Is it “optimization” or an eating disorder?
- Hope Corrigan
Jack Dorsey has been a vocal proponent of intermittent fasting. Photo by David Becker/Getty Images
Jack Dorsey doesn’t eat anything in the morning. Instead, he meditates for two hours, he takes an ice bath, and drinks a lot of water. He doesn’t eat anything for lunch, either. After subsisting on water all day, Dorsey consumes a dinner of proteins, greens, and mixed berries between 6:30-8:30pm, as the Twitter CEO explained on the Ben Greenfield Fitness podcast in April 2019.
If Dorsey were a woman, we might call this disordered eating. But because he’s a man—and a powerful one in the tech industry—we call it “optimizing.”
For decades, women, especially those in the public eye, bore the brunt of unrealistic beauty standards, which caused many to develop or exacerbated unhealthy relationships with food. Actress and Goop founder Gwenyth Paltrow reportedly ate 300 calories a day during a January 2018 detox regimen; reality TV star Nicole Richie admitted that she “liv[es] on a diet of sunflower seeds, celery juice, and chewing gum.” Just this week, Today Show hosts Jenna Bush Hager and Hoda Kotb weighed themselves on live television after spending a week only eating between 10am and 6pm, with the intention of losing weight and improving “brain health, and energy and skin.”
When these prominent women share their regimens, the public and media outlets accuse them of disordered eating, in the process normalizing the kinds of body images that have driven millions of women to develop eating disorders of their own.
But in recent years, high-profile men have begun to publicly divulge their eating habits, not as a way to meet a standard, as women feel they must, but to show how they exceed one.
That is, many famous men have attributed their success to an “optimizing” regimen of intermittent fasting. In 2013, actor Hugh Jackman revealed his intermittent-fasting plan that involved an eight-hour window to eat, followed by 16 hours of fasting. Phil Libin, the former CEO of Evernote, explained his decision to fast for up to 8 days at a time, attributing his lack of excitement about his work to his carbohydrate intake. In 2016, tech entrepreneur Kevin Rose decided to cash in on the trend and created Zero, an app intended to help users track their fasting regimens.
For decades, the stigma surrounding eating disorders put women at risk. Today, men who adopt these practices in efforts to enhance mental clarity and boost energy levels (and with little scrutiny towards the scientific backing of intermittent fasting) run the same risk of sliding into dangerous eating practices without even knowing it.
What Does the Research Say?
Intermittent fasting is a regimen that severely restricts calorie intake during certain days of the week or hours of the day. If done correctly, intermittent fasting can be beneficial to those struggling with obesity or for those trying to prevent diabetes and heart disease, since weight loss occurs as the body expends more energy than it takes in. Some research also suggests fasting can slow aging and reduce inflammation, but there’s little to support the idea that this is linked to anything other than weight loss. For some people, it also comes with a mental clarity that can feel good. “Fasting seems to let you harness the highs of self-starvation without getting an eating disorder,” wrote Kat Stoeffel in Elle.
But the regimen is not right for everyone—fasting for long periods of time can cause drops in blood sugar levels, which can lead to grogginess, dizziness, headaches, irritability, fatigue, and dehydration. It’s difficult to generalize the effects (both desirable and undesirable) of intermittent fasting, however, since studies on it tend to be short in duration and have small sample sizes.
The research on disordered eating, however, is much better established. A 2019 study from Britain’s National Health Service found the number of hospital admissions for eating disorders has doubled in preteen children in the past 10 years, with the majority of cases being girls. Behavioral indications of anorexia often include preoccupation with food and calories, developing food rituals, and severely limiting food intake through fasting. The prevailing sentiment amongst eating disorder research is that anorexia in men is “likely underrepresented, under-diagnosed, and under-treated.”
Intermittent fasting can be a precursor to severe disordered eating. “For some people who are vulnerable (genetically) to binge eating, for example, intermittent fasting can set them up for a rebound binge. For other individuals who are genetically prone to anorexia nervosa, experimenting with intermittent fasting can be the first step in a slippery slope toward anorexia nervosa,” says Dr. Cynthia Bulik, the director of the Center for Excellence for Eating Disorders at the University of North Carolina and the director of the Centre for Eating Disorders Innovation at the Karolinska Institutet.
The Role of Gender
Historically, men and women were socialized to strive for different goals. Men were to be successful, and women beautiful. That precedent has something to do with why Dorsey’s eating habits aren’t considered an eating disorder (could you imagine him weighing himself on live TV?). “If female Silicon Valley execs came out with New York Times articles on biohacking, they would be pounced on as having eating disorders, but because men are proponents of the behavior it is viewed as less pathological,” Bulik says.
Productivity, biohacking, and control are all factors that play into the branding of intermittent fasting as something positive instead of the more accusatory responses women often faced for restrictive diet choices. Bulik recalls first hearing about the resurgence of intermittent fasting and immediately noting how different the public reception was. If the proponents of intermittent fasting were women, Bulik says, “there would be finger-pointing, there would be accusations, there would be diagnoses, there would be all those sorts of things. But for guys, it’s like, wow, they’re really improving their productivity and they’re showing such amazing control.”
The way our work-revering society frames men and women’s eating habits has a lot to do with this difference. While women’s behavior is often pegged as “disordered,” such language is less often applied to men because their eating habits (though they are the same as women’s) are touted as a boon for success, productivity, and self-improvement. “People who have extreme eating behaviors (intermittent fasting, biohacking, extreme pickiness) can have variants of anorexia nervosa or avoidant restrictive food intake disorder (ARFID) and go undetected because they are packaged as healthy or productivity-promoting,” Bulik says.
This “productive” framing around food issues can make it difficult for doctors to diagnose men with eating disorders—or even for men to acknowledge a problematic relationship with food. “There are not-so-subtle differences in gender effects related to eating disorders. Men are more comfortable saying they have a food addiction than a binge-eating disorder for example—in part because eating disorders have traditionally (and erroneously) been viewed as women’s disorders, whereas addiction is not so gendered of a construct,” Bulik says.
The result: a persistent stigma around a diagnosis of disordered eating for men that’s putting their health in danger. According to the American Psychiatric Association, eating disorders are more prevalent in women but men who are diagnosed with them are more likely to experience coinciding depression and less likely to seek treatment.
The buzz around intermittent fasting seems to be a direct result of societal obsession with productivity and self-improvement at any cost. For men, fasting goes beyond the superficiality of simply looking “better”—it’s positioned as a noble pursuit that spins severe food restriction into a tool for optimization of the self. If there were less stigma around eating disorders for men, intermittent fasting (and its proponents) might be perceived differently by the general public. That shift could help keep men—and women—healthier.
If you or a loved one are currently battling an eating disorder, please reach out to the National Eating Disorder Helpline at (800) 931-2237 or visit the National Eating Disorder Association Helpline website to live chat with a Helpline volunteer.
Hope Corrigan is the Audience Editor for the Special Projects team at Quartz. Previously, she worked in marketing at VICE Media and Lonely Planet.