Thin, Sick, and Nearly Dead
The Dangerous Dark Side of Trying to Be Well in a World Where Nothing is Ever Enough
By Kaci Baez
* This article contains content that may be triggering for some.
When Janice* arrived at an eating disorder rehabilitation center in her early 20s, she was at her wits’ end. Her severely disordered eating habits, a result of unaddressed early trauma, went unacknowledged through childhood and spiraled as she worked to maintain good grades and pretend she was fine. But she wasn’t. When she finally made her way into a treatment center, what she got wasn’t rehabilitation, but destruction disguised as help: a quick, inadequate evaluation, misdiagnosis, and a variety of neurological pills that only made her symptoms worse and put her in frightening medical withdrawal after she left.
While at the (now) poorly-reviewed 2.9-star treatment center covered by her insurance, Janice was forced to count calories, have frequent weigh-ins, and talk about why she wasn’t afraid of donuts in group therapy. She, like countless others, was made to leave after 30 days and had no aftercare plan. Janice quickly went off her medication, and her health worsened for several years as she dealt with the long-term side effects of taking unnecessary, dangerous, off-label brain meds that she did not need.
Some residents at the treatment center later died from their disease. Janice somehow made it through her extremely long eating disorder episode on her own, she said, despite “nearly dying multiple times.”
Eating disorders, including bulimia, anorexia nervosa, and binge eating disorder, have the second-highest mortality rate of any mental illness, following opioid overdoses. According to a 2020 report, that's one death every 52 minutes.
For a while, Janice said that things seemed a little better. The mass whitewashed heroin-chic body-shaming of the ‘90s and 2000s had eased up. The body positive movement took hold. Hell, people even listened to what women had to say for a while during the “Me Too” years. Janice tried to shift her focus.
But a new generation of mass thinness hysteria has taken hold of the world, and we have lost the plot. There is no safe place for Janice or literally anyone right now if you have body dysmorphia, an eating disorder, are recovering from an eating disorder, or are generally alive in any way.
A new cult has taken over; better hold onto your hats. We’re in a real-life Hunger Games meets Black Mirror era, a for-profit societal promise of perfection guaranteed, if you make it off of this comparative, gamified, mass-promoted weight-loss deprivation island alive.
The widespread message that thin equates to happiness is knowingly harming children.
A study of American elementary school girls reported that 69% of elementary school students are influenced by images in magazines of ideal bodies; almost half stated that the pictures made them want to lose weight. It is well documented in research that if a mental illness such as an eating disorder develops in childhood, and it's not addressed right away, the chances of effectively treating it later in life are much, much smaller.
One person dies from an eating disorder every 52 minutes, and about 9% or more of the population will develop one in their lifetime.
Eating disorders are widely treated with unapproved drugs that can worsen health, according to data. These diseases are often associated with or stem from numerous underlying influences, including other health conditions such as autism, PTSD, OCD, or a genetic disorder of sex development that impacts hormones.
People like Janice are routinely given some pretty strong drugs after a ten-minute evaluation with no consideration of genetics, sex-based, or ancestral differences. Janice was not psychotic, but said that her treatment provider routinely offered her antipsychotic drugs. Today, crowdsourced digital wellness is sometimes all folks have the strength or ability to muster or access. Health inequities, abuse, neglect, trauma, and poverty remain widespread. Some only dare to consult anonymous online forums such as Reddit for literal life-or-death advice. TikTok misinformation is rampant.
We preach about boundaries, but where do they end and begin when it comes to the age of oversharing?
Countless barriers to adequate and personalized health treatments exist, especially if you are in the LGBQT+ and Black, Hispanic, and Native American populations; these groups are also more at risk of developing an eating disorder and suffer from them at least double the rate or more, according to research.
And it’s not just young girls who are at risk: 15% of gay and bisexual men and 4.6% of heterosexual men have a full or subthreshold eating disorder at some point in their lives; over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors.
Males represent 25% of individuals with anorexia nervosa, and they are at a higher risk of dying, in part because they are often diagnosed later since many people assume males don’t have eating disorders.
From both a cultural and societal standpoint, we are unapologetically cruel and judgemental about health. We feel inadequate 24/7 because external mass messages tell us we are unwell. While wellness is a huge, profitable trend and we talk openly about mental health online, we still stigmatize people for being supposedly “imperfect” through a barrage of loosely regulated social media and streaming ads, shouting at everyone to just “keep five pounds off” and “stop being depressed.”
One could consider that, perhaps, in the spirit of the recent Ben McKenzie documentary, Everyone Is Lying To You For Your Money?
The mass marketing of chronic illness knows no bounds: There are numerous accounts of people developing eating disorders after watching television or consuming other forms of media, especially social media. The popular self-help memoirist Glennon Doyle has stated that she developed bulimia after she watched an afterschool special. At the same time, she encouraged millions of people she knew nothing about to take SSRIs, despite the research questioning their efficacy, dangers, and overuse.
Unregulated, dangerous marketing is sickening millions, triggering disease, and putting even more at risk for a wide range of health problems. Nearly half of online pharmacies selling weight loss drugs are operating illegally, a study published in JAMA Network Open found. Many experts are now raising concerns about the potential risks these weight loss medications pose to patients. Known side effects include muscle loss, pancreatitis, kidney and gallbladder issues, and even vision and hair loss or death.
And, ethical questions surrounding access and fairness of use are raising red flags, as stated in Columbia Psychiatry’s The Rise of Ozempic for Weight Loss Sparks Ethical Concerns. In the article, Robert Klitzman, MD, an expert in bioethics and public health and coauthor of a recent Hastings Center report, Anti-obesity Medications: Ethical, Policy, and Public Health Concerns, said: "The high costs of anti-obesity drugs and the need for lifelong use pose significant financial challenges, which could worsen health disparities.” Dr. Klitzman, who is also a professor of psychiatry and director of the Master of Science in Bioethics Program at Columbia University, also acknowledged the possible benefits of proper medication usage and stated in the article: "There's also a risk that the excitement about these new medications might overshadow crucial public health efforts focused on prevention and lifestyle changes."
A recent pharmacoepidemiological review, “From prescription to trend: the misuse of Ozempic in the age of social media,” reinforces these concerns, highlighting that the misuse of GLP-1 analogs may expose individuals without metabolic disease to adverse effects for which they lack protective physiological buffers.
“Of particular concern is how social media rebrands this metabolic drug as a quick-fix lifestyle enhancer. This reframing not only distorts public understanding but may contribute to overprescription, unnecessary exposure to side effects, and medication shortages. As shown in multiple studies, misleading portrayals of semaglutide have led to inequitable access, where those with financial means obtain the drug off-label. At the same time, patients with diabetes or obesity face barriers due to limited supply,” the review states.
Indeed, quick fixes and weight improvements are widely touted to the masses not only online but also at home and at school. The vast majority of eating disorders are developed in childhood, and most eating disorders, nearly 90%, occur in vulnerable individuals under the age of 25 who are still developing.
Too often, toxic body idealism is reinforced at home by moms or parental figures who themselves are unable to escape their own quests for perfection. Research has shown that young women are more likely to have disordered eating attitudes and behaviors when their mothers often communicate criticism and are over-involved.
According to a study by Analisa Arroyo, Ph.D., young adult females whose mothers frequently engaged in “family expressed emotion,” which she explained as “an extraordinarily harmful pattern of criticism, over-involvement, excessive attention, and emotional reactivity that is usually communicated by parents toward their children,” tended to have poorer social and relationship skills.
Two Yale University psychologists compared the mothers of normal adolescent girls with those whose daughters showed signs of anorexia or bulimia. They found that mothers of eating-disordered children urged their daughters to lose significantly more weight than did mothers of normal girls, and generally rated their daughters as less attractive than the daughters rated themselves.
In a 2013 episode of The Real Housewives of Beverly Hills, supermodel Gigi Hadid (then a teenager) called her mom Yolanda to say she was feeling weak, and her mom’s solution was to “have a couple of almonds and chew them really well.” When Gigi resurfaced the clip nearly a decade later, daughters of “almond moms” posted videos to share their own experiences, and TikTok videos about almond moms garnered more than 900 million views.
In an article on the topic, Erikka Dzirasa, MD, MPH, said: “It’s important to understand that these people are likely projecting their own negative sense of self onto their children.”
*Name changed at the request of the individual I spoke to who offered their personal experience, which will be highlighted along with other interviews in future articles on this topic as part of a series and book.
For help and eating disorder resources, visit https://www.nationaleatingdisorders.org.
Additional References:
Arroyo, Analisa, and Chris Segrin. "Family interactions and disordered eating attitudes: The mediating roles of social competence and psychological distress." Communication Monographs 80.4 (2013): 399-424.
Blicht, Taylor, OH, OH, NO OZEMPIC: THE DANGERS OF OZEMPIC’S DIRECT-TO-CONSUMER ADVERTISEMENTS, 34 J. L. & Pol'y 167 (2025): https://brooklynworks.brooklaw.edu/jlp/vol34/iss1/7
Muhammad HE, Cheema AAA. From prescription to trend: the misuse of Ozempic in the age of social media. Ann Med Surg (Lond). 2025 Aug 29;87(10):6876-6877. doi: 10.1097/MS9.0000000000003801. PMID: 41181496; PMCID: PMC12577951.
Nagata JM, Ganson KT, Austin SB. Emerging trends in eating disorders among sexual and gender minorities. Curr Opin Psychiatry. 2020 Nov;33(6):562-567. doi: 10.1097/YCO.0000000000000645. PMID: 32858597; PMCID: PMC8060208.
Pike, Kathleen M., and Judith Rodin. "Mothers, daughters, and disordered eating." Journal of Abnormal Psychology 100.2 (1991): 198.