While I would like to give a shout out to Lammily, the new doll on the market who is based on realistic body proportions, I am pretty sure that Barbie dolls don’t cause eating disorders. Neither do uber-thin models featured in the glossy pages of fashion magazines or calorie counting/exercise tracking apps on your phone. Eating disorders aren’t caused by peer pressure, an over-controlling mother, or the thin ideal. If all of the above caused eating disorders, pretty much everyone I know would have one.

Do you know what does cause eating disorders? You don’t? Neither do I. In fact, neither does anyone. Scientists and researchers are still trying to figure that out. If anyone tells you that they definitively know what causes anorexia, I bet they also have a bridge to sell you. It may not be just one cause, but a combination of factors, which helps explain why there is no  “one treatment fits all”.

It is my personal belief, based on extensive research, that anorexia is a brain based, biological illness; meaning that while it can be triggered or precipitated by external factors, it is unlikely that it is caused by them. Without the precipitating factor, it’s like a gun without bullets; potentially fatal, potentially capable of inflicting serious damage, but benign without the right ammunition. Since no one knows with any degree of certainty what the “ammunition” is that triggers anorexia in people whose brains are wired in a way that makes them predisposed to develop an eating disorder, all of the social triggers carry potential harm. This is one of the reasons that eating disorder advocacy groups are against anything that can negatively impact body image or lead to dangerous weight loss, because it can possibly trigger anorexia in someone whose brain is “wired” for it. However, that is a far cry from saying that external triggers or environmental/cultural factors actually cause eating disorders. That is like saying that flashing lights cause epilepsy. In a percentage of people with epilepsy, flashing lights may trigger a seizure; however, the cause of epilepsy is clearly found in the brain and not in the triggering lights.

Creating a new Barbie type doll with reality based proportions, forbidding digital alteration of models’ photos, stopping “fat talk”, creating school programs that promote body acceptance, etc. are all affirmative steps toward promoting positive body image and I fully support these initiatives. However, we need to also focus on different, deeper angles of eating disorders; for example, let’s take an ultra-Orthodox girl here in Israel who has never owned a Barbie doll, never opened a fashion magazine, never competed in sports or danced as a ballerina, and comes from a warm, functional, intact family—and yet, she is suffering with anorexia.

I hope that this helps explain why I want people looking for anorexia in the human brain and not pointing fingers at Barbie–I want anorexia taken seriously. I want anorexia to get significant research funding and increased treatment budgets around the world, but particularly here in Israel. I want anorexia studied, poked, and prodded until there is a working understanding of how anorexia takes hold of the human brain, whether it is preventable, and how to best treat it. I want this for my daughter and for all of the other “warrior families” out there who fight like the devil to keep anorexia from destroying their children’s lives.

During the summer craze of the ALS Bucket Challenge, I thought to myself that there would never be an Anorexia Bucket Challenge, because anorexia is widely perceived as some type of twisted lifestyle choice of the “entitled”, a diet gone awry, and not as the debilitating, cruel illness-without-a-cure that it is.  For the most part, anorexia doesn’t garner empathy. Lest anyone call me out on comparing anorexia to ALS, I have experienced both from a painfully close proximity. I watched my mother die of ALS, literally gasping for breath as the muscles that controlled her breathing shut down. I saw the fear in her eyes as she was dying and I knew that she was there, fully conscious, inside of her inert body, no longer able to control her own life in any way.

I see frightening parallels to my daughter’s fight with anorexia; it is also crippling, paralyzing, and agonizing. In some cases, it can take away a person’s independence, limit their activity and self-expression, seize control of every aspect of their life, and cut down their life plans. Just as my mother would have never chosen ALS, my daughter did not choose her anorexia. Anorexia is not just about food, it dictates behaviors that have no connection to eating. There have been times when I could not find my own daughter even when she was standing in front of me; she has been as powerless under the thumb of her anorexia as my mother was under the control of her ALS, but I knew that they were both still in there.

Obviously I am incredibly grateful that there is hope in recovery from anorexia that does not exist with ALS. Anorexia can be overcome; even if full recovery is not in the cards, functionality is possible. The sun can come out from behind the clouds.

If society is educated enough to see anorexia for what it really is, I can only hope that great strides will be made in discovering both cause and cure for this train wreck of an illness.