Gluten-Centric Culture: The Commensality Conundrum - Chapter 4 - The Body Battleground

Celiac.com 01/14/2022 - Sometimes it’s hard to be a woman. —Tammy Wynette, 1968

Is your body a battleground embarrassing you with gas, bloat, pain, and dysfunction? In addition to that humiliation, do you also feel like people are judging you because your corporeal essence is too big, too small, or too noisy? Many people with food sensitivities or celiac disease are at odds with their most intimate companion, their body. This discontent is magnified when coupled with definitions of “feminine ideals” defined by the media, advertising, and celebrity role models. These ideals are unattainable or sustainable. Women in particular are taught to scrutinize each other for fashion, physical, and dietary infractions. We publicly convey dissatisfaction with our physical bodies, to always be “on a diet” in order to fit in, and to focus on physical attributes rather than intellectual endeavors. These pop culture edicts put even more pressure on those following special diets.

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In the previous chapters, we discussed how we live in a gluten-centric society (Chapter 1). We’ve identified several ideologies or “truths” that have emerged that cause trouble for those with food sensitivities or celiac disease (Chapter 2). Then we discussed some of the public venues where these ideologies play out (Chapter 3). Before moving on to how ideologies or given “truths” affect our home and family life in the next chapter, I want to now talk about the female body as a centerpiece for surveillance and scrutiny by others, and torment for it’s owner. Since 85 percent of study participants are female, it makes sense to focus specifically on feminine issues around the body. First, I’ll explain how cultural influences cause women to focus on dieting mostly for weight-loss, rather than for thriving on the “right” foods. I’ll point out the ideologies that cause us to overly scrutinize each other and ourselves. We’ll start with an overview of the macro-level influencers such as the media and corporations that define these “truths” in our culture. Then we’ll examine how these ideals impact individuals, but first I’d like to share a personal story.

Jean’s Story - Associating Physical Issues with Diet

I spent my whole childhood and much of my adulthood suffering chronic stomach pains and vomiting regularly. I was nauseated and often had a runny nose. My father had indigestion, too, so I thought it was normal to feel sick after eating. As an adult, I came across an article on stomach issues and dairy allergies in a woman’s magazine, while on a flight to Hawaii with my husband. Until that moment, it never occurred to me that food could be causing my stomach problems. Though it seemed like a monumental undertaking, on the trip, I decided to experiment with limiting my dairy intake. I avoided dairy for a few days and felt immediately better. Not yet entirely convinced, and lacking ideas for a substantive alternative, I ate cereal and milk before an all-day excursion later in the vacation. While hiking the stunning Haleakala Crater, my stomachache returned. I was nauseated, cramped, and uncomfortable—unable to enjoy one of the most fascinating landscapes I’d ever encountered. In that moment, it clicked: a lifetime of stomachaches and vomiting was caused—I was now certain—by dairy products.

The Fascinating Human Body

A few years ago, at the Denver Museum of Natural History, I attended the Body Worlds exhibit on the human body. Real humans were dissected to show the reproductive, circulatory, digestive, endocrine, immune, muscular, and nervous systems in a fascinating display. It was intriguing how these systems work together. I wandered through the exhibit full of awe and wonder. When it works, our body is truly remarkable, to be appreciated and honored. When something upsets its delicate balance, it is equally as curious to observe its ways of reacting to protect itself and to heal. Adapting to a physical malady also involves a psychological aspect too.

Corbin (2003) conducted interviews on people who had a heart attack before age 65, asking how participant’s perspectives of their bodies changed as a result of the disease. She found that after an event such as a heart attack, or diagnosis of a disease, people detach themselves from their body by thinking of it as an object. This disassociation is part of the acceptance process, to re-establish trust and a new definition of normal. Participants in the study clashed with their bodies too. They opened their interviews by describing many physical maladies caused from consuming gluten. Ava (#7) describes her daily routine to go to work with the ever-present diarrhea many people with celiac disease experience:

It's extremely frustrating because it's exhausting, and embarrassing. You are on your way to work and whoops, you have an accident. And then you have to turn around and go back home to change clothes. When I got to work late, I’d explain, “I had an accident.” And nobody would understand, so I’d have to get graphic to explain what happened. They’d say, “Well you should go to the doctor.” I’d say, “I’ve been to the doctor.” They’d say, “You should take Imodium and just deal with it.”

Ava’s body’s unpredictability ultimately caused her to quit working. Many other participants described similar situations where their bodies embarrassed them by spontaneously vomiting, farting, or having diarrhea, or how they lived with debilitating, undiagnosed pain. I asked Ava if she struggled with her weight, thinking she must be very thin because she experienced regular diarrhea. She said, “Gosh no. I’m very large. I weigh 250 pounds. I have diarrhea so often, how can I possibly be obese? I should be thin as a rail. But when I found out that I was not actually absorbing any of the nutrients from the foods that I was eating, that explains why I am obese. I have malnutrition.” When she was finally diagnosed and altered her diet, her debilitating gas, diarrhea, and body mass reduced.

Just as the body is a site of contention for those with food sensitivities and celiac disease, for many women, the body is an adversary as they struggle to attain what they perceive as their ideal weight. The dieter sees her body as a point of betrayal. In an out-of-control roller coaster, the body’s weight goes up when consuming delicacies or down when electing deprivation. Rather than seeing the body as a fascinating place to live in as we navigate the world, many view their bodies as an obstacle – something that defies earnest goals and restricts them from participating in many aspects of life. Diet failure reveals itself with the number on the tape measure, the dress that won’t zip, or the turned up nose of a friend who at that very moment is successful with her dietary goals and fitness achievements. And we hate her for her success as we wallow in our misery, wishing we’d bought a size bigger in that new outfit we thought we’d shrink into by now.

Jean’s Story - Momma’s Diet

My mother joined a weight loss program when I was nine years old. She was five feet, two inches tall, with intense blue eyes and brown hair. In middle age, she deemed her body was larger than she wished (albeit by today’s standards, she was “healthy”). Her weight annoyed her because this was a time when Twiggy had the coveted female body. Bone-thin was in! She counted calories, weighed everything she ate, and studied the program cookbook. In those days, a hot dog with cabbage in tomato sauce passed for a “skinny” meal. One dessert recipe from the cookbook instructed dieters to whip powdered milk, water, and a packet of artificial sweetener into a light cream. It tasted like sweet air. I left those meals feeling hungry and dissatisfied.

My mother stayed with the program through the years, becoming a long-term member as she strived to achieve her ideal body. Foods were marked “good” or “bad,” depending on how fattening they were. Cookies and cakes were “bad” and fruits and vegetables were “good.” Year after year, she cycled through the loss and gain of the same 10 pounds, alternating between making “skinny” dinners, or rich, memorable “Sunday” dinners worthy of a magazine cover. As a dutiful daughter, I celebrated and commiserated on cue but since I was thin then, I didn’t need a diet program.

In the 1980s, I worked for IBM. Their wellness program included a free diet program membership, offering lunchtime support-group meetings in the office. I arrived at the meeting wearing a dark green suit with a lizard pattern shirt and shoes. Immediately, I was ushered to the corner for the weigh-in. Stepping my 5’5” body on the scale, shoes and all, I weighed 124 lbs. The group leader looked at me, irritated, and said, “Why are you here?” “I think I’m allergic to dairy products and need help with my diet,” I responded. “We don’t deal with food allergies here. And you don’t weigh enough to join our program.” Her comments were loud enough for my curvy coworkers to hear. A few clicked their tongues and many rolled their eyes. I was humiliated and left to figure out a healthy diet plan for myself.

Dieting is a woman’s project.
—Corrinne Bedecarre, 1971

Dieting is a Rite of Womanhood

The “thin trend” began in the 1960s with social-cultural influences directing feminine ideals. In the past sixty years, diet fads have swept the nation with promises of weight loss and health, with catchy brand names such as: “Skinny Bitch” and “The Zone,” or medical sounding names such as “Blood Type,” “Glycemic Index,” and “Macrobiotic.” Some are named after people, such as “Jenny Craig” and “Atkins,” or places like “South Beach.” A “diet culture” has evolved in the U.S. over the past fifty years, perpetuating gender biases that pressure women to pursue health, physical, and dietary standards (Lockford, 1996). Women have become “entrepreneurialized” (Thornton, 2011, p. 399) as companies profit from the diet awareness and able-body bias ideologies. Similarly, dieting women are “governed through their own freedom and subjectivity” (p. 401), as they flip through a magazine full of food ads and diet plans with thoughts of experiencing a fulfilling life with a slimmer, healthier body, thus upholding the ideology that a “fit, healthy body … is the best fashion statement” (Scott, 2017). In addition to pressuring women to attain certain physical features, magazines may “instill false confidence in one’s ability to achieve unattainable results through impractical strategies and time periods” (Sarge & Knobloch-Westerwick, 2017, p. 260). The effect of dieting is failure for 95% of the population (Statistics on Weight, 2011), and most dieters gain additional weight within a few years (Statistics on Weight, 2011). Websites targeted at weight loss generate $842 million, according to a six-year trend analysis conducted by Market Data Enterprises (2016) pointing to why dieting ideologies for women permeate cultural practices. It’s big business!

Physical Ideals

Between the ages of 16 and 45, women report trying an average of 61 diets (Smith, 2012). The weight loss industry has flourished in popular culture due to the rising weight of many Americans. Controlling one’s body by limiting caloric intake has become common practice. Physical archetypes of the female body perpetuated in the media since the 1950s (Montanari, 2006) have led to dieting as a “permanent rather than temporary condition” (Andretta, 2015, p. 470) for the past half century. Gender inequities and cultural norms complicate social behaviors specifically by affecting women and how their bodies are viewed by society. The exemplary body in Western culture is able, fit, and healthy (Spitzack, 1993). This obsession with attaining physical perfection is a form of oppression, as women strive to maintain their goal weight and an optimal physique in order to be accepted (Bedecarre, 2005). Dieting seems to be a rite of womanhood after childbirth, to thwart off additional pounds from aging, or to attain a healthy body. People are pressured by the media to lose weight. Further, media exposure, along with feedback from family and friends affect “eating attitudes and behaviors” (Ata, Ludden, & Lally, 2007, p. 1033). Studies show that women who viewed advertisements depicting the ideal feminine body were more likely to convey dissatisfaction with their bodies afterward (Levine & Smolak, 2002; Yamamiya, Cash, Melnyk, Posavac & Posavac, 2004). Millions of Americans engage in dieting with the goal of weight loss or improving overall health and physical function.

Diet Consciousness

How did this diet consciousness evolve? For the past 60 years, large dieting companies have defined American food practices and gender-based ideologies particularly among women. With millions of members, 90% of whom are women (AdAge, 2011 quoting MarketData Enterprises), these companies have had a pervasive influence on women’s sense of the “perfect” body (Lockford, 1996). Their ideals of “wellness that works,” reflect that a fit, healthy body is a coveted symbol of success and competence (Bentley, 2005). Some of the companies provide group support and camaraderie of others striving for similar goals. Some programs help members attain their goals through behavior transformation techniques and weekly attendance at face-to-face or online support group meetings. The support-group-style meetings reinforce that “weight consciousness is principally a women’s condition” and diets are something you go on and off of (Bayrd, 1978 as cited in Lockford, 1996, p. 291). Surprisingly, when compared to other popular weight loss programs, one of the most popular programs yields the least weight loss per year (Statista, 2017a) -- at least 2.6% greater weight loss than those assigned to a control” group (Gudzune, et al., 2015, p. 1). This means a successful 150-pound dieter would benefit by losing 20.5 pounds on the program versus 20 pounds going it alone in a given year. The difference is that the person going it alone would not have access to the support systems offered by the program.

National dieting companies cultivate a powerful diet consciousness. Support meetings and apps attract millions of subscribers who learn accountability and earn rewards for compliance and goal attainment. Celebrity endorsements instill ideal standards for behaviors of everyday people (Schultz, Nolan, Cialdini, Goldstein & Griskevicius, 2007). Publicly awarded charms, group meetings, and weigh-ins create a culture of constant surveillance (Lockford, 1996) and reinforce mastery over one’s body as the symbol of success (Bordo, 1993). Also, the practice of setting goals, and attaining them gives participants a sense of accomplishment (Heyes, 2006). Dieting ideologies are common in our society. It is normal to say, “I’m on a diet” when declining to eat dessert, or foregoing the rich sauce. The wild success of the weight loss industry in the past half-century has made comments such as this part of our accepted culture.

Performing Womanhood

The popularity of weight loss programs have created ideologies on how women “perform” womanhood, perpetuating these ideals where “culture’s grip on the body is a constant, intimate fact of everyday life” (Bordo, 2003, p. 17), and self-esteem is linked to body image (Harter, 1999). Weight is a common topic of discussion among my participants, as exemplified by Arina (#47) who weighed 160 pounds at 5’5” before being diagnosed with celiac disease; after going gluten free, she lost 30 pounds. Without being asked, many female respondents volunteer their current weight and fluctuations after being diagnosed and going on the gluten-free diet, expressing frustration at weighing too much or too little. Those with celiac disease are stereotyped in the medical community as being ultra thin, however this is not true. People with celiac disease come in all shapes and sizes. Some study participants who were ultra thin report being relieved to gain weight after being diagnosed with celiac disease, such as Ivy (#40) who gained ten pounds once off of gluten. Layla (#66) talks of being betrayed by food, saying: “When I was younger, before the dietary change, my favorite foods were glazed doughnuts and French fries. It is impossible to have gluten free glazed doughnuts. There was a bit of a sting when I found out it was my favorite thing that was making me feel so sick. I felt hurt and betrayed by my body, and the foods I loved.” Layla’s statement describes the conflict between our favorite foods and their negative impact on our bodies.

Jean’s Story - Eating Frenzy

Years after going off dairy, feeling a little better but not great, I was finally diagnosed with celiac disease. Desperate to feel better and perplexed about what to eat, I decided to eat only vegetables, berries, fish, chicken, seeds, and nuts. I did this for a long time, and even though I was a lot better, I eventually felt deprived on that drudge of a diet. One Christmas, I stuffed my husband’s stocking with a bag of dark chocolate covered almonds. He politely offered me one when he opened them on Christmas morning. I ate one. Then perhaps from having a little ketosis from eating so few carbs for so long, I ate the whole bag as he looked on with surprise. I couldn’t stop! I scarfed those chocolate almonds like frenzied maggots eat carrion. That taste of sugar set me on a bender. In the following months, I indulged. I developed gluten and dairy free recipes for chocolate pie with brownie crust, peanut butter sandwich cookies with sugar on top, cheesecake with a graham cracker crust and strawberry sauce on top, chocolate cupcakes with marshmallow filling and chocolate icing, banana muffins with chocolate chips, carrot cake with raisins, pecans and thick white icing, chocolate chip cookies, butterscotch pie, lemon meringue pie, fudge, angel food cake, gingerbread, oatmeal cookies with chocolate covered raisins and pecans, pineapple upside down cake with sticky brown sugar on top, sweet cornbread, bread sticks, pizza, focaccia, strawberry shortcake, cherry cobbler, baked custard, puff pastry, chocolate soufflé, lemon torte... all of the foods I ate while growing up. The bender was good in a way, because it enabled me to develop most of the recipes in my Bake Deliciously cookbook!

I became obsessed with temptation, causing me to forsake my dietary resolves, seeking to fulfill myself with sweet treats, triggered from eating those sugary chocolate almonds. It was no different from being an ex-smoker smoking “just one” cigarette, or an alcoholic taking “just a little” drink! Those delicious chocolate almonds triggered me to an orgy of sugar consumption. I got along fine with my delightful sugary snacks until one day when I had a business meeting and had to wear a suit. I put on my favorite worsted wool suit (the one I’ve worn for years) and I couldn’t get the pants zipped! I needed four more inches. I had gained weight. I felt betrayed by my body once again. Being gluten and dairy free wasn’t enough to satisfy my body’s needs. In order to be thinner, I had to go on a reducing diet. I needed to find a diet program! (It never occurred to me to buy a bigger suit.)

The best slave doesn’t need to be beaten, she beats herself.
—Erica Jong, 1991

Perpetual Dieting

Women’s weight is a sore topic, and one many struggle with for a lifetime. Why is this? Aside from childbirth and sporadic exercise plans, I think it is because everywhere you look there are pictures of tempting foods and because food norms have drastically changed. It used to be that we were told to eat three square meals a day, but now, advertisers encourage us to eat throughout the day. Further, it used to be that we only ate while sitting at a proper table. Now it is acceptable to eat virtually anywhere. Fast food is readily available to pick up on the way home from work for dinner and ride-share drivers deliver food from almost any restaurant. While many restaurants and fast food joints offer healthier options such as veggie bowls, salads, and lean meats, when hungry, it is tempting to throw in the fries or the delectable dessert. It is just too convenient to eat these ubiquitously available foods. This is not a new problem. Margaret Mead said this in 1971: “The problem for great numbers of Americans is not how to get enough food or how to be well-nourished, instead it is how to fend off the insistent pressure to eat” (Mead, 1971, p. 19). Bordo (2003) echoes this 30 years later by observing that “almost all of us who can afford to be eating well are dieting – and hungry – almost all of the time” (p. 14). Women reported feeling guilty 11 percent of the time after eating certain “forbidden” foods in the course of one week (Steenhuis, 2009). That speaks to the power of advertising and constant reminders on social media. According to the CDC, 42.4% of Americans are overweight (CDC, 2017-18). Disparagement of the body and its physical enjoyment of food are viewed by some women as “disgusting and transgressive” (Magee, 2007, citing Bordo, 1998, p. 18) by saying self-judging statements such as: “I was such a pig,” or “I can’t believe I ate all of that,” or “I am so disgusted with my weight, I can’t believe how fat I’ve become.”

Food “porn” encouraging excessiveness is commonly displayed on TV with concoctions such as eating hamburgers using glazed doughnuts as buns, topped with cheese and bacon. It is common to go to gatherings and hear about the latest “sinful” dessert someone has devised with names such as “Death by Chocolate” (Desaulniers, 1993) and ingredient combinations of candy bars, whipped cream, brownies, ice cream, nuts, etc. (Incidentally, this recipe has evolved to no less than 15 iterations online!) Or “crack,” that winning combination of salted peanuts and candy corn. Temptations abound, and participation is a way to being accepted in the “club.” Eating is social, and as discussed before, not participating in it causes subjugation. When people get together and there is cake, wine, and chocolate, who wants to be the person abstaining? That isn’t socially acceptable. It’s not fun either!

We’ve discussed the cultural influencers above. Next, let’s examine the specific ideologies that shape the diet mentality and how it plays out in our daily lives. By labeling these, and pointing them out when we experience them, we start to empower ourselves to change these “truths.” How do we know when we are successful? Change is a gradual process as people revise their long-held beliefs. We know we’ve affected positive change when we listen to comedians from the last generation and realize the jokes they are telling are totally inappropriate in this time. Or on the contrary, when we watch a movie from yesteryear and see how those affected are treated then versus now… sometimes we realize we haven’t made any progress and wonder if things will ever change. There isn’t a “social change playbook,” but steps followed by those wishing to affect social change include:

1. A relentless effort to create awareness of how the dominant hegemonic group affects those who are dis-empowered.
2. Figuring out how to peacefully show those who represent the status quo, so they are aware of the plight and hear the voices of those usually silenced or oppressed.
3. Reclaiming and redefining maligning labels – redefining the maligning words to positive meaning.
4. Developing and incorporating language to use to call out infractions and publicly pointing them out, so others understand and use the language too.

Unless the status quo is disrupted, those in the dominant hegemonic group are complacent. I’ll develop this more in a later chapter, but as you read through this chapter, think about how women are influenced by media and corporations to see their bodies as a battleground, rather than something to uphold, love, and nurture. Keep in mind that in order to change ideologies, we need to first label them. The next section identifies some of the most prevalent ideologies surrounding women’s bodies.

Diet Discretion Ideology

The diet discretion ideology is when others are overly interested and often (but not always) judgmental about our dietary choices. Ideologies about diet adherence equate to a “perfect” woman with a “perfect” body. It is commonplace for a woman to ask another about her diet. The other night, I was eating dinner at a large wedding, sitting next to someone I’d never met before. She asked me what I did, and I said that I was writing a book about the social aspects of food sensitivities. She told me a touching story about how her son had been diagnosed with Autism when he was young, and after years of seeking help, they finally found a doctor who suggested a gluten and casein (dairy) free diet. Within three months, her son went from non-verbal to verbal and regained his health through dietary changes. In the meantime, she said, “I know I shouldn’t eat gluten and dairy, but I do, and here’s what happens.” She pulled out her cell phone and showed me pictures of her face and neck with a flaring rash. Then she asked me what my diet consisted of as she assessed what I had eaten on the plate in front of me. This didn’t surprise me at all, because it happens all the time and illustrates several levels of the diet discretion ideology. Women are in charge of providing nourishing meals for their loved ones, and constantly seek to learn how other’s attain health through various practices including diet. To do this, we are innately trained to observe what others eat. It is a form of survival, and a way of human bonding.

Just as this book strives to create awareness of our gluten-centric culture, lately organizations have formed to de-stigmatize stereotypes of curvier people. These societies seek to create awareness of weight discrimination. Rather than apologizing or hiding those curves, women are encouraged to be proud of their bodies, accept them, and celebrate it’s ability to do the things in life they enjoy doing. It is a power movement that may change some of the biases formed over the past half-century. One recent result is seeing women of all sizes in ads, films, and on television, playing in desirable roles, doing activities, living a well-rounded life, rather than seeing those that don’t meet an arbitrary ideal as the butt of a joke. This is a positive change pointing to social acceptance of all body shapes.

Celiac-Specific Dietary Discretion

In a culture of dietary surveillance, women with celiac disease are subject to a host of assumptions around their requirement to maintain a gluten free diet. Some women participants experienced suggestions that their gluten free adherence is actually a form of self-punishment. Others are accused of trying to evoke sympathy, as exemplified by Sadie’s (#41) mother. She dismissed her daughter’s illness, noting, “You are just trying to get attention.” Some even face outright denials such as when Carrie (#4) reports that her daughter “didn’t believe in” the need for a gluten-free diet and says it is a “stupid fad.” Similarly, Julia’s stepmother “doesn’t believe in ‘Celiacs,’ or that people have food allergies.” These practices lead to obsession with food, weight, and the development of disordered eating behaviors. This sentiment is illustrated by Julia’s (#49) father’s chide when he commented, after learning of her condition, “If you are unable to eat so much, why are you so chubby?” His observation reinforces her need to be aware of her appearance, and that others are observing her body size. Women self-regulate their diets to fit within the confines of current trends. When not compliant, women often have feelings of insecurity, shame, guilt, and negative self-image (Science Daily, 2011). When women successfully lose, weight loss companies tout feelings of “true self-knowledge, self-development, self-mastery, and self-care” (Heyes, 2006, p. 145). Women are constantly reminded of success or failure because mirrors and scales are gauges of self-regulation (Bedecarre, 2005). Another ideology that results from over-awareness is the by-the-numbers ideology.

By the Numbers Ideology

Dieters quantify everything – how much they weigh, how many grams of fat, carbs, and protein that they eat, the total number of calories in a given day, their measurements, etc. We are taught to do this when learning different diet programs. And it’s normal because as we strive to learn what a serving size is (often a quarter of what we think!) we have to learn these things to manage weight. We enjoy success from this too because by limiting our carb and fat intake to an ideal number of grams per day, the scale rewards us with lower weight, and we can finally wear those “skinny” clothes in our closets. The annual doctor’s examination brings on another set of numbers tied to what we eat – the complete blood count, showing the amount of lipids in our blood, the glucose and HbA1c number that indicates diabetes, and giladin, tTG, IgA, and/or IgG numbers for those with celiac disease. And since we know that our numbers improve by watching what, and how much we eat, it is easy to find yourself living by the numbers – counting everything and monitoring the outcome. It’s an analytical approach to discovering “truths” for your body. However it is completely frustrating when attaining undesired results even after adherence to a recommended diet plan. Why doesn’t it work? Because every body is different! There is not a one-size-fits-all diet plan. It is something we have to learn for ourselves. It takes time, patience, education, and a willing doctor to help us navigate it. It also requires us to surrender to the fact that we have inherited genes that work against us.

Size Surveillance Ideology

Starting in childhood, girls are pressured to stay thin. Parents Google “is my daughter overweight” and “is my son a genius” (Stephens-Davidowitz, 2014). This illustrates what parents focus on depending on the gender of their children perpetuating the notion that genius boys and thinner girls have the best prospects. Throughout life, women monitor each other’s weight, so much so that “you can remember if their weight was ‘up’ or ‘down’ at different times of their lives” (Bedecarre, 2005, p. 220). This illustrates the size surveillance ideology. Rather than focusing on each other’s accomplishments, we seem to be preoccupied with how we look and whether or not we have succeeded on our diet plan. It is a regular topic of conversation. A weight-conscious culture and the fanatical behavior it influences combined with regular peer-surveillance, (Spitzack, 1993) make dieting a gendered issue and source of social conflict, magnified when coupled with a food allergy.

When someone finally conquers an addiction, or attains a fitness level, it is something to be celebrated. But an unintended downside is that your proud announcement causes everybody to look, and look again next time to see if you still are complicit (Lockford, 1996). Women are defined by their physical attributes to the point that their “humanity has been dismissed” (Bedecarre, 2005, p. 215). Being overweight instills self-loathing and emotional strife (Lockford, 1996) in many women who feel they are substandard because of their bodily size. As a result, our culture subjects women’s bodies to constant surveillance (Bordo, 1993). It is ironic that what once started off as an individual quest to watch her weight became a cultural norm of watching each other’s weight.

Women regularly scrutinized each other’s weight and food-related behaviors (Bedecarre, 2005) in ritualistic surveillance practices focusing on defects (Spitzack, 1993). Women judge those who have allergies for consistencies and behavior (Samuels, 2003). Once a coworker watched me eating a gluten-free cookie. She said, “I knew you weren’t 100% gluten-free – look you are eating a cookie!” I didn’t even bother to explain. Dietary discretion and size surveillance by others is exemplified by Ruth’s (#69) comment:

After many years of trying to fit in at extended family dinners, pretending to eat but not eating a thing, I finally decided to bring my own food to my aunt’s house for brunch. It was Easter morning, and the family members were eating gooey cinnamon rolls, sausage, and chocolate Easter eggs – foods I dearly love. They were commenting to each other how good it all tasted, pairing Easter eggs with bites of cinnamon rolls. I opened my sack and began eating. Out of the corner of my eye, I thought I saw my aunt sneaking a picture of me eating my food. Was she taking a picture of me because I was eating my own food? I looked up and she hurriedly put the camera away. I felt like my resolve to bring my own food was being judged and watched. I was embarrassed and wondered if she was going to post the picture of me eating the foods I brought on social media.

Ruth describes how she felt when she finally resolved to bring her own food. I imagine it was hard for her not to feel deprived as she listened to her family describe the treats they were eating, but she shared that she was comfortable with her decision because she knew it was the only way to stay healthy. Her feelings of familial acceptance changed when she caught her aunt taking a picture. That heartbreaking act showed that her aunt’s previous encouragement for Ruth to bring her own food were disingenuous. What fortitude and a charity of forgiveness Ruth must have had to over look her aunt’s peccadillo and to press ahead with her resolve. This scene Ruth describes illustrates the minute-by-minute challenges we face whenever we defy established customs or norms, no matter why. It takes courage to persevere. Clara (#70) says,

I have a friend who tells me every January, “I’ve gone back on the diet.” And every year she describes the new tweaks the plan has taken. It is normal for me to want to drop my eyes to assess her body. After years of conditioning, I have learned not to look, and not to ask as the months go by. While I want to support her in this endeavor, I do not want to scrutinize her weight. Predictably, every June she announces she has “gone off of the diet” and then eats whatever she wants until December. It is a cycle she has repeated for twenty-five years. It works for her because ultimately she nets the same average weight.

Ideologies of feminine physical perfection kick in and the woman’s food choices and dieting success or failure becomes an acceptable topic of conversation (Dworkin, 1989). It is a yo-yo cycle that for many goes on for years and years, losing and gaining the same ten to twenty pounds into perpetuity.

Sexual Scrutiny Ideology

There seems to be a separate set of medical standards for the genders. For example, Kaylee (#52) describes how she went to three doctors, who prescribed pills for her complaints that included “painful constipation, a throat full of phlegm, and hair falling out.” She also gained weight. One doctor said it was hormonal, another prescribed steroids. One thought she had lupus. Finally, two years later, she found a doctor who suggested eliminating gluten from her diet, and that “literally changed everything.” All of the complaints went away in time. Kaylee wondered if a male had presented the same symptoms, if they would have been subjected to the same years of rigmarole.

According to Stone (1995), women are more prone to concealing their disabilities and are “morally responsible for their own imperfections” (p. 414), blaming eating habits and lack of exercise for their maladies (Spitzak, 1993). Individuals who fear there is something wrong with their health regularly “misidentify the factors that were responsible for the maladies” (Davis, 2005, p. 171) and are often misdiagnosed by the medical community. Since there is already a propensity for food-related disorders in this demographic, the woman may not be taken seriously when she presents with a gastric-related illness and the doctor may erroneously conclude that her symptoms are caused by a life-long-cycle of dieting practices. This mentality illustrates the sexual scrutiny ideology. Many women with celiac disease who have been told there is nothing wrong with them, or that their symptoms are “in their head,” or misdiagnosed by physicians, are left to suffer for an average of eleven years before learning that gluten is the cause (Green & Jabri, 2003). Celiac disease is overlooked for a variety of reasons, including the inability to correlate systemic symptoms with celiac disease, inadequate medical tests (Fine, 2003), and myths indicating that it is a “mal-absorption syndrome of childhood” (Green & Cellier, 2007, p. 1731). Misdiagnosis, coupled with accelerating symptoms causes those with celiac disease to experiment with one diet or another in order to feel better, sometimes leading to peculiar eating practices.

Unintended Disordered Eating Patterns

The intense focus on dieting promoted by diet companies may be one of the primary reasons that 90% of those with eating disorders are women (Arroyo & Segrin, 2013 citing American Psychiatric Association, 1994). Multiple years of dieting to attain physical ideals are a form of oppression, as women strive to maintain their lifetime goal weight and an optimal physique (Bedecarre, 2005). In addition to dieting in private, women also self-deprecate their bodies in public in order to be accepted by their peers (Britton, Martz, Bazzini, Curtin & LeaSchomb, 2006). In fact, public claims of physical satisfaction with their bodies led to women being ostracized in social circles (Britton, Martz, Bazzini, Curtin & LeaSchomb, 2006). So we learn not to talk about our physical achievements, and to hide our dietary idiosyncrasies. But as we achieve health, we strive to learn more about how to maximize our success.

What began as a quest to attain health through dietary choices may escalate in time to an obsession, perpetuated with positive results (Oberle, Samaghabadi, & Hughes, 2017). Those with food allergies are prime candidates for the development of disordered eating as they strive to find foods that do not make them sick. Extreme practices create an identity through food (Guptil, Copelton, & Lual, 2013), causing relational strife for newly diagnosed individuals, as their families adjust to new eating behaviors, which may include a only a few “safe” foods. It is not uncommon to hear someone declare, “I’m vegan” or “I’m gluten free.” Piper (#43) says, “I think about food all the time.” She goes on to describe a time when traveling in France as her sister enjoyed wine, cheese, and bread – foods she no longer can consume. Piper said, “I felt sad. I couldn’t do what everybody else in the world can do.” Hailey (#38) says she feels that people with celiac disease are more sensitive to other foods too. She notes, “If I want to feel good, I just eat fruits, veggies, and meat.” Sixty one percent of the study participants reported consuming a diet comprised mostly of lean meat, vegetables, and fruits.

William (#60) describes the extremes he has endured in order to regain his health. He was diagnosed at age 45. Still not feeling well on the gluten free diet, six years later he did a food sensitivity test and learned he was sensitive to 39 foods. He struggled to find professionals who could help him, spending a lot of money in the process. He learned from trial and error that his best diet consists of meat (grass fed beef and meats raised with no antibiotics), vegetables and some roots such as sweet potato. He eats very little fruit, and no nuts or seeds. He eats no coconut oil or avocado because he has found both cause skin rashes. His body does not tolerate alcohol, wine, garlic, or onions. He rotates the foods he eats to aid in the digestive process. Further, he takes supplements to substantiate the digestive process including vinegar, hydrolyzing enzymes, de-glycerized licorice, pepsin, glutamine, zinc carnosine, magnesium, turmeric, calcium, and magnesium citrate. Doctors prescribed antacids for his stomachaches, and he learned that was the worst thing a person with celiac disease could take because it caused pancreatitis. Though he is aware he is being observed and discussed when visiting extended family to join them for a meal, he prepares his own using the microwave or hotplate in the basement to avoid being cross-contaminated, or from breathing the gluten-filled air in the main kitchen. All of these practices have made him feel better in spite of being 5’10” and weighing 120 lbs. He would like to weigh 160 lbs. He has lived this way for 17 years and admits it is tough, but his efforts have paid off. He has healed his skin rash, eliminated chronic constipation, and rid himself of stomach pains. This illustrates someone who has taken the initiative to learn “what it takes” to fix himself and to feel better though his efforts may be deemed extreme. In the process, he has endured surveillance and scrutiny by family and friends. This is a glowing example of courage and taking initiative to regain health.

Others describe practices that would classify them as “disordered” because thoughts of food prevail and affect all other aspects of life yet they maintain these habits to stay healthy. Allison (#35) after describing the physical misery she endured before being diagnosed, and despite the hardship it imposes says, “The gluten free diet saved my life.” Attaining a healthy body can drive a person to practice extreme eating habits as a form of self-preservation. Liza (#68), describes her daily lifestyle:

As long as I can make my meals myself, I’m fine; but the minute I have to rely on someone else’s judgment, whether it is a pharmacist, doctor, dentist, food server, or whatever, to deem what is OK for me to put into my mouth, I feel vulnerable. Unless you are highly sensitive and reactive, and live with the disease, you have no idea what it is like to worry about every single instance where you could be cross-contaminated. People are careless, forget, or don’t take it that seriously. Some just “throw up their hands” in frustration with my special needs. I’d rather take care of myself, but really fear the day I may need to rely on others to feed and care for me.

If there are crumbs on the table in the coffee shop left by the previous occupant, or in the air in my friend’s home from baking cookies yesterday, or in the glue of the new paper straws, life becomes a never ending game of Russian Roulette to avoid being contaminated. I’m constantly wiping down surfaces, sometimes breathing through a mask (to avoid flour particles!) and always wary. Gluten can be in some very unusual things that don’t have to report it, such as hairspray, teabags, hand lotion, over-the-counter pills, and pharmaceuticals – many things that you wouldn’t expect. Existing day-to-day in this gluten-filled world is risky.

Crossing the Line

The Anorexia Nervosa and Associated Disorders Organization estimates that 30 million Americans across all ages and genders suffer from an eating disorder at some time in their lives. What’s more, among women over 50, one-in-ten exhibit eating disorder behaviors (ANAD, 2020). Eating disorders are a serious illness that can result in altered lifestyles, and death. Disordered eating begins with spending an inordinate amount of time thinking about physical health, through diet, exercise, reading labels, understanding the functions of foods, and limiting the diet to the few foods that don’t cause “trouble.”

Jean’s Story - I Haven’t Farted Since 2005!

I’ve been called “a dysfunctional eater” by acquaintances because I omit whole food groups. And there are medical professionals out there that would say the same thing. I am not anorexic – I don’t hate food. I love it. I consider it an art form. To create a successful recipe with alternative ingredients is rewarding. But many foods don’t like me. I’m frankly tired of the havoc foods impose on my body. Most people look at a feast with zeal. I look at it and think, “that will cause my forehead to puff out, that will cause a rash, that will make me bloat and fart, that one causes rosacea, that one might get stuck in the digestive process, and on and on.” After I told a nutritionist that I was allergic to dairy, she insisted that I had to have it in my diet in order to get calcium! In her narrow understanding of food, fortified dairy products were the only source of calcium. We have to realize that a lot of people who judge us are ill-informed, and maybe non-reactive to food. I’ve encountered people who eat anything and everything and shake their head at me when I refuse to. Some even have told me, “If it’s made with loving hands, it will nourish your body.” Not if it’s got the wrong ingredients, thank you very much! My lifestyle choices do not feel disordered or dysfunctional. Rather, they serve me.

After finally being diagnosed, and eliminating gluten and dairy from my diet, and then all grains, and all processed foods, I experienced profound health in my body. I stopped my sugar indulging and went back to eating vegetables, some lean meat, berries, nuts, and seeds. I feel better at this age than I did 20 years ago. I have plenty of energy to serve my daily needs. In fact, I think it is kind of surprising when friends younger than me have to go to bed at 9:00 PM because they just “run out of gas.” I don’t experience that. My body finally functions relatively normally. I sleep well, and nothing chronically hurts. These changes came from focusing on my diet, carefully tracking what I ate and how I felt a few hours and days later. Over the years, I learned which foods my body can process without giving me trouble, so I focus only on eating those foods each day. As a result, I maintain the same weight. That is a far cry from how I was 15 years ago when I was larger, bloated, gassy, covered in a terrible itchy rash, and had rosacea on my nose. I was dying then. I am thriving now. It’s been a hard road, though, to eat foods and experience their affects, sometimes most unpleasantly for weeks in order to learn what “works” and what doesn’t with this fascinating body of mine. It comes with its own reward. The reward is a “working” body, which if you have, you don’t realize what a gift it is until it is gone. The war is over. My body and I have achieved peace. Most importantly, I haven’t farted since 2005!

Orthorexia – Healthy Anorexia

People who focus a lot of energy on their health, to the point where it is a major feature of life are termed disordered or dysfunctional. People who carefully read labels of the foods they eat, who limit their foods to a very few, who have regulated exercise routines and spiritual practices are termed “orthorexic” or “healthy anorexic,” where someone maintains her health while practicing “disordered eating practices” (Musolino, et al., 2015, p. 18). By their definition, because I am gluten-free, dairy-free, grain-free, sugar free, and mostly vegetarian (except fish and chicken occasionally), because I read labels carefully (to avoid these foods, and other allergens), have planned meals with few foods and a regular exercise regimen, I’m orthorexic. Well bring it on! I’m much better than I was when I was “normal.”

I also know that I have food anxiety. If I am at home and can control my diet, I’m fine. But when I travel, and have to rely on other people’s decisions about restaurants, have no way to store food, and have to carry whatever I am going to eat, I panic. Food anxiety isn’t a fun thing. Knowing I have this helps me plan around it, but the best made plans don’t always work. Later in this book, I’ll detail my travel strategies, but when border control takes away all of my food upon arrival to a country for a two week trip, panic sets in. It’s a trigger that can cause a cascade of fear-induced extreme behavior. Knowing this about myself helps me to control it with adaptive strategies.

Adaptive strategies include eating few foods as reported by Julia (#49) who says, “I eat the same foods day after day because I know they don’t make me sick.” Julia struggles with anorexia largely because her family does not help her find gluten free foods, so she avoids eating, fearing she’ll be sickened. It is easy to accidentally become anorexic when on an extremely restrictive diet (Ricca, et al., 2000). Remember the woman I met in the pet shop from Chapter 1 whose niece was diagnosed with celiac disease and then who became anorexic? That poor girl was dodging gluten in her home, with a family that did not embrace her needs, or help her. As a result, she developed anorexic behavior, where she feared food. Who can blame her? She was uninformed, and getting cross-contaminated on a regular basis. In this case, the dietary restriction triggered the disorder (Ricca, et al., 2000). Her hysteria to stay well caused her to fear food, and eat the very few items she considered safe. If her aunt is to be believed, the girl developed mental illness, likely due to malnutrition, coupled with the fear of what foods would do to her body. For her, it was a downward spiral, where one malady fed the other.

An Alternative Attitude

The diet culture seems to entail members “going on the diet” periodically throughout the year, only to “go off” at some point, and having to “go back on” in the future. This perpetuates feelings of “self-criticism” or “self-mastery,” depending on which end of the spectrum the dieter is on, that can potentially lead to disordered eating (Heyes, 2016, p. 140). This behavior affects all aspects of life. If a woman is dis-heartened by the size of her body, she is likely feeling out of control with her career, possibly with her marriage, and her personal relationships. She may even self-sabotage. The research I’ve presented from my study and from others points to the idea that women are more socially acceptable if they communicate discontentment with their bodies and other elements of their lives, rather than indicating a general state of satisfaction. Social norms teach us to “hate” those who are accomplished and happy and to “love” those struggling. Again, awareness is the first step to change. It is also very normal to be angry about the deprivation imposed by allergy-reaction-free diets. Eliminating major food groups means you will not eat like a “normal” person, and you will never be able to participate in routine acts of commensality, key to social interactions. If we are aware that cultural norms perpetuate the attitude of discontentment, we can take steps to change by saying to ourselves: “I accept my body as it is. I love my arms, legs, trunk, face, hair, feet, legs, butt, eyes, nose, mouth, hands – all of me! I am grateful for a functioning body that allows me to hike, bike, walk, run, etc. It is a gift. My body serves my physical needs and allows me to be a functioning individual. I am grateful for the hard-earned knowledge of a diet that makes my body thrive. It’s been a painful process and I’m happy I finally worked it out. I am sincerely grateful for being included in social and family food-related gatherings even though I don’t always participate in the act of commensality, because inclusion is paramount, and sharing time with loved ones is certainly more important than eating with them.” This is a good first step toward self-love and acceptance. Having a positive outlook on one’s body could permeate all other aspects of life.

Recap and Moving Forward to Family “Vexing Venues”

We have seen in these first few chapters how gluten is a mainstay in cultural practices ranging from wedding and religious rituals, to customs for holidays and celebrations throughout the year. Examples show how avoiding gluten can result in subjugation, scrutiny, and social isolation. Study participants describe how gluten ignorance or sexual biases sustained by medical practitioners prolong a proper diagnosis. We’ve seen how religious practices that require the consumption of gluten, even by those with celiac disease, further the dissonance for those told to avoid it completely. We’ve covered other influencers including the diet industry, which encourages a culture of scrutiny particularly with women who seek to boost their self-esteem, and station in life with a “fit,” attractive body.

Sometimes our extreme dietary restrictions cause us to become “disordered” albeit with good reason, leading some professionals to deem us as “dysfunctional” even though we thrive on our dietary choices. Our gluten-centric culture forms ideologies or “truths” that affect our interpersonal relationships with family and friends -- the topic of the next chapter that focuses on how these ideologies play out in familial settings.

Invitation to Continue the Conversation

Would you like to work through the concepts presented in this book in more detail, perhaps developing a plan of how to address interpersonal and cultural issues caused from living the gluten-free lifestyle? Please visit www.alternativecook.com for information on workshops, or to schedule a consulting session with Dr. Jean Duane.

Ideologies in Chapter 4

Discussion Question:

1. Do you feel like your body is your enemy or friend? What causes you to feel this way?
2. How have the dietary discretion, sexist scrutiny, size surveillance and living by the numbers ideologies discussed in this chapter impacted your life?
3. Do you feel your body size is scrutinized by your friends/family?

Copyright © 2021 by Alternative Cook, LLC

References in Chapter 4

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Continue to: Gluten-Centric Culture: Chapter 5 - Grabbing A Bite Together

Back to: Gluten-Centric Culture: The Commensality Conundrum - Chapter 3 - Where Ideologies Collide In Public Settings