"When I wrote Unbearable Weight, it was widely believed that privileged white girls had the monopoly on eating and body-image problems. The presumption was a relic of the old medical models, which accepted the “profile” presented by the typical recipient of therapy-who was indeed largely white and upper middle class- as definitive, and which failed to recognize the central role of media imagery in “spreading” eating and body-image problems across race and class (and sexual orientation). Like the Black Africans and the Fijians and the Russians (and lesbians and [Latins]] and every other “subculture” boasting a history of regard for fleshy women), African Americans were believed “protected” by their alternative cultural values. And so, many young girls were left feeling stranded and alone, dealing with feelings about their bodies that they weren’t “supposed” to have, as they struggled, along with their white peers, with unprecedented pressure to achieve, and watched Janet Jackson and Halle Berry shrink before their eyes. Many medical professionals, too, were trapped in what I’d call the “anorexic paradigm.” They hadn’t yet understood that eating problems take many different forms and inhabit bodies of many different sizes and shapes. Binge eating-a chronic problem among many African American women-is no less a disordered relation to good than habitual purging, and large women who don’t or won’t diet are not necessarily comfortable with their bodies. Exercise addiction is rarely listed among the criteria for eating problems, but it has become the weight control of choice among an generation emulating Jennifer Lopez’s round tight buns rather than Kate Moss’s skeletal collarbones. Just because e a teenager looks healthy and fit does not mean that she is not living her life on a treadmill-metaphorically as well as literally-which she dare not step off lest food and fat overtake her body. Until recently, most clinicians were not receptive to the arguments of feminists like Susie Ohrbach (and later, myself) that “body image disturbance syndrome,” binge/purge cycling, bulimic thinking,” and all the rest needed to be understood as much more culturally normative than generally recognized. They wanted to draw a sharp dividing line between pathology and normality-a line that can be very blurry when it comes to eating and body-image problems in this culture. And while they acknowledged that images “play a role,” they clung to the notion that only girls with a “predisposing vulnerability” get into trouble. Trained in a medical model which seeks the ause of disorder in individual and family pathology, they hadn’t yet understood just how powerful, ubiquitous, and invasive the demands of culture are on our bodies and souls."