August 11, 2023 - 10:00am

In 1987, I was first diagnosed with an eating disorder. It’s hard to convey just how different things were back then. 

If people had heard of anorexia and bulimia, it tended to be through gossip columns on Karen Carpenter or Lena Zavaroni. Those with “slimmer’s diseases” were regarded as vain and selfish, even among members of the medical profession. Sufferers did not just feel overlooked; if we were discussed at all, it was rarely with any sympathy. 

This is possibly why, when Princess Diana gave her famous speech on eating disorders in 1993, I felt so grateful I could almost cry. It seemed as though it could be a turning point on how sufferers were perceived, and maybe it was. The past three decades have seen dramatic improvements in eating disorder awareness, and an end to sufferers being dismissed — officially, at least — as “middle-class brats”. This has not, however, been matched by a reduction in eating disorder prevalence or severity

We are definitely living in kinder times. I wonder, though, whether all publicity is good publicity, particularly when it falls into the hands of the not-yet-suffering. Princess Diana’s own experiences with bulimia are due to be featured in the latest instalment of the Little People, Big Dreams series of books for children. When I look at the way this will be presented, I can’t help but think it’s a terrible idea. 

“Whenever [the Princess] felt alone,” children will be told, alongside a brightly-coloured artwork of a sad-faced, beautiful princess, “she sought relief by eating all the cakes she could find in the royal kitchen. But that sweet feeling of comfort didn’t last. Once it was gone, she would try to get rid of all the food she had eaten by making herself sick.”

Reading that, I am certain it will inspire some vulnerable, deeply unhappy girls to experiment with bulimia. This is not because some girls are so stupid that they’ll decide sticking their fingers down their throats will make them the queen of everyone’s hearts. This form of contagion is never that straightforward. That does not make it any less destructive. 

In Crazy Like Us, Ethan Watters describes the way in which the publicity surrounding the 1994 death of a teenage anorexia sufferer in Hong Kong led to changes in the way other teenagers there manifested symptoms. He links this to the idea of the “symptom pool”:

At another point in history, the population of troubled teenage girls might be drawn to a different unconscious behaviour to express their internal distress. But starting in 1994 a new belief became prominent […] Each newspaper article, magazine essay and television programme that depicted anorexia as a valid and dramatic expression of mental distress for young women made that conclusion self-fulfilling.
- Ethan Watters, Crazy Like Us

It is very hard to discuss social contagion without being accused of trivialising or disbelieving girls. Nonetheless, we need to be honest about the way in which narratives of self-harm — even nominally “disgusting” ones, involving vomit and laxatives — offer girls a way of “telling their story”. You can’t choose to be a princess, but you can choose to hurt yourself like one.  

While the Eighties were generally a wasteland for anorexia awareness, there was the odd book about it — Maureen Dunbar’s Catherine, or Deborah Hautzig’s Second Star to the RightFor years, I couldn’t tell anyone about the way Hautzig’s book affected me for fear it would confirm their prejudices about sufferers being stupid and impressionable. I no longer worry about this, but feel that we should think hard about the impact of even seemingly innocuous eating disorder stories. 

Years ago, I was desperate for people to know and understand more about anorexia and bulimia. The truth is, I still am. I just don’t believe a picture book about a tragic princess who was loved by a nation is the way to introduce the topic to girls. I remain grateful to Diana, but that’s not how this story should be told.


Victoria Smith is a writer and creator of the Glosswitch newsletter.

glosswitch