“Does This Meal Make Me Look Fat?”

Are girls learning the difference between fullness and "feeling fat"?

Source: Stock Photo/Flickr

Lately, I have been hearing a disturbing but recurring theme expressed by many adolescent girls and young women. Many of them tell me: “If I eat, I’ve failed”. I’ve heard girls say that they put off eating each day as long as possible because they believe “If my stomach has food in it, it will stick out and I will look fat” or “If I eat, then I won’t look as good as I do when I’m empty”. They actually try to avoid eating, especially in public, because when they have food in their stomachs, they believe others will immediately notice the difference. They believe that any feeling of fullness on the inside means that they will then appear “fat” on the outside. They believe that every time they eat any food, it will lead to weight gain.

This has caused me to wonder why girls today are internalizing these beliefs. Why would girls believe that fullness is the same as being fat, and that all eating leads to appearing fat? While distorted beliefs related to fear of food and weight gain are common among those with diagnosed eating disorders, I’ve been surprised to hear them expressed so explicitly among the adolescents and young women with whom I work (none of whom have an eating disorder). What might be going on in our culture that contributes to these beliefs? Pressure for women to be thin and beautiful is nothing new. Worries about how their appearance is evaluated by others have long been problematic. But maybe what is different today is that in addition to previous pressures, girls and young women are being bombarded with social messages that glorify extreme food restriction and deprivation as the avenue to “health” and “fitness”.

We know that adolescent girls and young women are the heaviest users of social media, where they are pervasively exposed to such messages. For example, for the trend #fitspiration on Instagram, influencers claim to serve as inspiration for followers as they post images of their weight loss journeys, “before” and “after” photos, carefully shot (and often edited) selfies to showcase sculpted bodies, and secrets for refraining from eating and for obtaining an ideal shape. Not surprisingly, recent research demonstrates that viewing these images is related to negative body image.

While #fitspiration has been popular with girls for several years, these accounts also overlap with and promote the newer trends #IntermittentFasting, #Fasting, and #WaterFast. Most of us are familiar with Intermittent Fasting, a popular diet trend that many adults have bought into, with mixed results. The problem is that the “intermittent” part of the term has been ignored by many young women, resulting in #Fasting challenges. During a cursory Instagram search, I saw hundreds of posts boasting of how many consecutive hours that users had been able to fast. Just like some people post how many miles or minutes they worked out that day, now the trend is to post how many hours you have fasted. There are apps and programs that generate these posts for you (e.g., “Total fasting time = twenty-three hours and 10 minutes!”) that you can share with the public. I also saw #Waterfast challenges where influencers drink only water, going up to 30 days with no food, and their accounts contain hundreds of comments encouraging them to persist toward their goal of not eating.

What is the Harm?

Extreme diets, even in the name of “health” and “fasting”, can nevertheless cause harm. If an adolescent girl or young woman is not consuming enough energy to supply her nutritional needs, this deficit can lead to depression, fatigue, irritability, and an inability to concentrate. But even more concerning, dieting is the strongest predictor for the development of an eating disorder. Studies show that adolescents who are extreme dieters are 18 times more likely to develop an eating disorder than those who do not diet, and those who diet at even a moderate level are still 5 times more likely to develop an eating disorder¹ So it should grab adults’ attention to know that these “health” trends are not harmless; in fact, they can lead to lasting physical and mental health problems.

How to Help

• Help her examine the accounts she follows. Does she follow accounts for fasting or fitspiration, and what are these influencers teaching her about extreme diets, restricting or not eating for long periods of time, excessive exercise, and weight loss? Are they couching their extreme ideas in terms of “health”? Do they promote a balanced approach to eating, weight, and shape, or are they promoting an ultra-thin beauty ideal that is unattainable for most people?
• Educate about the facts. For those adults who work with girls and young women, help her to understand the difference between the physical sensations of satiety or fullness and the experience of “feeling fat”. Help her know that the sensation she feels after eating is natural and temporary, but is in no way an indicator of weight gain. It has nothing to do with how she will look to others. Ask some of the following questions to help her break the connection between physical sensations and unhelpful, invalid beliefs: If your friend just ate a large amount of food and she is very full, could you tell just by looking at her? After you see one of your friends eat, does she immediately look larger? Can you tell the difference in her body before and after she ate?
• Help her to change her self-talk. Help her to internalize a new message: “If I am feeling full, that does not mean I am fat. No one can see that I have eaten or that I am full. The truth is that I need food for fuel in order to feel my best and in order to think clearly. Eating well is what leads to my success, not to my failure”.