Girls, Food, and Body Image: A New Book and an Old Problem
When Charlotte Markey started teaching a class on the psychology of eating, she was surprised by what her students didn’t know. “Why didn’t I know about this sooner?” they often asked, when she showed them the data suggesting that, for example, diets don’t work.
So Markey, a psychology professor at Rutgers University-Camden who lives in Swarthmore, decided to write a book. “Smart People Don’t Diet” came out in 2014.
But a few years later, when her children were finishing elementary school, Markey saw how little information about eating and body image was available for kids. Perhaps a different kind of book could fill that gap.
“The Body Image Book for Girls: Love Yourself and Grow Up Fearless” was published by Cambridge University Press this month. Geared to girls between nine and 15 years old, it mixes research-based information with Q&As, myths and misbeliefs, and girls’ stories told in their own words.
Markey had recently received advance copies of the book when she visited my porch one afternoon last month for a conversation with another visitor, Emma Borgstrom, a 21-year-old Temple University student and Strath Haven High School graduate, who struggled with an eating disorder for years.
What Is Body Image?
“Body image is typically defined as one’s thoughts and feelings about their body,” Markey explains. “I’ve expanded that definition to be more inclusive — how we think about ourselves, our appearance, and our bodies’ abilities.” The book explores a wide range of topics, including body hair, the problematic pleasures of primping, body dysmorphia, advice on ways to relax, and how published photos of celebrities routinely get digitally modified.
“I wanted the book to be accessible,” Markey says. “But also to be real.”
Issues around eating and body image are complicated. But the evidence is clear, Markey says, that people with a poor body image are particularly vulnerable to anxiety, depression, and eating disorders — including anorexia, bulimia, and binge-eating disorder. And the stakes couldn’t be higher. Markey says that eating disorders have the highest fatality rate among all psychiatric disorders: 10%.
Emma Borgstrom deadlifting behind her house in Swarthmore. Photo: Katarina Borichevsky
A Survivor’s Story
Borgstrom (whose father is Swarthmorean publisher Rob Borgstrom) says her eating disorder started in middle school. But it was in high school, when she began running cross country, that it became severe. Intensely focused on exercise, she began burning more calories than she consumed. This situation can lead to brain function changes that leave people unable to think clearly. And it makes them acutely vulnerable to social and media pressure, Borgstrom explains.
In other words, too much exercise led to body image issues, which led to more exercise. Borgstrom also began to restrict what she ate.
For a while, though, she managed to hide what she was doing from her family and — largely — from herself. “I always pictured that I was hovering above a red line,” she explains. She convinced herself that she was well enough to stay in sports. She believed she looked healthy enough that no one would suspect anything was wrong.
Eventually, though, her parents did get worried. They took her to a sports nutrition therapist who believed that Borgstrom could manage her issues as an outpatient.
Far From Home
In 2017, Borgstrom graduated from high school and left home to attend the University of Vermont. She convinced her parents she would be fine. She told them she would do better away from the familiar triggers at home.
She was wrong.
On her own for the first time, Borgstrom crashed. She was so strict about what she ate that eating with others became impossible. Her thoughts were scattered. She couldn’t concentrate on her schoolwork. “I failed all the assignments I had when I was at Vermont,” she recalls.
On the phone from Swarthmore, her parents could tell something was wrong. In October, her mother urged Borgstrom to go to the counseling center, but there were no appointments available for weeks. She did go see a physician, which led her to learn just how much weight she had lost. “I didn’t know how to stop it,” she says.
Even more frightening, her heart rate was extremely low. “I remember one night, I was lying on my bed, trying to get to sleep, and I couldn’t,” she recalls. “I couldn’t get comfortable on my own mattress, because I was so fragile.” And she feared that, with her heart rate so low, if she fell asleep, she wouldn’t wake up.
Understanding that Borgstrom was in real danger, her mother drove to Vermont and brought her to the Children’s Hospital of Philadelphia. She spent the next month as an in-patient there, getting stable enough to begin her recovery.
“I hit my own rock bottom,” Borgstrom says. “It woke me up to the fact that I wanted a life beyond something so restrictive.”
Turning Things Around
After withdrawing from school and spending a year focusing on getting well, Borgstrom transferred to Temple University in Philadelphia. She quit running and started weightlifting. Hoping to become a therapist, she changed her major from kinesiology to social work.
And, with her mother, Tracey Borgstrom, a nurse, she started a blog. “Rooted” aims to spark honest conversations about eating disorders.
She also started giving talks to high school girls. Visiting health classes, she described what it can look like when someone has an eating disorder. She provided statistics and encouraged the girls to talk. Girls in those sessions seldom spoke about themselves directly, but they would ask about a friend, or the sister of a friend. “Everyone in the class had some connection to somebody who’s struggled with disordered eating, an eating disorder, and body image issues,” Borgstrom says.
At the end of the first session, she decided to put her email address on the blackboard. She didn’t know if anyone would use it. But they did.
Conversations with Girls
Charlotte Markey at home with her daughter, Grace. Photo: Charlotte Markey
Markey’s book is based in part on surveys of and conversations with girls. Lots of girls.
At first, she connected with them through friends who had teenage daughters. She was looking for positive stories to tell, so she asked her friends to send girls her way who felt good about themselves. But often, when she talked to them, she learned that those girls struggled, too.
Markey says that the deeper she got into conversations with her sources, the more issues she realized she had to cover. They would tell her that their friends were sending naked selfies to their boyfriends, or wonder what to do if their uncle made a comment about their breasts, or ask about depression. “There aren’t always easy answers,” Markey says. “The book just kept growing.”
Girls aren’t the only people she talks to. Every year, she meets with medical students to discuss how best to talk with kids about dieting and weight. Many doctors, she says, “make a lot of recommendations that can put people on an unfortunate trajectory.”
Borgstrom agrees. “Going to the doctor is sometimes the first time kids start to think about their weight. For me it was like, ‘Oh, I saw that right there on the chart. Am I on the right side?’”
She also notes the many ways that society pressures girls to look and behave in certain ways. “As girls, we’re always complimented for being pretty,” Borgstrom says. “Or, ‘You’re so tiny.’ I wish, growing up, there were more compliments like, ‘You looked really strong when you were playing soccer.’”
Looking Ahead
Borgstrom recently talked about her eating disorder on a friend’s podcast, and got a strong positive response from listeners. Now she’s working on a podcast of her own, which she hopes to release next spring.
Despite the problems girls face, Markey says she is heartened by the improvement from the way things were in her generation. Nowadays, “even the ones who struggle, or are not sure how they feel about themselves, are often very articulate about it,” she explains. She’s heartened, too, by how girls’ ambitions for their lives have expanded over the years. “They’re talking about becoming chemical engineers.”
And she’s well aware that girls aren’t the only ones who struggle with body image. Her next project? “The Body Image Book for Boys.”
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