Content warning: This story contains detailed descriptions of eating disorders and fatphobia.
The funny thing about hunger pangs is that, eventually, they stop. Or, at least, they subside. Your body gets used to that gnawing pain in your gut, a testament to its incredible resilience. If you stop eating for long enough, eventually your stomach will give in, will contract, and you can fill it more quickly and less frequently.
I first discovered this little trick—the digestive system’s secret trump card—in my first year of university. I’d hovered somewhere around that medical line between “overweight” and “obese” for basically my whole life. I don’t remember a time during my childhood where I could peer down at my feet and see my belt buckle without my stomach blocking my view. I could hardly run on the playground without losing my breath. Gym class was a living hell, and the weight-related torment I endured from my classmates throughout my childhood and adolescence didn’t make things any better.
“The two insults most often hurled my way were ‘fatty’ and ‘faggot,’ and they were usually spoken with the same breath.”
My fatness became synonymous with the burgeoning—and, at the time, horrifying—realization that I was a flaming homosexual. The two insults most often hurled my way were “fatty” and “faggot,” and they were usually spoken with the same breath.
But by the end of high school, I managed to shed about 30 pounds of weight through diet and exercise. “Healthy weight loss,” some might call it. I still hated looking at myself, and I still wouldn’t swim for fear of being seen in a bathing suit, but it was a bit easier to find clothes that fit, and the bullying stopped.
But then came university. Suddenly, my time became completely consumed with my program—a combined honours in both journalism and humanities at Carleton University. When I wasn’t at school, I was at work, on my feet for 25 hours a week as a barista at a local coffee shop, picking up extra shifts to pay off my degree.
I was also newly out, and beginning to navigate the sometimes seedy, often embarrassing realm of dating as a gay man. Fatphobia within the queer community, and particularly among men who have sex with men, is well-documented, but its prevalence is so beyond what any single study can capture.
Trying to date, to seek love and acceptance from strangers who were riddled with the same social burdens and internalized prejudices I was, exacerbated the already strained relationship I had with my body. I remember several dates where my body got scanned by the other guy, and they heard my lispy, high-pitched voice for the first time. I would see a flicker in their eyes temper, and they’d have to leave suddenly, something had come up. On several occasions I got left alone at the café or the bar or the park or wherever we had decided to meet.
I also had chronic acne, the kind that covers your face and bulges and blisters in puffs of deep red. The only thing that seemed to work was Accutane, an extremely powerful pill that dries out the oils on your face to kill the acne at its root. It also puckers your lips, dries out your eyelids, and can, in some cases, cause or worsen anxiety and depression, which is exactly what it did to me. I started having severe panic attacks and grew profoundly depressed. Nothing in my life was under my control; not my mental health, or my time, or my love life, not the fact that I was gay, or the way people looked at me. The only thing I could control, I felt, was what I put in my mouth. So I decided to stop eating.
During the first two years of my degree, I counted every calorie I consumed using a fitness app. The average man is supposed to consume about 2,500 calories each day—I usually reached about 800. The app allowed me to gamify what I now understand was an eating disorder. I began rapidly losing weight, and got praised by almost everyone in my life for it. I started seeing better results in my dating life—more matches, more second dates, more compliments from strangers about my appearance.
I weighed myself obsessively, often multiple times a day. I felt successful if I woke up at one weight and went to bed a couple pounds lighter, because I knew I’d burn more weight as I slept. Within a few months, I’d dropped more than 70 pounds. (The Centers for Disease Control and Prevention says it’s unhealthy and unsustainable to lose more than two pounds per week, or eight per month). And yes, as my desire to be thin superseded my need to be healthy, the pain of self-induced hunger became a part of me and, eventually, that pain did slowly ebb away.
Deprived of caloric energy, I became physically weaker. I was plagued by constant fatigue, I couldn’t sleep deeply and my hand would often tremor, a visual indicator of my body quietly emaciating itself. My mind was weaker, too. I couldn’t concentrate; everything was a bit out of focus. I don’t remember much about that time in my life, but I remember the constant sense of paranoia—worry over whether my gut was visible through my shirt, absent-mindedly wondering if the scattered laughter of strangers was prompted by my disgusting body. My only small moments of relief came from two things: fleeting compliments about my appearance and the diminishing sum on my scale.
The eating disorder I had—and have—came about largely as a result of my queerness. More precisely, it came about as a result of the complicated social stressors associated with being queer. And I’m not alone. Although there is a dearth of recent studies on the intersection between sexual and gender identity and eating disorders, the limited data that is available is alarming. One study from last November found that sexual minorities experience eating disorders at “higher” rates than cisgender, heterosexual people. It also found that trans men self-reported eating disorders five times more often than cisgender folks of any sexuality. Trans women self-reported eating disorders four times more often.
“Racism, homophobia, transphobia, settler colonialism—environmental factors can sometimes keep people stuck with an eating disorder.”
This study did not include data on non-binary, gender questioning or other gender minorities, although non-binary people do experience many of the same stressors that are thought to result in eating disorders, including dissatisfaction with one’s body and higher rates of mental illnesses like anxiety and depression. (One study even found that non-binary and gender questioning individuals actually experience “significantly higher” rates of anxiety and depression than binary transgender folks.)
Ary Maharaj is the outreach and education coordinator at the National Eating Disorder Information Centre (NEDIC), a Toronto-based organization that circulates information about eating disorders and provides a toll-free helpline. He says queer and trans folks’ high rates of disordered eating are largely fuelled by external and internal stressors that come as a result of their identities—what is more formally known as “social determinants of health.”
“Racism, homophobia, transphobia, settler colonialism—environmental factors can sometimes keep people stuck with an eating disorder,” Maharaj says.
Maharaj is careful to differentiate between these environmental factors, which can perpetuate eating disorders, and things that cause them in the first place. “What causes an eating disorder are the things that put people at risk,” he says, such as biological and hereditary predisposition and psychological risk factors like unhealthy perfectionism. These can also include what he calls “sociocultural risks,” like being bullied as a young person, experiencing discrimination or being exposed to impossible beauty standards on social media. “For queer, trans, gender diverse folks, the way in which society is treating them might put them more at risk for an eating disorder.”
Once an eating disorder develops, those same factors can prevent recovery. “What can keep people stuck in an eating disorder is society potentially not treating you well, and you feeling like you don’t really have other coping behaviors to go to,” he continues. “It might be really reasonable for you to think about wanting to change your body in order to preserve relationships or maintain control over an unchanging world.”
For Maharaj, the ideal solution is to change that world. The only sure-fire way to ensure social risks like homophobia and transphobia don’t contribute to the development of any more eating disorders—or any other mental illnesses—is to eliminate homophobia and transphobia altogether.
“Creating accepting, inclusive, positive spaces where we’re able to celebrate people, regardless of their sexual orientation or their gender identity, also counts as eating disorder prevention,” he says.
But Maharaj acknowledges that broad societal change doesn’t happen overnight. The need for innovative prevention and treatment aimed specifically at LGBTQ2S+ individuals is urgent and overdue. Practical, small-scale change is necessary.
On a medical level, one of the most effective treatments for eating disorders is cognitive behavioural therapy (CBT), a leading form of psychotherapy that effectively rewires patients’ brains by differentiating between core beliefs, rational thoughts and reality. Research has shown that mental health professionals can employ CBT to help those with eating disorders monitor and improve eating and binging habits while also challenging and improving patient’s narratives surrounding their bodies.
“It’s crucial that treatment providers incorporate a ‘minority stress framework’ into their care.”
But according to Stephanie Cassin, an associate professor of psychology at X University (formerly known as Ryerson University) and a disordered eating expert, CBT alone will not adequately address the needs of queer and trans folks. “Sexual and gender minority folks experience some unique stressors that place them at greater risk of developing eating disorders, such as anorexia nervosa, bulimia nervosa and binge eating disorder,” Cassin says in an email.
For Cassin, it’s crucial that treatment providers incorporate a “minority stress framework” into their care. She says this can mean the unique challenges queer and trans folks endure, while also fostering a sense of community and “emphasizing their unique strengths and resilience.”
Cassin adds that this kind of treatment could be accessed through centres that serve the LGBTQ2S+ community, and would be best administered by trained peer support workers with relevant lived experience. Identity-oriented resources are hard to come by in Canada, but in a 2019 report, Theresa Tam, the nation’s chief public health officer, acknowledged their vitality, citing stigma against marginalized communities as a dangerous symptom of the way Canada’s health system is currently set up. “These many forms of stigma that intersect in complex ways are very much present in our health system, driving those most in need from getting effective care and accessing services,” Tam wrote. “It means that we, as health system leaders and practitioners, are contributing to negative health outcomes.”
That kind of treatment is not just a theoretical ideal. Sookie Bardwell and Zachary Grant have made it a reality.
“I realized I could create the change I wanted to see in the world.”
Bardwell and Grant are the facilitators of Trans, Non-binary & Gender Questioning Support, an eating disorder support group created exclusively by and for trans, non-binary and gender questioning individuals. Since 2018, Grant and Bardwell have run the group out of Sheena’s Place, a Toronto-based eating disorder support centre. During the pandemic, meetings have been happening each week over Zoom. The group allows for open discussion about gender identity, eating disorders or any combination of the two among people who share similar experiences.
The concept for the group first came to Grant when they were finishing up a bachelor’s degree in social work. “At the time, I was struggling with my own eating disorder, and over and over I kept seeing people on these support forums asking ‘Where’s the help for trans people?’” Grant says. “Everyone said, ‘It doesn’t exist.’”
“I realized I could create the change I wanted to see in the world.”
Grant approached Sheena’s Place with the idea, asked Bardwell, a body liberation educator, to co-facilitate and launched the support group. (Grant also runs a separate group out of Sheena’s Place more broadly aimed at any LGBTQ2S+-identifying folks struggling with disordered eating.) The weekly sessions last about an hour and a half. Grant said they typically begin with a five-minute quiet period, followed by introductions and icebreakers. Then comes the meat of the session: Grant and Bardwell lead a roundtable discussion about how everyone is faring and how their disordered eating has been affecting them. The session, on the surface, isn’t run much differently than other eating disorder support groups, but the fact that everyone in the session shares a common experience allows for more nuanced and, ultimately, more effective discussions about how to deal with disordered eating. Typical topics, like access to eating disorder support services and approaching medical professionals, are mixed in with subjects like gender transition and dysphoria, providing a more liberating environment that is virtually non-existent elsewhere–according to Grant, theirs is the only group of its kind in Canada.
Sheena’s Place approaches eating disorder treatment and support in unconventional ways—ways that Grant says mitigate discomfort, smash stigma and produce better and more lasting results in the people that are a part of the group. For one, Sheena’s Place discourages people from naming their eating disorders. “I don’t think eating disorders tend to fit so nicely into diagnostic criteria,” Grant explains. “Whether we’re talking about restricting or binging and purging, or any other eating disorder symptom, the reality is there’s something else going on.”
Grant and Bardwell’s group attempts to cut a bit deeper than their attendees’ relationships with food—it’s a safe space for people to unpack how they developed those relationships in the first place.
“It’s not that an eating disorder is all that different in anyone, whether you’re folks of colour, trans folks or disabled folks,” says Grant. “It’s that there are aspects of people’s identities that need to be thought of in the context of recovery.”
For Bardwell, one of the most effective aspects of the program is the fact that both they and Grant have lived experiences—both as non-binary people and as people who have experienced disordered eating.
“In the context of distressed and disordered eating, providing support isn’t something that relies on having lived experience, but it’s bolstered by it,” Bardwell says. “I am a non-binary woman, and I move through the world in a way that really confounds the people around me. They might assume that I am a very large-chested, white, cisgender man, maybe, but the configuration of my face doesn’t seem to quite track, and when I start speaking they’re even more confused.”
Having people like Bardwell and Grant facilitate the group—people who understand firsthand, on some level, what the attendees’ lives outside of the group are like—allows for a baseline respect and comfort that fosters deeper, more impactful conversation. “There’s a mutual understanding that everyone in this space has a relationship with gender that is somewhere outside of this cisgender assumption we make in this colonial, binary system which we’re living our lives in.”
But there’s limitations to a group like this. In order to keep it working for everyone, group participation is capped at 18 people per season, meaning some people inevitably get turned away, and resources like this one are few and far between. The pandemic has allowed folks from outside of Toronto to access the group, but it’s still only available to people within Ontario. And eating disorder resource hubs like Sheena’s Place are also rare, mostly only existing in highly urbanized and densely populated cities like Toronto and Vancouver.
Although they can’t say exactly what the results of the group are (there is no ethical way to accurately track the progress of attendees after they’ve finished with the group), Grant believes the group’s success can be measured by the high morale of the people in it.
“It’s closer to a family than anything else, and I think that speaks to how this sort of programming is needed,” Grant says. “That sense of community is one of the first steps of dismantling eating disorders and working towards recovery.”
When I started my own long, arduous and probably eternal road to recovery, I craved that sense of community. My journey with my eating disorder has been defined by solitude; I believed, in those dark university days, that nobody understood me, and that I could only be understood or loved if I emaciated myself. For years, I fought wars against my mind alone and nothing changed. I starved myself until my stomach was as hollow as I was, and sunk low.
My lowest point came during finals week in second year. Ravaged by deadlines and deprived of nutrition, I made a pilgrimage to my school library’s “silent floor,” a pseudo-liminal space where nobody is allowed to make any noise—the perfect place to pump out the several thousand words I needed to in order to pass my classes. I think I was trying to write something about the Biblical Judith, but, paralyzed by panic, I couldn’t get the words out. My breath quickened; my body froze. It felt like my heart was stopping.
I ran to the bathroom and went to a stall. Crouched on a toilet, I remember howling; I was shaking violently, and all I could do was try to cry to get some emotional catharsis, but the tears just wouldn’t come. I called my mom, barely able to speak, but managed to get out that I needed to get home.
The panic gripped me overnight, lasting even as I woke from a troubled sleep. Eventually it subsided, and I confessed to my mother the mental health issues that had been ruling my life. I immediately got into intensive cognitive behavioural therapy, and after about a year of bi-weekly sessions with a caring but firm psychologist, my anxiety began to improve. Only then was I able to begin to work on my relationship to food and to my body.
My eating disorder, like my anxiety, has never truly gone away. Through years of CBT, I’ve been able to keep it at bay, but every time I eat food or look in the mirror a small, profoundly sad piece of me leaps upward, trying to tell me how ugly I am, or how disgusting I’ll become if I eat. Mostly, I can tamp him down, and I force myself to eat at least three full meals every single day, no matter how loud he gets.
In reporting this story, I often found myself wondering where I might be if I had a group that offered peer support, or if I had been given the tools earlier to figure out how my queerness exacerbated my disordered eating patterns. I was lucky to have a mother who supported my recovery, and to have the ability and privilege to quickly access life-changing medical resources. But even throughout that process, the way my identity and its associated social baggage intersected with what I was going through was hardly addressed.
But what-ifs are of no use to me now. I’m happy to report that I’m the best I’ve ever been—my anxiety is under control, and I’m no longer depressed. I eat what I want, when I want, and I haven’t weighed myself in years. I spend most days writing, and most evenings with a community of queer folks I’ve built around me. And those hunger pangs don’t plague me anymore—not because I’ve numbed myself to them, but simply because I’m full.
If you are experiencing an eating disorder and need support, contact the National Eating Disorder Information Centre’s toll-free helpline at 1-866-NEDIC-20 or visit their website at nedic.ca.
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