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Content warning: This article contains discussion of bulimia, anorexia, and binge eating disorder.
When I was seventeen years old, I was diagnosed with anorexia nervosa. The eating disorder, which causes people to obsess about weight and food, had mystified people in the first half of the 20th century. But, by the time of my diagnosis, it was openly discussed in mainstream culture.
Growing up in the 1990s and 2000s, I had heard about weight, bodies, and eating disorders for as long as I could remember. Celebrities were splashed across the front pages of my mum’s magazines, with Mel C or Mary-Kate Olsen confessing their struggles. Characters in my chick flicks asked each other if they had ‘anorexia or bulimia’ as if it were a mundane topic of conversation. Books aimed at teenage girls had a multitude of characters who casually starved themselves.
As someone stuck in the suffocating headspace of an eating disorder, my anorexia diagnosis felt like a badge of honour. It was like a special club, especially since the world around me seemed to glorify my unhealthy behaviour. When my elder sister tried desperately to understand me, by discussing mutual friends who had struggled with bulimia, I secretly looked down on them.
In my sick mindset, I believed anorexia was more glamorous than other eating disorders and made me superior. It seemed to be an achievement. Both in media and real life, anorexia was regarded as impressive and even desirable, while its cousin bulimia was viewed (unfairly) with disgust.
Teaching young readers about bulimia
Our children, however, may be introduced to the hell of eating disorders in a more sympathetic way. The latest instalment of the popular book series Little People, Big Dreams by Maria Isabel Sánchez Vegara touches on the struggles of bulimia. It focuses on the beloved Princess Diana, who joins Rosa Parks, David Attenborough, and Muhammed Ali in having her story rewritten for a young audience.
The book, aimed primarily at four-to-seven-year-olds, explains the Princess Of Wales would take comfort in eating large quantities of cake in private. Then “she would try to get rid of all the food she had eaten by making herself sick”. Bulimia is illustrated in a child-friendly way with a distressed Diana holding an empty plate and looking miserable.
“The inclusion of Diana’s battle with bulimia in a book aimed at children has divided opinions.”
Little People, Big Dreams is one of the first attempts to depict the serious mental illness to young children. I sat down with eating disorder specialist Cliona Bryne to get her take on the book.
Bryne praised the book: “explaining to children that people can be ill both physically and mentally is an excellent thing to do.”
But the inclusion of Diana’s battle with bulimia in a book aimed at children has divided opinions.
Although bulimia is a psychiatric illness, there is some risk in telling children about binging and purging, the behaviours which characterise bulimia. It could be dangerous for children who are already struggling with mental health and body image issues.
Byrne explains: “Many of my clients who have struggled with bulimia [and other binge eating disorders] only started this form of self harm once they learned that it was an option.”
The dangers of depicting eating disorders
Little People, Big Dreams is far from the first piece of media to depict eating disorders.
In addition to other biopics about Diana Spencer, The Karen Carpenter Story (1987) taught many people about the existence of anorexia. Later, made-for-TV movies like When Friendship Kills (1996) and Sharing The Secret (2000) were created to warn young girls about disordered eating.
More recently, Netflix’s To The Bone (2017) was criticised for being triggering, especially due to actress Lily Collins losing so much weight for the role. The TV show Insatiable (2018) explored the lesser-discussed binge eating disorder (BED), which affects more people than anorexia and bulimia combined. This year, Heartstopper‘s latest season was applauded for focusing on a male character with an eating disorder.
“Most media has good intentions in mind”
Eating disorders in books, movies, and TV are often criticised for being “thinspiration”. Seeing ultra-skinny actresses and “tricks” used to avoid gaining weight can be potentially triggering for people already suffering from or at risk of an eating disorder.
Most media has good intentions in mind: making the public aware of complex disorders and trying to remove the stigma surrounding them. But depictions of eating disorders have only succeeded in raising awareness.
Why the stigma remains
Bulimia, as well as BED, Eating Disorder Not Otherwise Specified (EDNOS), and Avoidant Restrictive Food Intake Disorder (AFRID), are still highly stigmatised. They are often taken less seriously than anorexia (even by medical professionals) and the symptoms are seen as shameful.
According to UK charity BEAT, over 1.25 million people in the UK suffer from an eating disorder. But the stigma can result in a lack of diagnosis, feelings of judgement, and further isolation for suffers. Education on the issue needs to be far more thorough, especially since so many people are affected.
Eating disorders are both fickle and life-threatening. They often morph from one disorder to another (which my anorexia attempted to do). Better education would have improved the experience of those around me. It would have provided more tools on how to support me and comforted them.
What Little People, Big Dreams gets wrong
The illustrations and storybook context of the Princess Diana book is a “naive, harmful simplification of how [eating disorders] work”, according to Bryne.
buliThe book doesn’t go into extreme detail, due to the young audience. As a result, it doesn’t provide adequate information about the dangers of binging and purging. Bulimia has several life-threatening complications, such as heart and kidney failure. Even those who recover will experience long-term health problems.
The other problem arises with the child-friendly nature of the illustration. It attempts to rightly shield readers from the more graphic symptoms of bulimia. However, the artwork downplays the severe illness by depicting a pretty woman with a sad face.
“The lack of discussion around the exhausting process of recovery suggests bulimia is an easy illness to overcome.”
Despite trying to combat stigma, the book unintentionally reinforces stereotypes. One is the notion that eating disorders only affect middle-class white women. It’s estimated one third of bulimia sufferers are men. Other studies have found it adversely affects Black women and those from lower-class families.
Moreover, the lack of discussion around the exhausting process of recovery suggests bulimia is an easy illness to overcome. This is reminiscent of both Ellie in Girls Under Pressure by Jacqueline Wilson and DJ in Ashley Oslen’s Full House, both of whom miraculously ‘see sense’ and recover immediately. This ignores the years and decades most people spend in recovery.
What Little People gets right
The book does help to quell some of the taboos around the subject of eating disorders, such as the idea that they are primarily about food and looks. It refers to Diana’s marriage problems as being the source of her emotional distress and consequential problems with binge eating.
Little People cements the importance of teaching children about mental illnesses. It’s a common misconception that eating disorders only affect young adults.
Nikki Grahame, who later died from the complications of anorexia, developed the disorder at the age of eight. In her biography, she says she didn’t understand what was happening to her. In their respective memoirs, Nancy Tucker and Marya Hornbacher also note their symptoms starting at a similar age.
Eating disorders can start at any age – including in childhood – and it’s important to give kids the language to talk about their problems.
There is no ‘right way’ to depict bulimia
Conversations around eating disorders are vital. They help remove stigma, educate individuals, and give sufferers the words needed to reach out. Teaching people the warning signs of an eating disorder can be important in saving lives.
The trick comes with striking the correct balance.
“Eating disorders thrive on secrecy and shame…”
Eating disorders are too complex of an issue to drop into children’s books without much explanation or support for readers. But disorders also need to be explored in more depth than just providing a list of symptoms. Emotions are central to eating disorders – not food.
Although bulimia can be hard to ‘get right’ in the media, it’s important that we continue to try. Eating disorders thrive on secrecy and shame, so talking about them is the best way to combat them.
If you or someone you know might be struggling, please contact BEAT.
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Featured image courtesy of Russ Quinlan on Flickr. No changes were made to this image. Image license can be found here.
Faraday Gamble-Gittings
I am a fashion writer and stylist. I love anything travel and have an obsession with Hummus. I have written for Fashion North, Luxe magazine, Sunderland Vibe and the Telegraph.