The Resurgence of “Skinny Culture” and Its Impact on Eating Disorders

Are we mentally prepared for the return of skinny culture?

Cultural ideals around body size have continually shifted, with periods of intense thinness idealization seen in the flapper era of the 1920s, Twiggy-inspired fashion of the 1960s, and “heroin chic” of the 1990s. ^[1]

We are now seeing the resurgence of “skinny culture”, which has renewed concerns about the impact of idealizing thinner bodies and the development and maintenance of disordered eating and eating disorders.

With the popularity and accessibility of weight loss medications, thinness is increasingly idealized across social media, fashion, and celebrity culture.

This can intensify body dissatisfaction, weight and shape preoccupation, motivation for cosmetic procedures, and restrictive eating behaviors. ^[2]

For those vulnerable to eating disorders, these messages can reinforce harmful beliefs about thinness, control, and self-worth, potentially contributing to the development, maintenance, or relapse of disordered eating.

The role culture plays in eating disorders and body dysmorphia

Eating disorders are complex, and there is rarely one single cause. But the culture we live in matters. When thinness is repeatedly associated with health, attractiveness, and success, it can shape how people come to view their own bodies.

For people who may be vulnerable to developing an eating disorder, the constant exposure to idealized bodies, weight-loss content, and diet trends can fuel comparison, body dissatisfaction, and preoccupation with food, weight, and shape. It can also make recovery harder when behaviors someone is trying to move away from are being praised or normalized around them. ^[3]

Culture does not cause eating disorders in isolation, but it can create an environment in which disordered beliefs and behaviors are easier to develop and reinforce and harder to challenge.

Media

Social media has changed the way we are exposed to body ideals. Rather than occasionally seeing an airbrushed image in a magazine, we are now surrounded by curated, filtered, and edited bodies every time we open our phones. This creates almost constant opportunities for comparison, often without us knowing what is realistic in the first place. ^[4]

Algorithms can compound this further; engaging with even a small amount of weight-, fitness-, or body-related content can lead to more of the same appearing in our feeds. For someone already struggling with their body image or relationship with food, this can quickly create an online environment that reinforces the very beliefs they may be trying to challenge. ^[4][5][8]

Social media can be positive. Recent research suggests that body-positive social media can improve body satisfaction, appreciation, and mood. However, its impact on social comparison and body surveillance is more limited, and keeping the body at the center of attention may inadvertently maintain appearance-focused thinking. ^[6]

Medicine

The rise of weight-loss medications has added another layer to our changing relationship with body size. These medications have an important and legitimate role in healthcare, but their place in popular culture has also made weight loss a much more visible part of everyday conversation.

Celebrity transformations, before-and-after images, and discussions about appetite and weight can reinforce the message that becoming smaller is both achievable and desirable. For people struggling with body image or recovering from an eating disorder, this renewed cultural focus on weight loss may be particularly difficult to navigate. ^[7][8]

Wellness

Wellness has turned into a concept that often encourages us to spend money. We see a variety of products, such as supplements, fitness programs, trendy diets, wearable tech, and carefully structured routines, marketed as ways to become healthier and better versions of ourselves.

While there is nothing inherently wrong with wanting to look after our health, the line between wellness and diet culture can become blurred.

Restriction can be reframed as “clean eating”, weight loss as a “lifestyle change”, and constant monitoring of food and exercise as self-care.

It is worth asking when looking after ourselves stops being about feeling well and starts becoming another standard we feel under pressure to meet.

What is influencing the rise of skinny ideals?

The resurgence of thinness as a beauty ideal is being driven by a confluence of cultural factors. These factors are many and complicated, but three central aspects can be highlighted to explain the rapid change in body ideals. These include the fading influence of the body positivity movement, the widespread normalization of weight-loss medications, and the algorithmic reinforcement of restrictive behaviors on social media.

The decline of body positivity

The body positivity movement helped challenge the idea that there is only one acceptable way for a body to look. Lately, that message has become less prominent, with thinness once again becoming increasingly visible and desirable in popular culture. ^[5][6]

At the same time, we should be careful not to respond by simply shifting scrutiny onto thinner bodies. Comments about celebrities looking “too thin”, “unhealthy” or having “lost too much weight” still involve analyzing and judging someone’s body from the outside.

This could reinforce a current problem: the idea that our bodies are only meant for judgment, evaluation, and discussion. A healthier cultural shift might involve adopting body neutrality, which emphasizes caring less about appearances in general rather than simply switching from one beauty standard to another.

GLP-1 normalization

GLP-1 receptor agonist medications were developed for type 2 diabetes and are now prescribed for weight management due to their appetite-suppressing and weight-loss effects. ^[7]

The rise in availability of GLP-1 medications has made medically assisted weight loss more noticeable and accepted in society. There has been a significant shift in online culture, especially among influencers and content creators. A lot of those who used to promote body positivity are now shifting their focus to weight loss.

Discussions around appetite suppression, weight loss, and the use of GLP-1 medications are popping up more frequently on social media. This change sends a concerning message that we should try to suppress hunger and that gaining weight is something to dread. This is especially problematic for those who may already be dealing with restrictive eating habits or who place importance on their weight and appearance. ^[7][8]

“SkinnyTok” and other social fads

“SkinnyTok” is just the latest chapter in an ongoing issue. Content that emphasizes thinness, dieting, daily eating habits, and body transformations often promotes restrictive eating, constant body checking, and unhealthy comparisons, presenting these behaviors as healthy or aspirational. For individuals susceptible to eating disorders, seeing this kind of content too often can alter their views on what’s considered normal and exacerbate their worries about food, weight, and body shape. ^[9]

The current body pressures affect not only women but also boys and men. Men may be less likely to talk about these pressures. ^[8]

GLP-1 misuse and eating disorders

The increasing use of GLP-1 medications raises important questions about their relationship with disordered eating. For someone already vulnerable to developing an eating disorder, appetite suppression may reinforce restriction and strengthen existing beliefs about thinness, control, and self-worth. It can also make it harder for someone to trust their body and to understand their usual hunger cues. ^[7][8]

It's important to recognize that the risk is not limited to those with a history of eating issues. Weight loss can be incredibly reinforcing, especially when it leads to positive feedback from people around us.

People using GLP-1s should pay close attention to when medical support shifts from being beneficial to becoming rigid and unhelpful. This can happen when someone starts to fear hunger, feels that gaining weight is unacceptable, and places a growing psychological importance on being thinner. ^[7][8]

Identifying an eating disorder

Eating disorders are complicated mental health issues that impact not only those who struggle with them but also their friends and family. They involve much more than just concerns about food or weight; they are linked to a variety of emotional and psychological challenges.

Recognizing the seriousness of eating disorders is an important first step in the healing and recovery process. It's important to recognize that these disorders are relatively prevalent, affecting around 9% of Americans at some stage in their lives. ^[2]

Eating disorders do not have a particular “look”. Someone can be struggling significantly regardless of their weight, body shape, age, or gender. The first signs are usually changes in someone’s relationship with food, exercise, or their body: becoming increasingly preoccupied, anxious, or rigid; avoiding situations involving food; withdrawing socially; or placing more and more importance on weight and appearance.

Presented next are various types of eating disorders with the different presentations they may have.

Anorexia nervosa

• Significant reduction in body weight.
• Wears multiple layers to conceal weight loss or to keep warm.
• Constantly thinks about weight, food, calorie intake, fat content, and dieting.
• Regularly expresses feelings of being “overweight”.
• Struggles to keep a healthy weight that matches their height, age, and body type.
• Follows a strict and intense exercise routine regardless of weather conditions, tiredness, illness, or injury.

Bulimia nervosa

• Engages in episodes of consuming large quantities of food within a short timeframe, often in secret.
• After binge episodes, frequently partakes in compensatory actions such as self-induced vomiting, use of diuretics or laxatives, fasting or restricting food intake, excessive exercising, or altering insulin dosage.
• Consumes excessive amounts of water or non-caloric drinks and/or uses large quantities of mouthwash, mints, and chewing gum.
• Displays cuts and calluses on the fingers, particularly over the joints, as a consequence of inducing vomiting.
• Experiences dental issues related to purging, which may include enamel wear, bleeding gums or periodontal issues, temperature sensitivity, cavities, tooth discoloration, dry mouth, swelling of the salivary glands, and difficulty swallowing.

Binge eating disorder

• Partakes in episodes of consuming large quantities of food in a brief timeframe, often in private (consuming significantly more food than most people would typically eat under similar conditions).
• Feels an inability to control the urge to stop eating.
• Experiences feelings of shame, guilt, and hopelessness following binge-eating episodes.
• Conceals or reserves food in unusual locations.
• Establishes routines or rituals to allocate time for binge-eating sessions.
• Changes in typical eating patterns can include eating at irregular times rather than sticking to a set schedule, sometimes missing meals, taking very small portions during regular mealtimes, and alternating between different dieting methods or practicing inconsistent fasting.

Atypical eating disorders/other eating disorders

• Substantial limitations, episodes of overeating, compensatory actions, or an intense focus on food may be observed.
• The individual's challenges might bear a close resemblance to anorexia or bulimia, even if they do not fulfill all the diagnostic criteria. These symptoms can lead to significant distress and functional impairment.
• Failing to satisfy the complete requirements for anorexia or bulimia does not indicate that the issue is any less severe.
• Avoidant/restrictive food intake disorder (ARFID).
• Weight loss isn't always a feature of ARFID; significant weight loss or slow growth can indicate restrictive eating habits.
• Individuals often have a limited variety of acceptable foods, which may become even more restricted over time (essentially worsening disordered eating).
• There may be fears related to choking or vomiting, but there is no concern about body image or anxiety over weight gain.

Body dysmorphic disorder

• This involves an ongoing focus on a perceived issue or imperfection in one's physical looks.
• The flaw may be minor or not noticeable to others.
• This can lead to behaviors such as frequent checking, comparing, grooming, hiding, or seeking reassurance.
• It often results in considerable distress related to one's appearance.

How healthcare professionals treat eating disorders

Eating disorders are typically treated through a multidisciplinary approach combining psychological therapy, nutritional support, and physical health monitoring. Treatment options involve specialized therapies, like cognitive behavioral therapy for eating disorders or family-based approaches, as well as medical supervision and management of any accompanying mental health issues. In cases where there are serious physical or psychiatric concerns, a more intensive level of care, such as day-patient or inpatient treatment, may be necessary.

It is possible to rebuild a healthy relationship with food after an eating disorder with the right support. These tips on building a healthy relationship with food can support you during your recovery, but they are not a substitute for professional medical advice. Always consult a healthcare provider for personalized guidance.

What can be done to improve how eating disorders are treated?

Improving eating disorder care requires earlier intervention, better access to specialist services, and a more individualized approach to recovery. This includes moving away from an over-reliance on weight-based metrics towards holistic, whole-person indicators of physical and psychological health. Greater consideration of harm-reduction approaches in medical care may also help engage and support individuals who are not yet able or ready to pursue full recovery, while reducing immediate risks and maintaining connections to services.