Struggling with Body Image Issues? ‘Almost Anorexic’ Authors Say “Full Recovery is Possible”

You don’t have to be extremely underweight to feel crushed under the pressure of body hatred. Authors Jenni Schaefer and Dr. Jennifer Thomas tell us how to fight back.

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With summer in full swing, it’s practically impossible not to stumble upon articles glorifying the unattainable “bikini body”, “thinspo” and “fitspo” images urging you to shed fat at any cost, and friends comparing their bodies to the lean limbs of the stars. And when you’re told that you’re not quite good enough (unless you lose 20 pounds) on a daily basis, sometimes, you start to believe it. While millions of people in the United States alone are struggling with full-blown eating disorders, many more are trapped somewhere between “healthy” and “disordered”.


We spoke with Jenni Schaefer and Dr. Jennifer Thomas, authors of Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem?, about recognizing unhealthy patterns, society’s thin ideal, and being a good ally to those who are recovering.

Betty Confidential: We know you’ve done a lot of inspirational work around healing/recovering from eating disorders. What inspired you to co-author Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem? How is this book different from what’s on the market today?

Jenni Schaefer-HeadshotJenni Schaefer: Thanks so much for your support of my work! When people think of anorexia nervosa, they usually think of a person who is extremely underweight.  But that doesn’t describe most people with eating disorders. In our new book, Almost Anorexic, we are reaching out to the even larger group of people who are struggling in the grey area between normal eating and a full-blown eating disorder like anorexia, bulimia, or binge eating disorder.



BC: Why was it so important to use examples of people who aren’t diagnosed as anorexic but have body image issues in your book?

Harvard Health PublicationsDr. Jennifer Thomas: Sadly, many individuals with almost anorexia never get treatment because they don’t fit the specific criteria for anorexia nervosa described in the Diagnostic and Statistical Manual of Mental Disorders (DSM).  In Almost Anorexic, it was important for us to include examples of folks who are struggling immensely with restricting, bingeing, purging, and body image disturbance—regardless of the number on the scale.  The majority of individuals with eating disorders don’t fit into a specific diagnostic box.


BC: How widespread is this issue?

JT: While only 1 in 200 adults will struggle with full-blown anorexia nervosa, at least 1 in 20 (including 1 in 10 teen girls!) will exhibit key symptoms of one or more of the officially recognized DSM eating disorders anorexia nervosa, bulimia nervosa, and binge eating disorder. (These estimates come from the National Comorbidity Survey Replication, which interviewed thousands of adults in the United States.)

BC: With social media, women and girls are constantly bombarded with “Thinspiration” or “Fitspiration” images that could be very triggering, especially for those who are struggling or have struggled with eating disorders or body image issues. How can we talk to people in our lives about those types of images?

JS: Arguably, “fitspo” sites promote an even more unattainable body ideal than “thinspo” sites. Now it’s not enough to be ultrathin—you have to have to be ultramuscular too.  But both thinspo and fitspo sites do one thing very well: make people feel bad about themselves.  It’s important to realize that many photographs on these sites are often digitally enhanced—not real. There are plenty of self-love and even anti-thinspiration pages out there. You might decide to start your own positive website, social media site, or blog!

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BC: A lot of women are tempted to lose weight, especially in the summer. How do you distinguish between healthy weight loss and something that is clearly unhealthy?

JT: Here are some questions to help you determine if you (or your loved one) might be struggling in the gray area between anorexia nervosa and normal eating:

  • Are you underweight, or does your weight frequently shift due to repeated attempts to drop pounds?
  • Do you regularly restrict your food intake by amount or variety?
  • Do you eat large amounts of food while feeling out of control?
  • Do you try to “make up for” calories consumed (e.g., vomiting, laxatives, diuretics, exercise, fasting)?
  • Does negative body image interfere with living your life to the fullest?

The more “yes” responses you provide, the more likely it is that your relationship with food is problematic. But please know that freedom is possible. You (or your loved one) can take steps to make peace with food—whether you struggle with anorexia nervosa or a subclinical variation.

BC: What are some things people could do to support those with eating disorders or body image issues and things we should never do?

JT: This is such an important question that we created a table called “Dos and Don’ts of Supporting a Loved One.”  You can check it out here.

BC: One of the things that haunts me most about my own experience with an eating disorder was that even though I was clearly struggling, other people told me that my body “looked great”. How do you handle that? What do you say?

JS: This happened to me too!  When I first started losing weight, my college friends (ones who had just met me) gave me tons of compliments. Only my high school friends (who knew me before at my normal weight) expressed concern. I can’t say that I handled either situation perfectly. Later, when I was in recovery from my eating disorder and restoring my weight, I got better at using my voice. Sometimes, well-meaning friends and relatives, noticing my much-needed weight gain, said, “We’re so glad you’re feeling better!” Although I was incredibly grateful for their support, I started explaining to them that my body weight wasn’t a barometer of my mental health. If they wanted to know how I was doing on the inside, they would need to ask me directly.

BC: Do you believe that our society’s preoccupation with the thin ideal helps foster a culture of disordered eating? What are ways we can combat that?

JS: After repeatedly being told by people who had read my first book, Life Without Ed, “I don’t have an eating disorder, but I do have an Ed in my head,” I decided to name the voice that seemingly everyone was hearing. It was almost like society itself had an eating disorder, so, in my next book, Goodbye Ed, Hello Me, I named that voice “Societal Ed.” Societal Ed lives in so many places—from movies and television to magazines and online advertisements—that you can hardly avoid hearing “his” pervasive message that our bodies aren’t good enough. But we don’t have to listen.  If you want to fight Societal Ed proactively, check out the National Eating Disorder Association’s Media Watchdog program. (For those who aren’t familiar with my work, Ed is an acronym for “eating disorder.” In therapy, I learned to treat my illness like a relationship—rather than an illness or a condition. Ultimately, I “divorced” Ed!)

BC: What are a few ways to be more body positive in our own lives?

JT: I write prescriptions for retail therapy!  Most people with almost anorexia have an almost anorexic closet to match, with a wide range of sides including clothing that only fit them when they were thinner, to baggy shapeless clothes they wear when feeling “fat.”  I say, step away from the skinny jeans.  Go out and buy yourself an outfit that fits you now, not 5 lbs from now.

BC: What are resources for those who are struggling with eating disorders or body image issues?

JT: If you are worried about yourself or a loved one, please visit to complete a free and confidential screening.  To find a health professional in your area who specializes in eating disorders, visit,, or

BC: If you could go back and tell your struggling self one thing, what would it be and why?

JS: I needed to hear this: Full recovery is possible. Unfortunately, I didn’t hear that in the beginning of my recovery process. However, eventually, both clinicians and those who had recovered themselves began sharing this important message with me. In Almost Anorexic, Dr. Thomas and I encourage people, “Don’t settle for barely recovered.”

Diana Denza is BettyConfidential’s contributing editor. 

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6 thoughts on “Struggling with Body Image Issues? ‘Almost Anorexic’ Authors Say “Full Recovery is Possible”

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