How Diet Culture Harms Women in Recovery

By Olivia Pennelle 11/13/19
Overlooking the physical impact that substance use disorder has had on our bodies will exacerbate disordered eating and poor mental health. As many as 72% of women with alcohol use disorder also have an eating disorder.
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woman's head served on a dinner plate
Substance use disorder can cause considerable damage to our bodies that can take years to even out. Photo by DESIGNECOLOGIST on Unsplash

Diet culture is insidious. We spend our lives obsessed with our bodies — always wishing for a smaller shape, scrutinizing the size of the portions on our plates, and unscrupulously comparing ourselves to thinner people. It’s damaging because it leads us to equate our worth with our appearance. For people in recovery, that is especially harmful. We experience physiological changes quickly — including weight gain — once we find recovery, and we can often leap to the assumption that we have a food addiction and reach for harmful, quick-fix solutions.

But what if that weight gain is actually the inevitable evolution of our bodies in early recovery?

When we stop taking drugs and drinking and instead prioritize basic human needs that we previously neglected, like eating, we often gain weight. Unfortunately, before allowing our bodies and appetite to achieve homeostasis, we seek to avoid feelings of discomfort which makes us vulnerable to the pervasive messaging from diet culture.

What Is Diet Culture?

Diet culture affects people of all body sizes, but it is particularly harmful for people who have larger bodies. It also perpetuates eating disorders because being seen as fat is believed to be one of the worst things that can happen to a person. And in many ways, it is: we’re treated differently, we're stigmatized, and we’re valued less.

The National Eating Disorders Association states: “Diet culture creates the belief that it’s okay to risk the life of a fat person in order to make them a thin person.”

In order to overcome diet culture, however, we must first create awareness of what it looks like. NEDA identified the key tenets of diet culture as:

  • Encouraging rules about what, when, and how much to eat. This can manifest as restrictive diets — perhaps marketed as juice cleanses or liquid diets — and the trend to label food “good” and “bad.” We can also see it demonstrated in fasting diets and not eating within certain time frames.
  • Suggesting that people are more or less good/moral/worthy based on their body size. As a culture, we reward people for thinness. Compliments are almost always based on how someone looks, and we’re particularly congratulatory if the person we’re complimenting looks like they’ve lost weight. Conversely, we stigmatize, oppress, stereotype, shame, and harass fat people because they don’t meet our perception of how we think they should look. Fatness is the butt of many jokes, it is the source of much ridicule, and it is the reason we make assumptions about people in larger bodies. We assume that fat people are lazy, that they sit in front of the TV favoring binge-eating over exercising, and that they are probably depressed.
  • Creating thin privilege. Weight becomes a barrier to jobs, benefits, support, comfort, and accommodation. Expecting that public transportation, amusement park rides, medical facility waiting rooms, and exam rooms will accommodate you is thin privilege.
  • Using exercise as punishment. Instead of exercise being joyful, movement is seen as a means of punishing ourselves for eating too much, or a way to “earn” a “cheat meal.”
  • Viewing fat people as higher risk medically. Clinicians often recommend restrictive surgeries or prescribe medications to fat people, even though there are serious (sometimes fatal) and lifelong risks associated with these treatments. These invasive and drastic measures are often favored by doctors over evidence-based interventions, completely overlooking the patient’s quality of life and the associated risks.

The Risks of Diet Culture for People in Recovery

We often overlook our physical needs in early recovery, instead focusing on getting and staying sober. But programs focused solely on spiritual well-being aren’t enough. Overlooking the physical impact that substance use disorder has had on our bodies will only exacerbate disordered eating and poor mental health. Prioritizing proper nutrition, however, has been shown to significantly improve rates of recovery.

Substance use disorder can cause considerable damage to our bodies that can take years to even out. It can disrupt metabolic and hormonal processes leading to poor calorie consumption and nutrient deficiencies. These deficiencies can be serious as they impact our mental health, vital organs, and immunity — that’s why we often feel depressed, agitated, and out of sorts in early recovery. What we eat during this crucial time has the potential to impact our mental well-being and how our bodies heal. Part of that healing often includes weight gain, whether we like it or not.

Once we remove drugs and alcohol, we experience biochemical changes that can lead to an increased appetite and a desire to boost our low mood. Our brains are now wired to seek that pleasure externally, so we look to highly palatable foods: candy, fried foods, fast food, cake, cookies, and sugary caffeinated drinks.

People in recovery often lack sufficient nutritional education about the right foods to eat. We also move less in early recovery, sitting in meetings, spending a lot of time in coffee shops, or sleeping. The combination of increased consumption of highly palatable foods, disrupted bodily processes, poor food choices, and a lack of exercise inevitably lead to weight gain.

However, despite the fact that many of us were underweight when we came into recovery, we still treat any weight gain as a negative. That’s because of diet culture. We are quick to label our sudden increase in appetite and desire for highly palatable food as a problem. Some jump to the conclusion that they are addicted to sugar or food.

Many women in recovery have a disordered relationship with food. As many as 72 percent of women with alcohol use disorder also have an eating disorder. This makes it even more crucial that we allow the process of recovery to take place and eat a balanced diet free from restrictions.

Carbohydrates are needed to produce the neurochemical serotonin to balance our mood, help us sleep, curb food cravings, and sustain energy. Protein is crucial to healing and mental health: a lack of dopamine can trigger a return to substance use to improve mood. Fat is essential for mental health and also plays a role in stabilizing mood and reducing symptoms of anxiety and depression.

It can be hard to accept weight gain. It leads us to look at our bodies and our relationship with food more critically. But this hyper-focus on our appearance leads to further harming our already damaged self-esteem.

“Women in recovery have already been through a tremendous amount of shame,” says intuitive eating coach and RN Tiffany Thoen.

“Feeling that we are not good enough or that there is something wrong with us is familiar and contributes to the desire to change ourselves to be ‘better,’” she says. “Diet culture preys on these feelings of low self-worth for profit. For women in recovery, this adds to self-loathing by becoming one more way we aren’t good enough.”

Rather than acknowledge that our bodies need food in order to heal and what we are experiencing is a normal part of recovery, we try to reverse that weight gain by going on restrictive diets, which only undermines the healing process. It can also have disastrous consequences: it can inhibit the healing process and our ability to function, trigger co-occurring conditions like eating disorders, and risk a return to using substances.

How Do We Combat Diet Culture?

In order to focus on our healing, we must allow for the process of recovery and not get sucked into diet culture. Thoen recommends that we empower ourselves to reject diet culture by taking these steps:

  • Cultivate awareness around negative self-talk
  • Notice where you might see messages promoting diet culture: on TV, in magazines, or on social media
  • Consider who is benefiting from your believing these messages
  • Set boundaries with friends and family around diet talk and commenting on bodies
  • If you use social media, follow people of all shapes and sizes doing a variety of things, such as the hashtag #womeneatingfood
  • Cultivate respect, acceptance, and gratitude for your body as it is today, because our bodies are doing their best to support us
  • Do the inner work around value, worth, and self-forgiveness
  • Get support from the many available resources, books, podcasts, online groups, coaches, etc. so you don’t have to do it alone

Don’t lose hope. As Thoen says, “Diet culture is insidious and can keep up in a cycle of self-loathing. Healing your relationship with food and body is possible.”

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Located in Portland, OR, Olivia Pennelle (Liv) is an experienced writer, journalist, and coach. She is the founder of the popular site Liv’s Recovery Kitchen, a site dedicated to helping people flourish in their recovery. Liv is passionate about challenging limiting mentalities and empowering others to direct their own lives, health, and recovery. You can find her articles across the web on podcasts and addiction recovery websites, including Recovery.org, Workit Health, Ravishly, Recovery Campus, and The Recovery Village. Liv was recently featured in VICE. Find Liv on Twitter, Facebook, and LinkedIn

Liv also co-hosts a podcast — Breaking Free: Your Recovery. Your Way. Listen here.

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