I am genuinely questioning right now whether I will ever be able to eat out again if I can’t avoid calorie counts – the thought of having a menu in front of me with those figures dictating my choices brings me out in a cold sweat. My life is already ruled by numbers: calories, weight, steps. This is just one more area in which I cannot hide from anorexia, cannot blinker myself, cannot pretend, for even one minute, that my existence isn’t completely dictated by the calculations that go on in my head every minute of every day. This campaign and the reporting of it has the power to destabilise even the most recovered person who has an eating disorder in their history, however dormant it may be laying.

So my message to all of you struggling with these messages, no matter the size of the body you live in, is this:

You deserve food. You need food. Your existence gives you the right to eat. You do not have to spend your life making choices based on what you feel you are allowed to eat instead of what you want to eat. And not only do you deserve to eat, you deserve to enjoy food. It’s not ‘naughty’ to eat a chocolate bar. You are not ‘bad’ for picking up those biscuits. You should not feel ‘guilty’ for having a slice of that birthday cake someone brought into work. Not one single part of who you are or your worth as a human is attached to the food you put in your mouth, and the government should not make you feel like your existence is a burden.

It is true that more people in the UK are obese than underweight right now, but cases of eating disorders are rising astronomically, at a rate far exceeding that of obesity. Additionally, anorexia isn’t the only eating disorder, and people with bulimia and binge eating disorder often live in larger bodies. Eating disorder services, however, are so underfunded, that often only the very sickest can get treatment. Only those who are physically compromised, underweight and anorexic. Perhaps if the government invested more into mental health services rather than doomed campaigns, they might actually see some results.

Anorexia has the highest mortality rate of all mental illnesses as a result of not only physical health complications, but of suicide. I would not wish an eating disorder on my worst enemy, but everywhere we turn we are suffocated by the idea that we don’t deserve to eat, that our worth is dependent on our weight and that somehow not fitting into the exact ideal that is expected from society means that somehow we are less moral, less pure. Less ‘good’.

There is no simple answer to solving either the problem with obesity or the problem with eating disorders – which so very often overlap.

What I can say absolutely categorically, is that this campaign isn’t it.

If you’ve been affected by any of these issues, please consider taking a look at the Beat website for support and advice.

14 comments

  1. Really powerful piece Cara, and absolutely spot on. Tackle the ill mental health and food poverty pandemics first, then educate people on the mental health benefits of exercise and particularly work to stop young girls from dropping out of sport in their teenage years. Then, and only MAYBE then, should those in power look at the education needed around food.

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    • Really good blog cara, there isn’t an easy answer. No matter where you go, what you are doing, there will always be many on so called diets. I found this so difficult when I was working. Sometime I’d need to go off to my room to eat so I wouldn’t see what they were eating and compare. You want to be “ one of the girls “ fit in. But yes, those who would analyse the menu calories are most probably those who do not need to. My sister has “ protein shakes” and other things while telling me I need to gain weight. It’s just another hurdle we continually need to keep jumping over. Sending love. Keep up your great effort. X

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  2. As an overweight person who’s struggled for years with body image and intense fasting periods, thank you for speaking out. This applies to bodies throughout the spectrum and I can tell you that even in my body positivity groups – where people are generally used to standing up for their body type and loving themselves as they are – this campaign is having an incredibly negative effect.

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  3. Such a powerful post Cara! In Canada, we have had calories printed out on our menus for some years now and I have to say, it’s upsetting to see those numbers. Firstly because each meal is usually a daily intake of calories, which means it should be your only meal of the day, and also because I do feel bad for selecting something with such a high calorie count. And I do not have an eating disorder. Nor do I usually worry about how many calories might be in a cookie or a dish of pasta. And at the end of the day, I don’t see anyone changing their lifestyle at all so what is the point of the calories on the menu? It’s not helping.

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  4. I have amazing math skills. Add subtract. Borrow here. I eat the same food everyday so there is no worry that a count might be off. If I do change it’s well thought out and is taking the place of something else. I’ve been challenged to eat some peanut butter. I’ve been to the store twice this week to get it. But i just can’t do it.

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  5. I entirely agree with you! The government’s new plans are going to be worse than just compleatly unhelpful and poorly aimed, but they are going to potentially cause so much damage to those suffering or at risk from suffering with eds, plus are going to create a society even more hostile to the idea of needing to fuel our bodies with energy for them to function correctly.
    To be honest I am not even sure if the government has even considered the harmful impact of this. They have certainly not considered why many people are actually obese to start with, for factors such as eds, poverty eg.

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