(TRIGGER WARNING: Eating disorders)

Originally posted on …Until Eating Disorders Are No More, and cross-posted here with their permission.

I work at a hospital with a lot of different buildings spread across the medical campus.

My job has me going between buildings to different patient units or administrative offices, so I come into contact with a lot of different people throughout a given week, but don’t work closely with most of them.

There are plenty of people that I see regularly, but the extent of our interactions are a friendly nod or greeting as we go about our day, not even knowing each other’s names.

One such work acquaintance recently saw me waiting to meet with a patient’s family, and greeted me by saying, “Hey, Skinny!”

This caught me off guard.

When I was anorexic and dangerously underweight, it was not uncommon for people to make comments or observations on my weight or appearance – meant to be compliments if they didn’t know me well, and usually concern if it was from a friend.

These days, the only comments that I get on that subject are from people who haven’t seen me in a long time. For example, I recently got back in touch with an ex-girlfriend who knew me when I was still underweight. She had found some old photos of me, and repeatedly mentioned how much healthier I look now and how glad she is that I am recovered.

But, as I’ve been writing and reflecting on the two years that I was sick, I’ve become even more aware to the way people think about weight and observe themselves and others.

It has become painfully obvious the degree to which popular culture and common knowledge embraces the idea that being thin is equal to being healthy and that thin is always preferable.

This happens to such an extent that few people even question whether or not it’s true. It’s accepted at face value as an absolute truth.

The seemingly harmless greeting from my work acquaintance is the perfect example: She clearly thought she was being friendly.

But if someone addressed another person in a way that referenced or drew attention to how thin they aren’t, I anticipate that it would not be taken in a friendly way.

Words like thin or skinny are typically regarded as either neutral words or as compliments. However much I rack my brain, though, I can’t think of any words that are opposites for skinny or thin that society has not placed an inherently negative connotation onto.

Words like fat were at one time neutral descriptors, much like thin.

These days, though, fat has become the scarlet letter, the thing of pariahs.

Children who haven’t even started puberty are experiencing fat-phobia and learning disordered eating behaviors at very young ages.

The popular response to this is usually something about obesity prevention, but what most people fail to realize is that if you are talking about obesity, then you are necessarily talking about eating disorders.

Rather than focus on things like overall health and activity, the focus is on numbers, be it weight or BMI. Teaching children to obsess over these things (particularly an arbitrary measure like the BMI) won’t instill a “healthy” mindset. It just tells them that the approval of their teachers, parents, and peers has more to do with how thin they are.

According to the most recent statistics compiled by the Eating Disorders Coalition, 40% of 9-year-old girls have dieted, 40-60% of high school girls have dieted, and 13% of high-school-age girls purge.

When I was going through recovery, especially early on, it occurred to me just how obsessed our culture is with body image.

I think many of us don’t notice how bad it is because A) we are used to hearing it, B) we don’t think much of it when we see diet ads or hear people talk about losing weight, and – perhaps most dangerously – C) often we agree with what we’re hearing without really thinking it through.

The average person can usually hear these things without becoming especially concerned or obsessing over it (though I would not go as far as to say that people succeed at “tuning out” these messages) but for someone with an eating disorder, you become hypersensitive to it.

Going out to eat with friends was often a challenge for me before and during my recovery. Just looking over a menu could be overwhelming, but being out with other people was nice because you could focus on socializing instead of the actual act of eating.

At least, that was the idea at the time.

It seemed inevitable that even close friends who knew what was going on would make comments on how much I was eating (usually intended in a friendly or encouraging way, but always having the effect of just drawing my attention back to eating) or would start discussing weight over meals.

Especially in larger groups, once the subject came up, it seemed that everyone had something to say about their weight and how much they had lost or gained recently.

I eventually learned to just excuse myself and walk outside for a few minutes in those situations, since at the time not all of my friends knew I was in recovery, and I didn’t always feel like explaining it.

I was reminded of this when I was greeted with “Hey, Skinny!” because, although I no longer worry about or even think about my weight, it’s obvious just how much seemingly most everyone else does.

What bothered me even more is how comfortable she was in combining a greeting with an observation about my appearance.

Our society (and this is undoubtedly not limited to American culture) has a nasty habit of judging and evaluating each other based on appearances.

The way I see it, if it would be considered rude or mean by most people to comment on how thin someone isn’t, then I’m equally concerned when superficial observations are made which in some way praise or compliment someone’s appearance.

This idea is explored in enormous detail in Alfie Kohn’s Punished By Rewards, which mostly focuses on school and the workplace, but is entirely applicable to the topic of body image and eating disorders, since it all revolves around self-perception and self-fulfillment. Not to mention, many weight-loss schemes involve incentive-based dieting or exercising, a form of self-rewarding or self-punishing.

He argues that it isn’t enough to abstain from punitive practices when students or workers under-perform, because praise or superficial rewards make people focus on and care more about the rewards themselves, and even rewards can have a punitive effect, such as when someone does not do well enough to earn a reward.

I feel this idea translates fairly easily into the discussion of body image and the overall focus of weight with regards to health. Or, as it’s written in the Tao Te Ching, “Recognize beauty and ugliness is born.”

It’s impossible to know what kind of perception someone has of their own body image.

My co-workers who complimented my extreme weight loss back when I was anorexic were really just reinforcing the disease and giving me excuses to not worry about what was happening.

I think that if we are to break out of our weight-obsessed culture and move towards something where people are valued for who they are and not what they weigh, one of the first places to start is with our own perceptions and ideas with how we perceive our fellow humans.

Is it really appropriate or even friendly to make random comments on someone’s body, regardless of how short, tall, fat, or thin they are?

Without context (like my ex-girlfriend excitedly telling me how healthy I now look), the only conclusion I have is no. It’s neither appropriate nor friendly, because despite how frequently and casually body image and weight get discussed, it remains a deeply personal subject for many people.

Obviously, this may not apply to everyone.

Recently I saw a friend’s mother for the first time in months who had been on a diet. She had noticeably lost weight, and truthfully, she looked like she had more energy and felt healthier. I almost commented on her weight loss and how “good she looked,” but then stopped myself.

Later, my friend reported that her mother was disappointed that I supposedly didn’t notice the weight loss. Though I felt bad, it made me wonder: Did she really feel good about herself and her body image if she was disappointed that I didn’t compliment her weight loss? Or was her feeling of self-esteem less about liking herself and her appearance and more about how other people perceived her?

I honestly don’t know the answer, but for many people I fear that it is the latter.

What do you think?

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Matt suffered from anorexia as an undergraduate in college and has been doing advocacy work with the Eating Disorders Coalition since 2007. He currently is a graduate student at Virginia Commonwealth University in the Department of Gender, Sexuality, and Women’s Studies, with a special interest in how gender constructs influence body image and access to eating disorder treatment. Matt maintains his blog, …Until Eating Disorders Are No More and is also a monthly contributor to We Are the Real Deal. Follow him on Twitter at@TilEDsAreNoMore.