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Over one million Australians are living with an eating disorder, but less than one in three are seeking support.
While we have come a long way when it comes to our understanding about disordered eating, it's not uncommon to hear comments made about people's bodies and appearance.
Lexi Crouch has lived experience of suffering an eating disorder for 15 years and is now a recovery coach helping others in their journey.
She says her eating disorder was triggered by a number of factors, including growing up in the prevalent diet culture of the 90s, and the impact of appearance-based comments.
"But I experienced some bullying for some just natural puppy fat essentially. And with that on board and the comments around diet culture of how we should be eating, I quickly formed disordered eating and was in eating disorder full-blown swing, definitely by the time I was 13 and 14. So that was all when I was growing up through school. And it really grabbed a hold of me when I was around 16 years old. So, I was no longer able to finish school and I was in the grits of anorexia and that started the hospital admissions for me."
Lexi had around 25 hospital admissions, which included as an outpatient, inpatient, and in intensive care.
She says she experienced some really dark periods, with her anorexia nervosa evolving into depression, anxiety and obsessive-compulsive disorder, as well as confronting a number of suicide attempts.
It wasn't until she was 25 years old when she started her recovery journey.
It involved a number of different tools, including finding a therapist who Lexi says adopted a more holistic approach to treatment, as well as discovering the importance of the mind-body connection through yoga.
"It takes something really severe for you to go, there has to be something better than this, and for me was, I was so sick and tired of being sick and tired, and I was in such a dark place if the eating disorder wasn't going to take me. I was looking for other options as well. But it was through that kind of feeling that I guess when the eating disorder was starting to work against me and life was just rock bottom. After many recovery attempts, I sought the path of recovery and it was a very slow journey."
This still happens today with the latest Body Kind Youth survey revealing 77 per cent of those aged 12-18 are teased about their appearance at school, and more than half are dissatisfied with their bodies.
Working as a life coach now, helping others navigate body image anxieties, Lexi knows firsthand how damaging appearance-based comments can be.
"They can have the most profound impact on your life. It's, we live in these physical bodies, and I think anyone that has the audacity to comment on somebody's body weight shape is just, that can be one of the most hurtful things you can do because I've seen it in myself that it was one comment on the playground that for somebody, water up a duck's back. But if you're a sensitive person, if you are going to take these things on, particularly when you're finding your way in the world, that one comment went on to essentially change my whole entire path."
In many cultures, appearance-based comments are normalised.
I spoke to colleagues from our different language teams at SBS, and it was clear that culture definitely intersects with people's personal relationships with their body.
Rami Aly is from SBS Arabic and says he definitely thinks about his body image.
"Well, it started with a negative relationship and a swing between negative and then positive, and now I say a bit of a neutral relationship. I stopped evaluating or just thinking of my body as a way to say, like or dislike. It's just there to do what it's supposed to do, and I'm thinking more of my wellbeing, health more than anything else."
He says it's quite common in his Egyptian culture for people to make appearance-based comments.
"I would say it's not very healthy and it's kind of a cycle, so people will be commenting publicly if you have a new haircut or maybe you gained a bit of weight, or maybe you've lost some weight, or you just had something, you dress differently. So yeah, people would be not afraid to share their comments publicly with you."
Yumi Oba from SBS Japanese also says there are unhealthy body image ideals in Japanese culture.
"I think there is definitely, especially among women, and I remember in an article five, six years ago about Japanese women having the most least confident about their body image. And I can sort of see that when I go back to Japan because everybody looks similar. Everybody has this not stick figure, but quite a tone figure. They're all dressed the same. And so, if you're not in that image, you obviously stand out."
She also felt pressures to conform to typical western body image types growing up in Australia.
"I personally do think about a lot, as you might not be able to see here, but I'm actually quite short. So growing up in Australia, I used to get so many comments from my peers, why are you so short? Why are you so small? And those questions always used to make me uncomfortable, but just always made me so conscious about how I look and how I appear."
Melissa Wilton is Head of Communications and Engagement at the Butterfly Foundation, and says their organisation is concerned by the increasing number of people presenting with eating disorders.
She says there's likely even more people with an eating disorder than we might realise, as not everyone suffering will come forward or seek help.
Ms Wilton explains the increasing rates could be due to a number of reasons.
"It could be a combination of a reduction in stigma, so more people are talking about eating disorders. It could be that people are recognising the symptoms and the signs better, so people are getting diagnosed more often than they were. It could also be a combination of things like social media and the impact of the diet culture we have, which is just so prevalent in society. So, there are a lot of compounding factors. COVID also had a big impact on people on mental health in general. And, of course, eating disorders are mental illness, so that also seems to have increased numbers. So again, a lot of different factors that all contribute."
She adds that there are certainly stigmas across different cultures, when it comes to body image, as well as around seeking support for mental health.
"We know that the prevalence rates in other communities are at least as high as Western prevalence rates, so there definitely exists eating disorders in those communities. It's just that they're not perhaps talked about as much. We certainly have lived experience. People within our community who are people of colour or people from different ethnic backgrounds who talk about the difficulty of talking to their family members who really don't understand, they have had no experience of any needing disorder, and it's a very stigmatising conversation to be able to have."
Peter Theodosiou is the Editorial Lead of SBS' language programs and is of Greek-Australian heritage.
He says there is definitely stigma around body image in Greek cultures, with family members often making comments about his appearance.
"Sometimes I would go to a family event and people would make little comments about how much weight you've put on. They would maybe comment on, you've put on weight. Oh, Pete, is there anything happening with you? Are you okay? Those things, they do play a factor in how you feel."
And when it comes to Indian culture, Priyanka Hatwalne from the Hindi language program at SBS, says body image pressures vary depending on your age and gender.
"In my culture, Indian culture, when people said Your kid is healthy, that means he's a little overweight, kid is a little bit overweight and that's how a kid should be. But once you pass certain age, like teenager, generally women, generally girls are very much being judged. I believe that who will get married, who will marry you if you're so fat, then that's how it happens. But I think it's very much biased because men and women both get married, but men are not that much affected by the fact that how overweight they are."
These body ideals can be particularly damaging, as healthiness is not associated with appearance.
In fact, there is still ignorance around eating disorders - with the Butterfly Foundation's latest community research revealing one in five Australians mistakenly believe you can tell if someone has an eating disorder just by looking at them.
Lexi says this is a dangerous perspective and is one that she says can deter people from seeking help, if they feel they fail to fit into any of the stereotypical eating disorder characteristics.
"It is still so prominent. A lot of people do not understand that it is not appearance based at all, and I think it's been very interesting. Even from my own experience, I've seen many different weight numbers on the scales over the years with the journey with the eating disorder, because I think a lot of people think too that it is such a straight linear journey. Like if you get a diagnosis of anorexia, all of a sudden you're here, and then when you're recovered you're meant via another way. But from myself, from anybody that I've coached, from what I've seen, it is an up and down journey."
The Butterfly Foundation's latest campaign 'Kindly Do, Kindly Don't' is seeking to raise awareness around how we can have healthier conversations around food, bodies, appearance and eating disorders - particularly looking to avoid appearance-based and fatphobia-driven comments.
As part of their campaign, they have developed a form for people visiting a GP to seek help for an eating disorder which acts as a support script for individuals to feel more comfortable in addressing this often-sensitive issue.
Lexi says better understanding the complexity of eating disorders is essential to people receiving life-saving support.
"That's the insidious thing about eating disorders as well. It can convince you that you are not unwell. It can convince you because what we've learned is many people with eating disorders are highly functional. I believe presenting this to GPS or those who want to help, it gives a broader sense of getting the conversation going, to dig deeper, which what we need to do with eating disorders to get to the root cause, and then essentially receive the proper help. And again, keep the conversation going because it's not going away. If you're wrong, you can gladly be wrong and move on because you're going to have a better life. So, I love that those implements are coming in to help overcome this insidious illness."
And if this story has raised issues for you or someone you know, you can get support from The Butterfly Foundation through 1800 33 46 73 - or via their website.
