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There is nothing managed about 'Managed Anorexia'


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Managed Anorexia is a concept I have come across fairly recently, and one which I strongly believe needs to be beaten down before it becomes a mainstream or, god forbid, widely accepted turn-of-phrase.

So, let’s first clarify, that ‘anorexia’ strictly refers to a psychological condition with adverse, and potentially life-threatening physical consequences; having a BMI so critically low that even if the sufferer does not starve to the point of organ failure, they could be left with underlying conditions such as osteoporosis or arrhythmia even if they were to get back up to a healthy weight.  

In fact, research indicates that as many as 20% of anorexia sufferers will die prematurely as either a direct, or indirect consequence of the condition, giving anorexia the highest fatality rate of any psychological disorder.

And yet, it is a condition now being casually thrown together with the term ‘managed’; definable as the ability to survive something despite difficult circumstances. And so, you can see how this dangerously misleading phrase had me somewhat mystified. How can something possibly be both fatal, and survivable?

This new phrase seems to play on the idea that a physical state of ‘anorexia’ (or, in other words, a critically low BMI) can be maintained, or ‘managed’ safely for an indefinite period without implicating serious health risks. Struggling to follow? Me to.  

Tell me if I’m wrong, but I can only see two ways this will play out - and neither of them are particularly ‘risk-free’.

First, let us consider how this concept might affect an individual suffering from anorexia. One of the biggest pitfalls in anorexia recovery and relapse is the struggle against self-denial and body-dysphoria. There is often a huge part of an anorexic which believes that they are not in fact ill, or at least not ill enough to deserve treatment. While body-dysphoria, (simply referring to having a distorted mental perception of what one looks like,) further prevents the individual from seeing themselves as they really are – so that even when critically underweight, an anorexic will not perceive themselves as anything short of healthy.  

And so, surely, by arming a recovering anorexic with the idea that a low BMI can be maintained without health risks, Managed Anorexia not only further distorts the individual's understanding of what is classified as ‘normal’, but also inflect doubt on the whole BMI system, which regards ‘underweight’ as anything below a score of 18. By normalising the physical side-effects, Managed Anorexia feeds the psychological illness, allowing the disordered mind to reject a weight-based diagnosis; raising doubts as to the seriousness of their condition, and potentially preventing them from seeking help.

Meanwhile, the concept of Managed Anorexia has the potential to be equally as damaging to vulnerable young people with no history of an eating disorder. By effectively endorsing the maintenance of a BMI below 18, the term encourages us to re-evaluate the definition of healthy. It is easy to see how this could very quickly spiral into a dieting fad – skewing the common interpretation of healthy even further down the BMI scale, leading people to desire a physical state which could incur some indisputably un-manageable health risks.  

As if treatment for eating disorders wasn’t hard enough pin down, still people insist on trivialising and even to some extent, glorifying this life-threatening mental illness. Anorexia is neither manageable, nor desirable.

And so it is, that I hereby call for a complete and immediate omission of this most destructive and insensitive term, Managed Anorexia.

For information and support  with mental health visit one of the following charities sites:
Young Minds:

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