The Problem With Before And After Photos In Eating Disorder Recovery

A few months ago, towards the end of February, it was Eating Disorders awareness week, so naturally I did as I always do on this occasion and buried my head in the sand for the duration of the week (I also allowed children to use the remaining sand to build sand castles atop my hiding place because I am such a lovely person). This may sound like odd behaviour for someone who is constantly talking about mental health problems like eating disorders in order to raise awareness and for someone who has a strong disliking of sand, but then again odd behaviour is what I am known for. Literally.

The reason that I avoided the internet during that week, and indeed avoid it every year, is that it is a week in which social media is filled with “before and after” pictures, aka photos of someone taken during the depths of their illness, compared to a later photo taken post/during recovery. Don’t get me wrong, these photos certainly have their place and I would be lying if I were to say that I have never been inspired by any of them. Often these pictures will come with an empowering and motivating story of someone’s journey in recovery and triumph over anorexia, and that is brilliant. That is something that should be celebrated, and those stories  are shared throughout the Eating Disorder community to encourage others to fight their illnesses and to give hope to those who doubt recovery is truly possible. I love these stories but it is not the stories of recovery that I have a problem with, rather I have a problem with the “before and after” photos that are often involved in telling the triumphant tale.

Firstly, these images will usually show the person in the depths of their illness as an incredibly underweight individual, with ribs popping out so far all over the place that you could easily use them as a xylophone. Regardless of the inspirational intention with which they were posted, there is always the risk of these pictures going on to be triggers for other sufferers or, dare I say it, “thinspiration” for all those misguided souls who think that anorexia is something to aspire to. They can also make sufferers who are perhaps not as underweight (or who are unable to see themselves as that underweight) consequently see these images and feel that they cannot seek help because they aren’t “thin enough” or “bad enough”, when encouraging people to seek treatment is supposed to be the whole point of a week dedicated to educating and raising awareness of eating disorders. Similarly, in their representation of someone with an eating disorder and someone without, they encourage the myth that eating disorders are about being thin and that eating disorders can be seen, (a myth I have tried to tackle here: Why it is physically impossible to “look anorexic”.)
For people who do not know much about eating disorders and who do not have the time or interest in reading full accounts of recovery journeys, these snapshots may be the only experience they get of someone with an eating disorder, so the risk is that the stigma and lesson of “ill is underweight”, “well is a healthy weight” will be perpetuated without taking into account the far more complex and important internal and mental struggle that is having an eating disorder.

Similarly, as an image to summarise recovery, I feel it is problematic in that the main difference that is visible between the two pictures is weight, which implies that the main difference one goes through is the difference of the number on the scales. It suggests that in recovery, the biggest thing you “gain” is weight, when really weight is probably the smallest of all the things I have seen people gain in recovery. I may not be able to speak as a recovered person myself, but of all the friends I have watched beat their eating disorders into a soggy pulp on the ground that is no longer able to control their lives, the change in their weight has been the least significant change of all. Okay there is a change in weight and perhaps clothes size, but when I see my recovered friends, I do not see the change in their BMI, what strikes me most is the change in their lifestyle and their overall presentation as a person. To me they have not gained weight as much as they have gained themselves. When you are in the depths of your eating disorder, as much as you fool yourself, you cannot maintain a normal life. Your ability to have a job, have normal relationships with people, be happy or even function are seriously compromised, and these things are all aspects of life that can be improved on with recovery. I have seen friends go on to study medicine at university, have romantic relationships, give birth to children, climb mountains (I am talking proper big mountains like Kilimanjaro), and travel the world. They have regained their ability to properly smile, to laugh without having to fake it, and to me seeing all those photos of them skydiving in Australia or getting married and having babies have been far more significant and noticeable changes than what size jeans they wear. It is these aspects of recovery that are the really important reasons that people need to fight and it is these changes in lifestyle that are the really inspiring stories. Yes weight gain is a part of the journey, but what is more important is the places that weight can take you, for example to medical school or up a flipping huge mountain.

On a similar note, my other issue is that I feel before and after photos simplify the process of recovery. In one picture you probably have someone who is underweight and either looking miserable or faking a smile out of dead eyes, and in the other you have someone who has gained weight and perhaps, is beaming at you with genuine joy. This then makes recovery very straight forward, “Being underweight make you unhappy and thus gaining weight will make you happy”. It automatically assumes that the happiness comes as the weight increases, without highlighting the far more complicated journey in getting that weight to be there.

It is hard to explain exactly what I mean, but it is like looking at a picture of someone standing in a field looking miserable, and then another photo of them smiling in the same field but with the addition of an ice cream. At face value then, you can look at these pictures and think “well a person was sad because they didn’t have an ice cream but then they got an ice cream and they were happy” , simple. What the picture will not tell you however, is how that ice cream got there. Little would you know that the person had not simply walked up to the nearest ice cream van, asked for a 99p Mr Whippy and walked away smiling, just as the person in recovery had not simply gained some weight, and in turn, a smile (side note did you know that they don’t even do 99p Mr Whippys anymore? They are now at least £1.50! How do those ice cream men still have the nerve to play jolly tunes as they patrol the streets for customers now that they are basically performing daylight robbery rather than offering a merry treat. You can play Greensleeves all you want but that doesn’t change the fact you are making me re-mortgage the house to buy myself an ice cream. SHAME ON YOU ICE CREAM MEN. SHAME ON YOU.)

Anyway, what the picture doesn’t show is that to acquire their ice cream they were forced to go on a perilous test of their endurance, that pushed them to the limits of mental and physical strength. To get that ice cream in the picture, that person had in fact had to walk across continents and cross oceans to America, the largest producer of almonds in 2014 I will have you know, and then had to hand pick hundreds of almonds ready to blend into a creamy milk worthy of a tasty frozen dessert (this person was lactose intolerant so almond milk was the milk required for the job.)
Then, exhausted from months of trekking, nut picking and milk making, that person had to swim across even more oceans into the freezing cold pole of the Arctic where they stirred their almond milk with a wooden spoon atop a large glacier that acted as a natural freezer for their ice cream churning process. Even when the ice cream was made it didn’t get any easier as they had to then wrestle with a penguin who had cheekily tried to steal the ice cream (I don’t blame him to be honest. I would steal ice cream if all I had ever eaten was raw fish), and then they had to get the ice cream all the way back to that field in their country of origin, back through the hot climate of almond fields in America, without the creation melting. Clearly that is a far more character building excursion to get to that point of “person with ice cream in a field” than the picture initially suggests, and I didn’t even tell you the 5 month side trip it took to make the cone in which the ice cream was to rest (it would take too long to tell you fully but as a brief summary it involved a very angry rhino and a lot of waffles).
The person worked hard to get to the point where they were standing in that field with that ice cream, and all that hard work is eradicated, as it is in recovery journeys, when all you see is a simple before and after shot.

Obviously I am not saying we should stop people from sharing their recovery stories and indeed, if you have recovered from an eating disorder, then I am OVERWHELMINGLY proud and impressed by your determination and strength. If you were here with me now rather than wherever you are reading this, I would give you so many rounds of applause that my hands would fall off and I would be left clapping stumpy wrists to show appreciation of your achievement. What I am saying is that maybe, more often we should be celebrating and telling these stories without the underweight photos that go with them. A story is still a great story without pictures. Hell, look at Harry Potter, that story changed and continues to change generations of people, it has grown theme parks and movie franchises, careers and other astonishing things, all from a pile of words cobbled together with no images at all (For the purpose of this post can we please just pretend that the illustrated versions that are currently in production don’t exist.) Still, even when pictures are added to the Harry Potter books, it will still be the words that are doing all the talking.

So that is why I have a problem with before and after photos when it comes to eating disorder recovery, not because I don’t like inspirational stories or don’t want people to celebrate their achievements, but because those pictures don’t really do anything but diminish and reduce the value and greatness of what has been achieved. As a snapshot ok, a picture may say a thousand words, but a recovery journey is made up of millions of them.

Take care everyone x

BeforeAndAfter

“But You Don’t Look Depressed”

Have you ever played real life Where’s Wally but instead of a man in a bobble hat and a striped jumper you had to find someone with depression? Hopefully you answered no, (if you answered yes I would advise you to make some changes to games you play for recreational purposes and would suggest Scrabble as an alternative). If you did answer no though, it is a game I do not recommend because playing such a game would be practically impossible (again, maybe try Scrabble).

Despite the fact that we now live in a time where there is a fairly wide understanding that depression is a “mental” illness, I still feel like there is the idea that somehow it is as visible as a broken leg. In fact I have lost count of the number of times someone has discovered I have depression before responding in surprise with that oh so familiar phrase to anyone with depression, “but you don’t look depressed”.
To be fair, no, no I often don’t. Then again Ralph Fiennes didn’t look like Ralph Fiennes when he was playing Lord Voldemort in the Harry Potter films with his nose all squished out of recognition, but underneath all that make up/genuine wizardry, he was still Ralph Fiennes.
Much like Ralph Fiennes, people with mental health problems like depression are often great actors, dare I say even better than the ones you see on TV to be honest, as we don’t even need green screen or CGI fake noses.

Whenever people say that I “don’t look depressed” I almost want to ask what exactly someone who has depression should look like considering I am clearly not living up to their expectations.
I think the traditional depressed person is supposed to look like the pictures you see when you search depression on google images or look at any of the pamphlets they hand out at doctors’ surgeries. In the majority of these images, the people are curled up in a corner somewhere with their heads in their hands, but like the images you see of skeletal anorexics in the media, this is not always the case, and it is dangerous to think so.
Admittedly sometimes in my life living with depression, there is a lot of curling up in a ball for a good cry (often with Celine Dion – “All By Myself” playing in the background), yet that is not my constant state of being and not something I allow many people to see.
Inside I may feel like staying in that soggy ball all the time, but at family occasions or social events for example, I always put on my “sane” face and play the part of “human who has life together” as required by expectations upon me, much like many other people do at work or when they are in front of their children.

Contrary to portrayals in the media, often both I and other sufferers of depression really do just look like “normal people”. However well disguised a depression suffer is though, it doesn’t mean they are any less ill or need be taken any less seriously than those who are visibly struggling. Indeed, what a person looks like on the outside will tell you nothing of the severity of their condition, and you cannot compare sufferers based on the number of tears they have cried in the last fortnight.
Depression may be one illness, yet it expresses itself and feels different to every individual who suffers from it, so how one depressed person behaves could be totally different to someone else who also has the condition.
Even single individuals can present the illness in totally different ways depending on what day you come into contact with them so you can’t even classify people in groups of “loud person with depression” or “quiet person with depression”.
Like I said there are some days where my depression means that I physically cannot talk or get out of bed, and then aside from the days I have to pretend to be a certain way in front of family members, I have days at home in private where I am so depressed that I spontaneously burst out into hysterical laughter despite being alone and “allowed” to show how I really feel without upsetting anyone. It is almost like those situations in which people without depression hear a piece of bad news and instead of reacting with tears as would be appropriate, they just start laughing because their brain physically cannot cope with the shock/that amount of sadness. Truthfully I have had days where I can be so depressed that I spent half an hour hysterically guffawing (I believe the kids today call it “LMAOing”/“Loling”) at a pencil. Yes, you read that right, I laughed for half an hour at a pencil (not even a particularly funny pencil. His jokes were terrible. No idea of timing when it came to landing a punchline).

Much like the problem I discussed in my post about people with eating disorders not always being underweight, this misconception that someone must “look depressed” to be depressed is actually a mistake that puts many people at risk as well as being frustrating.
It is often due to this “depressed people must look depressed” problem that sufferers may feel unable to “come out” and be honest with family members about their issues for fear that they won’t believe them or take them seriously. Admitting to someone that you have depression is hard, often embarrassing and can take a lot of courage as it is, but to do so and then be told that you must be mistaken because “you don’t look depressed” is a sure fire way to make someone feel more devalued, ashamed and deluded than ever.
It is when people feel the need to keep their illnesses quiet and not seek help for fear of this response that they end up feeling more alone than they already did and in some circumstances take their own lives. How many articles about a suicide victim have you read where the family conclude by saying “we knew this would happen. Too much crying/head holding in the corner”? Most likely none, as usually such columns end with the far more unfortunate “we had absolutely no idea”.

When it comes to those with depression, in this post I really want to urge people to see them/us, not as head clutching Celine Dion fans, but instead as ninjas, masters of disguise who can pop up anywhere without people realising (only without the resulting violence that often ensues around ninjas).
That jolly person who served you in the supermarket? They could have had depression. That milkman that never shows any emotion at all? They could have depression. That girl you saw cycle past your house this morning? They could be a penguin in disguise, which isn’t exactly the same as depression but it just goes to show that you cannot make any judgements based on appearance alone.
Literally the only way it would ever be possible to play Where’s Wally where the aim is to spot the person with depression would be to make every sufferer of the aforementioned condition wear a Where’s Wally jumper at all times, and thankfully, that is never going to happen… At least I hope it doesn’t… I really don’t suit horizontal stripes.

Take care everyone x

dontlookdepressed