Fifty years ago, I started thinking about the demand for women to look a certain way and the rebellions against the narrow ways in which we were supposed to display (and not display) our bodies. For a while, there was a conversation about the strictures. Some young women refused to conform. Some women risked being in the bodies they had rather than embodying the dominant images of being Madonna or the whore. But troubled eating abounded, even if it wasn’t always visible, stoked by the food and diet industries and their bedfellows in the beauty and fashion industries. These industries targeted appearance as crucial to girls’ and women’s identity and their place in the world.
Today, a new kind of troubled eating is stalking the land, entirely induced by the new GLP-1 weight-loss drugs produced by pharmaceutical companies and promoted by their willing agents on social media. It is totally understandable that people want relief from obsessive and invasive thoughts about their bodies and food. The explosion of GLP-1 drugs has provided a kind of psychological peace for many who feel less frightened of their appetites.
GLP-1 drugs have captured the public’s imagination, while prices have been dropping and online doctors in supermarkets prescribe quite freely. The reach will be ever greater as the pill version of the drug, as opposed to the current jab form, hits the marketplace. The notion of managing appetite, of the desire for food, of mouth hunger, of wanting to quell the food chatter that constitutes internal and often obsessive thoughts about eating and not eating, is the promise. So too is the longing for bodies to be transformed. To be slimmed down and disciplined. Having the right kind of body, by which is meant, the acceptable and admirably thin body, will become something to be bought through these drugs.
The meanings of troubled eating – which is to say why and how it has become so widespread – will be bypassed and erased. The beauty, food and fashion industries that help to provoke the distress will be able to continue peddling their products without censure.
The “GLP-1 face”, with the intense cheekbones caused by rapid weight loss after using these drugs, requires costly interventions from clinicians who seem to have no difficulty re-plumping emaciated faces. The Hippocratic oath of “first, do no harm” has slithered away.
Never mind that doctors know about muscle loss. Never mind the many people who can’t get on with these meds facing a new kind of discrimination – as others tut about their weight and ask why they aren’t on the drugs. Never mind the studies that show the drugs do nothing to re-educate people’s appetites and that most people regain all the weight lost within two years of stopping taking the drug.
GLP-1 drugs provide relief in the short term and that is to be welcomed. But the heartache and pain that is implicit in the search for a sustainable and reliable body is still elusive. The food, fashion, pharmaceutical and cosmetic surgery industries are still laughing all the way to the bank.
The food industry is run on the ethics of greed. Ultra-processed “non-food foods” are an important part of the business model – the high-salt, high-sugar, high-saturated-fat concoctions, which give taste and no substance except to further stimulate appetite, have free rein. They hook people by overstimulating taste receptors, with relief only coming at the end of the packet.
Now this same industry, which has been the biggest factor in the obesity epidemic, has developed divisions to reformulate foods to serve those who now find themselves with scant appetites, labelling the new food “GLP-1 friendly”. Food scientists talk excitedly about how to combine intensity and flavours with protein-rich foodstuffs to entice those whose appetites have shrunk and whose desires for food are alarmingly (for the food companies) suppressed. They don’t want to lose market share.
GLP-1 drugs only stop cravings for food as long as they are being taken. For them to have a real place in helping people, we need a deeper understanding of how troubled bodies and troubled appetites have come to be so prevalent. Wherever we look, at whatever stage in life, we can see anxiety around food and bodies, fuelled by the industries that both create and benefit from this distress.
A good place to start is at the very beginning of life, allowing babies and parents to relish their hunger and the satisfaction of it. Anxiety too often infuses pregnancy, and the postpartum period can be fraught when it comes to nursing.Inadvertently, a new parent’s desire to get back into pre-pregnancy clothes and back to a measured kind of eating can make feeding oneself and feeding an infant fraught. The cycle of troubled eating and fear of one’s appetites begins very young. We need a whole-body approach, starting at the beginning of life and welcoming the changes as our bodies grow.
Wouldn’t it be wonderful for our experience of food to be pleasurable, wholesome and unconflicted? Such relish would contest the power of all of the industries hellbent on inducing body anxieties. That would be really worth aiming for.
Susie Orbach is a psychotherapist, psychoanalyst and social critic. She is the author of many books, including Bodies and Fat Is a Feminist Issue