Author Emmeline Clein on the truth behind the eating disorder crisis

Eating disorder care is a booming industry, but its failure is self-evident: the prevalence of eating disorders is on the rise, and the current treatment paradigm has done little to improve outcomes for people diagnosed with anorexia – around 20 per cent of whom will either die from the condition or struggle with it for the duration of their lives. In her new book, Dead Weight: On Hunger, Harm, and Disordered Eating, Emmeline Clein – a writer and journalist who has written for The New York Times, The Nation, and Vice – argues it’s time for a radical new approach.

Dead Weight approaches its subject from a range of directions: it is, among other things, a memoir; a cultural critique of the “skinny, sexy sad girl” media of the 00s; an anti-capitalist polemic, and a history of fatphobia and its relation to white supremacy. It’s a remarkable book.

In it, Clein exposes the shocking systemic failures (or worse) that are exacerbating the crisis: pharmaceutical corporations funding fraudulent obesity task forces to market amphetamines as a cure for binge-eating; private insurance companies forcing people to make themselves more sick to qualify for treatment or cutting them off once they’re deemed too sick (while the American healthcare system is its own unique hell, a similar dynamic is playing out in the resource-starved NHS).  As Clein writes, “attempts to use the logic of capital to solve the problem of eating disorders inevitably fail, because eating disorders are good for capital.”

Dead Weight is harrowing and infuriating, but it’s not unremittingly bleak: Clein’s graceful, lyrical prose and her deep belief in solidarity and sistership shine throughout the book. I spoke with her about the dangers of ‘glamourising’ eating disorders, some of the pervasive myths around them, Ozempic, pro-eating disorders spaces online, and whether we are now returning to a more toxic body standard,

The book is critical of the weight loss industry and the role it plays in exacerbating disordered eating. Is Ozempic just the latest version of this?

Emmeline Clein: Even if it was a magical cure for obesity, which I don’t think it is, it has tonnes of side effects which we’ve already seen and which have already sparked lawsuits, and there is very little data on its effects over time, so we have no idea if it’s going to cause cancer down the road – it’s causing cancer in animals, but who knows? It’s very hard to prove that fatness is a disease worth taking a risky drug to cure, but we do have proof that eating disorders are incredibly lethal. And what these drugs are doing is replicating the conditions of an eating disorder; they’re not working on your metabolism, they’re just allowing you to consume less food.

What role does racism play in disordered eating?

Emmeline Clein: Unfortunately, a massive one. Two books that I would recommend to anyone who wants to understand that racism has constructed our beauty standard are Sabrina Strings’ Fearing the Black Body and Tressie McMillan Cottom’s Thick, which are both incredible. Fatphobia was developed in part around the stereotype of the bigger, stronger Black woman, which was actively constructed in order to justify the slave trade. In the Victorian era, white women were marketed early weight-loss drugs and holistic health spas, and told that it was their ‘duty to their race’ to maintain their beauty. These eugenics-inflected beauty standards were designed to uphold a racialised economic system.

Once you realise that, it makes the impetus to address your eating disorder feel more politicised, in a way that I have found to be cathartic and empowering. Having an eating disorder can feel like a form of control but in reality, you’re just entrenching a set of systems that you don’t actually believe in. Once you realise how much harm those systems have wrought, you can take control in a way that’s rooted in solidarity.

Why do you think that ‘pro-ED’ online spaces have, to some extent, been unfairly maligned?

Emmeline Clein: I’m not trying to let anyone off the hook, and I’m not saying that every person who has ever posted ‘thinspo’ was right to do so. But most of the people that we cast as the villains of the eating disorder epidemic are often also its victims. What I am trying to critique is the obsession with demonising teenagers for reposting images which they’ve seen on the covers of magazines and diets they’ve seen in mainstream publications, and then rewriting them in slang terms which get the point across faster. Why is the vitriol being directed at those communities, rather than at the publications which taught them what they are now simply restating?

“If you have ever hurt yourself to conform to a beauty standard that you don’t politically believe in, if you’ve ever blamed yourself for doing so and allowed that sense of blame to worsen your sickness, I just want you to know that none of it was your fault” – Emmeline Clein

What does recovery mean to you?

Emmeline Clein: The medical notions of recovery are often based on a linear narrative of people realising that they were overvaluing thinness, and realising that being thin wasn’t the most important thing about them. Of course, thinness isn’t the most important thing about anyone but, if you ask me, it’s completely deranged to tell an intelligent young person that they’re overvaluing thinness when they live in a society which is doing the same, and then release them from treatment back into that society without expecting them to relapse. It can be much more helpful to recovery trajectories to say, ‘No, you’re not overvaluing thinness; this society is overvaluing thinness, and we need to figure out why.’

I’ve been lucky to be in a good place with it for a long time now, and that’s because of how much education I’ve been able to access on the history of these issues, how many people I’ve been able to listen to who have survived and given me incredible models of bravery, and also just a deeply crushing desire for people who are younger than me to not have to go through what almost everyone my age did.

There’s been a lot of discussion lately about how ‘body positivity is over’ and we’re returning to a more toxic beauty standard. What do you think about that?

Emmeline Clein: I think the rhetoric of ‘return’ is misleading because the thin, white beauty standard never went away – a lot of the body positivity era was unfortunately quite tokenistic. But the rise of algorithmically-based social media platforms is making me worried that we’re going backwards. You really had to seek out the eating disorder platforms that we were talking about earlier; whereas now, on TikTok and Instagram, young people are being fed diet-forward and eating disorder-forward content when they’re not even looking for it. There have been multiple studies showing that if you code a bot as a 13-year-old girl and she doesn’t even search for weight loss, she’ll end up on a pro-eating disorder page within three days.

But on the flip side, the accessibility of social media has also allowed a lot of amazing fat liberation and body-positivity influencers to reach so many people, which wouldn’t have happened in the previous era. There are so many eating disorder recovery TikTokers and Instagrammers who are building beautiful communities, and those people really inspire me.

What is one piece of advice you’d give someone struggling with disordered eating?

Emmeline Clein: If you have ever hurt yourself to conform to a beauty standard that you don’t politically believe in, if you’ve ever blamed yourself for doing so and allowed that sense of blame to worsen your sickness, I just want you to know that none of it was your fault.

Dead Weight by Emmeline Clein is out now