Eating Disorders Are Not About Vanity: The Gendered Politics of Appetite

The Cultural Story We Tell Ourselves

The dominant narrative about eating disorders goes something like this: young women want to be thin because society tells them thinness is beautiful. They diet too much, exercise too hard, and eventually develop a clinical condition. The solution, therefore, is to promote body positivity and teach young women to love themselves.

This narrative is not entirely wrong, but it is dangerously incomplete. It reduces a complex psychiatric condition to a matter of vanity, locates the problem in the individual woman's self-esteem, and obscures the structural forces that produce eating disorders in the first place.

Eating disorders — anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding and eating disorders — are not about wanting to be beautiful. They are about control, trauma, power, and the gendered politics of appetite itself. To understand them, we need to look beyond the mirror.

We have turned a psychiatric illness into a lifestyle choice and then blamed women for choosing it.

Who Gets Eating Disorders

The epidemiology of eating disorders is revealing. Anorexia nervosa has the highest mortality rate of any psychiatric illness. Bulimia nervosa affects an estimated 1 to 1.5 percent of women in their lifetime. Binge eating disorder is the most common eating disorder, affecting approximately 3.5 percent of women.

But the gender disparity is only part of the story. Eating disorders cross class lines, though they are often perceived as affluent white women's diseases. Research consistently shows that eating disorders affect women across all socioeconomic strata, racial groups, and cultural contexts. In India, a 2022 study published in the *Indian Journal of Psychiatry* found that eating disorder prevalence among urban Indian women was comparable to Western rates, challenging the assumption that these were Western phenomena.

What is consistent across contexts is the gender ratio. Women are approximately nine times more likely than men to develop anorexia or bulimia. This disparity cannot be explained by biology alone. It is the product of a culture that subjects women's bodies to scrutiny, regulation, and control in ways that it does not subject men's bodies.

If eating disorders were simply about vanity, men would get them at equal rates. They do not. The difference is not biological. It is political.

The Control Thesis

The most robust psychological models of eating disorders centre on control. For many women, disordered eating begins not with a desire to be thin but with a need to manage overwhelming emotions, trauma, or circumstances that feel uncontrollable. Food restriction provides a sense of mastery when everything else feels chaotic. Bingeing provides temporary relief from pain. Purging provides a ritual of absolution.

This model is supported by the strong comorbidity between eating disorders and trauma. Women with eating disorders are significantly more likely to have experienced sexual abuse, physical abuse, or neglect. The eating disorder becomes a coping mechanism — a way of managing distress that the world has refused to address.

In India, where gender-based violence is endemic and mental health services are scarce, this connection is particularly relevant. A girl who is sexually abused and told to remain silent may find in food restriction the only domain of her life that she can control. A woman who is subjected to domestic violence may develop binge eating as a form of self-soothing when no other comfort is available.

The eating disorder is not the disease. It is the symptom. The disease is the world that made it the only way to survive.

Patriarchy and Appetite

The politics of appetite are inherently gendered. Women are expected to eat less, to want less, to take up less space. A woman who eats voraciously is seen as unfeminine. A woman who is hungry is seen as out of control. The message is clear: a good woman is a small woman, in body and in desire.

This is not a modern phenomenon. Historian Joan Jacobs Brumberg, in *The Body Project*, traced how ideals of feminine thinness have been intertwined with ideals of feminine virtue for centuries. The Victorians praised women who could survive on air and moral sentiment. The twentieth century invented the diet industry. The twenty-first century perfected it through social media.

In India, these pressures operate alongside caste and class expectations. Fairness, thinness, and delicacy are markers of upper-caste femininity. A Dalit woman who is stocky is seen as coarse. An upper-caste woman who eats heartily is seen as unladylike. The eating disorder, in this context, is not just a response to media images. It is a response to a caste-class-gender system that prescribes exactly how a woman's body should look and behave.

The diet industry is worth $72 billion globally. It does not sell health. It sells compliance.

The Medical Gaze

The medical response to eating disorders has its own gendered dimensions. Women with eating disorders are frequently subjected to treatment approaches that reproduce the power dynamics of the original condition. Forced feeding, invasive monitoring, and the removal of autonomy — these interventions, while sometimes necessary, can replicate the experience of control that the eating disorder was managing.

Research by feminist critics of eating disorder treatment has documented how the medical gaze pathologises women's relationship with food while ignoring the social conditions that produced it. A woman who restricts because she has been told her entire life that her body is too much is treated as though her problem is individual, not social.

In India, the medical response is complicated by the intersection of Western psychiatric models and traditional beliefs. Eating disorders are often misdiagnosed as digestive problems, or dismissed as phases that will pass with marriage or motherhood. The absence of specialist services means that many women receive treatment that is inadequate or actively harmful.

Treating an eating disorder without addressing the patriarchy that produced it is like treating a wound without removing the knife.

The Role of the Family

In India, where family structures are central to women's lives, the family plays a dual role in eating disorders. On one hand, familial pressure — about weight, appearance, marriageability, food habits — is a significant contributing factor. On the other hand, the family is often the first point of contact for a woman seeking help.

The stigma surrounding mental illness in Indian families means that eating disorders are frequently hidden, minimised, or attributed to spiritual causes. A woman who refuses to eat may be told to pray harder. A woman who binges may be told she lacks willpower. The delay in seeking treatment can be fatal.

In Indian families, the eating disorder is often the last thing anyone talks about. By the time they do, it may be too late.

Beyond Body Positivity

The body positivity movement, while valuable, has limitations as a response to eating disorders. Telling a woman to love her body does not address the trauma, the power dynamics, or the cultural structures that produced her eating disorder. It adds another expectation — to feel positive about her body on top of everything else — without providing the support needed to actually recover.

What is needed is not just cultural change but structural change: accessible eating disorder treatment, trauma-informed care, and a willingness to interrogate the patriarchal expectations that make women's bodies sites of control and contestation.

Recovery from an eating disorder is not about learning to love your body. It is about learning to live in a world that taught you your body was wrong.

The gendered politics of appetite run deep. They are embedded in our cultures, our families, our medical systems, and our economies. Addressing eating disorders means addressing all of these — not just telling women to eat differently.