This story appears in the January 2017 issue of National Geographic magazine.
Alexandra lives in a peaceful, leafy subdivision in a suburb of Dallas, Texas, with her parents, a brother, a sister, and at the moment, five dogs—her family rescues dogs. Alexandra, who is 22 years old, rescues people.
In high school she was president of the teen board of a suicide hotline. Before that, she and friends had founded a blog on Tumblr for suicidal adolescents. She gave out her cell phone number and counseled people who called, tracking down their Facebook friends and even calling the police.
When adults found out, they told her to stop immediately, terrified that amateurs might inadvertently do harm. “I had no training—it was really reckless on my part,” Alexandra said. “At that time I saw it as heroic. Now part of me thinks I was trying to save them because I couldn’t save myself.”
As early as first grade, she was comparing herself with other girls. They were more popular, prettier, thinner, smarter, more interesting. “I remember just really wanting to be someone else,” Alexandra said. “Even innocently—just spending a day as someone else. But that thought became more intrusive and obsessive.”
In high school Alexandra was depressed to the point of contemplating suicide. She wanted to change everything about her appearance. “I knew I had friends and family who loved me. I knew I had potential. I knew I was intelligent. But I was almost disgusted with myself.” (The last names of some people in this story have been withheld at their request to protect their privacy.)
Alexandra resorted to self-harm, a strategy some teenagers use to try to deal with their emotions, or even to punish themselves. She started burning the inside of her arms with her hair straightener, covering the burns with bracelets.
From ninth grade through 12th, Alexandra secretly skipped meals, and on days when she ate three meals, she would feel suicidal afterward. She was already thin—a serious ballet dancer, taking classes every day after school and all day on Saturdays—but wanted to be thinner. “I grew up in front of a huge mirror,” she said.
In a way, every girl in America grows up in front of a mirror. The normal existential struggles of teens—Who am I? Am I worthy of love and respect?—are too often channeled through another question: How do I look? For girls the most significant social pressures they face as teens are to conform to conventional notions of beauty.
Coping with this is easier today in some ways and much harder in others. Easier because America has become gentler on kids who are different: Beauty still rules, but our definition of beauty encompasses people previously excluded. Harder because social media—a factory for the mass production of insecurity—is transforming everything about adolescence.
In extreme cases this pressure can trigger the onset of anorexia—the disorder with the highest mortality rate of any psychiatric illness. Alexandra’s eating disorder was serious enough that she spent months of her senior year of high school in a daytime hospitalization program.
Restricting food allows a girl to seize control of one of the few things she feels she can control. “I thought that if I achieved the societal ideal of thinness, everything in my life would be perfect,” said Estrella, 23, a friend of Alexandra’s who was hospitalized for anorexia. “I would be controlling all the chaos of my life—which now I see is privileged and not very chaotic,” she said with a laugh.
Alexandra and Estrella are part of a group of young Dallas women, all of them survivors of eating disorders, who are trying to create a different way for girls to grow up: valuing themselves for their inner beauty, free from body shame.
Until recently in the United States there were only a few sure paths to high school acceptance for girls; the most obvious was being a beautiful, sleek-haired cheerleader. Now, in much of the country, a girl can be a geek, goth, jock, prep, nerd, emo, punk. “I’ve been called weird; I’ve been called strange,” said Desirée, a 15-year-old in Cranford, New Jersey. “There was a moment when I decided to be myself. In seventh grade I found my people, found my village.” Her village was nerds, she said, kids who loved Broadway musicals and video games.
There were fewer villages when I was in school, and they were harder to find. Now the Internet can make life hell for teens, but it can also help those who are different or who feel different. Girls who can’t find their village at school might find a version online. They can find other girls who bake Hello Kitty cupcakes, raise money to save elephants, practice mixed martial arts, love Barbra Streisand, build robots, or believe that Ross and Rachel on Friends should still be together. With Wi-Fi, no one is truly alone.
There were few women of color in the fashion magazines I read, few models who had normal curves. None was disabled, or transgender. Rarely was there even a model with curly hair. Now all are more common. The pressure to be beautiful is still oppressive, but beauty is increasingly seen as coming in all colors and a wider spectrum of shapes.
Life has improved in many ways for LGBTQ youths—most dramatically for gay, lesbian, and trans teens. These teens have always been victimized. They are nearly twice as likely to be bullied as heterosexual teens, and more than four times as likely to attempt suicide. The Centers for Disease Control and Prevention says that nearly 30 percent of gay, lesbian, and bisexual teens have attempted suicide.
But in major cities and increasingly in parts of rural America, these teens are more accepted and suffering less. About half of gay teens report having a gay-straight alliance club at their school, for example, double the number from 2001.
The same stigma, harassment, and rejection that lead to victimization and suicide also put gay, lesbian, and bisexual people at higher risk for eating disorders. Catherine Ratelle went to the prestigious Hockaday School in Dallas. Her eating disorder began when she was 15. This was also when her parents told her they were divorcing. “That was my world falling apart, and the world I wanted to control and fix.” Her secret eating disorder, she said, was embedded inside another secret: She was in a relationship with a girl.
She went to college at Texas Christian University in Fort Worth—“an environment even more difficult than Dallas,” she said. “I made it hard on myself. I wonder sometimes if I did that on purpose so I could prove to myself it was just a phase. In the heteronormative families I was growing up with, I didn’t see my reflection anywhere.”
It wasn’t a phase. She came out after moving to Washington, D.C. She took an internship and then a job coordinating pride festivals and community events for the Human Rights Campaign, which works for full equality for LGBTQ citizens.
It would be easier at Hockaday now, said Ratelle, who’s 26. Just in the past three years, she said, there’s been enormous progress. “The way being gay was talked about when I was 15 to 16 is not the way it’s talked about today. I laugh and want to hold my 15-year-old self so tightly. ‘Sweet girl! You will get through this!’ ”
When I was reporting this story, in Dallas and in Cranford, I found that expectations for girls vary widely. In New Jersey they said they felt pressure from adults and other girls to excel in science, technology, engineering, and math, popularly known as STEM. “Not being interested in STEM was very hard for me,” said Grace, a Cranford girl who’s 15.
Jennifer Bartkowski, chief executive officer of the Girl Scouts of Northeast Texas, which includes Dallas, believes that in much of Texas, the social expectations run in the opposite direction. “It’s a little better, but it’s still not cool to be smart after fourth or fifth grade. We haven’t moved the needle as much as we need to.”
Bartkowski believes that while there’s been progress for teenage girls, it’s often overshadowed by the harmful effects of media. Girls can find people who share their interests on the Internet, but they are “friends,” not friends. “So many girls are texting rather than having real conversation,” she said.
Bullying is an example of how advances have been undermined by online behavior. Many schools now have effective programs to create peer pressure against bullying. But in cyberspace bullies are empowered by anonymity—they need not face their victims or disapproving bystanders.
Estrella said she became a victim of bullying by a friend who was upset that Estrella missed her birthday party. Over a few days Estrella received several dozen text and Facebook messages from the girl’s other friends: “Nobody likes you.” “You’re a slut, no wonder no one wants to be friends with you.” “The world would be better without you in it.”
Estrella said she already was depressed and having suicidal thoughts, and the messages “confirmed all of my doubts about myself.” She never tried to commit suicide, but the incident intensified her eating disorder.
Ads, celebrity photos, and fashion layouts aimed at teen girls set standards of beauty and thinness impossible for girls to meet. Literally impossible, thanks to Photoshop and other photo-editing software. They start with stunning women, add hair extensions, false eyelashes, and makeup, and then use Photoshop to give them a longer neck, smaller waist, thinner thighs, smoother skin, silkier hair, wider eyes, lusher lashes. A video on CollegeHumor’s website shows it’s possible to create a photo of a beautiful woman modeling a bikini—starting with a shot of a slice of pizza.
And it’s not just models who get photoshopped. Many girls won’t post their own selfies on Instagram or Facebook without running them through Photoshop first.
Women have always relied on their peer group to set the rules for how they should look. For the first time in history, that pressure is coming from peers who do not even exist. Is it any wonder girls find themselves wanting?
And it starts young. Estrella, who is planning to apply to graduate school in psychology, works as a nanny. One day she and a seven-year-old girl were taking pictures and adding dog ears to them with Snapchat filters, when the girl looked at a particular picture. “Can you delete that?” the girl asked. “My cheeks look fat.”
Estrella thought carefully about how to respond. “Well, your cheeks look a lot like my cheeks, and I like my cheeks,” she told the girl. “Do you like my cheeks?”
“Yes,” said the girl.
“And I like yours,” she replied.
“It was like a dagger to my heart,” Estrella said.
At 17, Alexandra was the oldest in her hospital’s eating disorders unit—most of the children were 13 or 14. She was far from the sickest. “I met girls who were so kind—on feeding tubes, nearing heart attacks, on the edge of death,” she said.
“Every chance I got, I tried talking to people,” she said. “No, your weight doesn’t matter. No, you’re beautiful right now.” On her last day she gave each patient CDs she had burned with inspirational songs. “I promise you, I will be back as a therapist,” she told them.
When she was discharged, she had reached her goal weight, but her thinking about her body had not changed, she said. Right after her high school graduation, though, she began the activity that would transform her life.
On a Wednesday evening in Dallas in early June 2012, Alexandra walked into a group therapy session run by psychologist Melody Moore. Moore liked group therapy for teenage patients, since they listen mainly to each other. Alexandra joined a rotating group of high school girls. “I remember feeling above a lot of people in a sick, twisted way,” she said, because she was the only one who’d been in the hospital. “It’s some sort of achievement, being that bad.”
Moore’s other group, of college women, had been stable for a few years. Estrella and Catherine were among the members, as were two University of Virginia students, Caroline and Chloe. They met in person during summers and holidays, and by Skype when they were at college. Going to college is always perilous to self-esteem, and all the girls had fallen into and out of eating disorders.
The women were in recovery, “but what could I do to get them to be recovered and not have this be a lifelong struggle?” Moore said. One answer was for them to help other girls. “When you’re involved and engaged in being an activist, you are much less likely to fall back into it.”
Moore had other reasons. “If I didn’t do something to prevent more girls from body hatred, from negative self-image, from potential eating disorders, from criticism and comparison being ‘just the way it is,’ then I would be spending the rest of my life sitting back and waiting for more girls to get eating disorders so that I could help them recover. Everything about that felt wrong to me.”
In early 2011 Moore had sketched out a rough workshop that included yoga, which she often used in her practice. The workshop was designed to expose body shaming, identify its roots, and help girls change their thinking. In December she led it for some of her patients as a holiday gift. The women loved the idea and ran with it. They refined the workshop and practiced it with groups of girls in Moore’s office.
In May 2013 they presented it outside the office for the first time, to about 60 seventh graders at a Catholic school in Dallas. The women began by speaking briefly about how they got there. Chloe, now 24, said that when she was in seventh grade, a boy told her she had thunder thighs—the remark she credits with setting off her eating disorder. “Someone reaffirmed that I’m not normal,” she said. And yet, she told the girls, those thighs got her on the rowing team, which got her into the University of Virginia. “My thunder thighs have been good to me. Now I wouldn’t call them ‘big,’ but ‘strong.’ ”
In one exercise the participating girls formed a circle. The leaders read out statements: “I feel ugly sometimes.” “I compare myself to others.” “I would rather look different.” Girls who thought the statement applied to them stepped inside the circle. The purpose was for them to see that they were not alone in having such thoughts.
Chloe talked about how the media use unreal images to sell things. Then the girls broke into three groups of 20. In their group Alexandra and Estrella passed out magazines and asked the girls to tear out the first five pictures of a woman they found. “Do you see a woman of color?” they asked. “How many of these women would be considered plus sizes? Do you see any scars or acne?”
In the most powerful exercise, each girl wrote down what she didn’t like about herself, one thought per sticky note. In her group, Caroline, who is now 24, stood in the middle of the circle, and the girls stuck the notes on her corresponding body part. Soon she was covered with brightly colored notes. Alexandra read them aloud. “Fat legs,” she read. “Frizzy hair.” “Yellow teeth.”
“You wouldn’t say these things to a friend,” she told the silent girls. “So why say them to yourself?” The girls tore the notes into confetti.
“It got so concerning,” Alexandra said. “Over and over it was: no thigh gap, no thigh gap, no thigh gap. That was on my mind. But these girls were 11 or 12. Why was it on their minds?”
Moore required each of her patients to have progressed in her recovery before leading the workshop. “I was better, but far from full self-acceptance and self-love,” Estrella said. “But being next to Alexandra, doing that workshop, I felt an overwhelming sense of pride for both of us. I realized I could make this my life, carrying myself this way and not talking about how much I hate my thighs.”
That was the beginning of the Embody Love Movement, which now has 250 trained volunteers who run workshops in the U.S., Canada, England, Ireland, Australia, and New Zealand.
I watched a workshop in suburban Dallas one morning with about 60 Girl Scouts, ages 10 to 13, and also attended part of a weeklong summer camp at Alluem Yoga in Cranford.
Karen Gilmour, who runs the yoga studio, had the girls do partnered yoga, physically supporting each other in the poses. Other exercises were about mental support. The girls mirrored one another’s movements. They had to tell their partners one thing about them they found beautiful. Gilmour asked the girls to assume powerful poses, then they lay down on body-size sheets of paper and their partners traced them, creating a life-size portrait of a powerful girl. They received hand mirrors with “I am loved” written on the front.
Grace has taken the Embody Love workshop at Alluem four times. “Every time I’ve been at a different stage of my life,” she said. It was an epiphany the first time. “Whenever I felt insecure, I felt like I was the only one who feels like that. It turns out everyone feels like that.”
For Lily, who’s 12, four days at Alluem’s Embody Love camp reconfirmed her determination not to grow up too fast. Her screen time consists of watching old musicals, I Love Lucy, and cooking and home decorating shows on TV with her family. She’s not allowed on the Internet unsupervised, a rule she endorses. “I’m not sure I want to be exposed to the world yet,” she said.
When she is, she’ll understand better how to interpret the photos she sees. “It’s a false reality—even if you know it could be photoshopped, your brain forces you to believe it, because you’re seeing it,” she said. “It must be one of the worst jobs in the world to edit those pictures. You have to see the flaws in everything you look at.”
She keeps her “I am loved” mirror on her dresser. “I always look in there,” she said.
The sorority Tri Delta hired Moore to design a workshop for its second-year members. The workshop is now a part of Tri Delta on every campus. Estrella and others have led it at schools nationwide.
Alexandra brought the Embody Love workshop back to her college, leading several large workshops and training other women to lead them. She even confronted her friends. “We would sit around in the cafeteria and talk about bodies and our food and our weight,” she said. One day she’d had enough. “Can you imagine what we’d get done in the world if we weren’t spending time on this crap?” she told them. “I can’t remain friends with you if this is all you talk about.”
Alexandra considers herself recovered. “If I’m hungry, I eat,” she said. “I don’t know the last time I weighed myself. I don’t think about calories.”
Preventing suicide remains a focus of her life. The week we met, she had attended a funeral for a close friend who had killed herself. She works as research coordinator for a clinic that treats suicidal adolescents. She plans to go to graduate school in psychology. A few weeks earlier Alexandra’s mother had dropped her off for professional training at the hospital where five years earlier she had been treated—and had promised to come back as a therapist. “I felt just like she had dropped me off for therapy,” she said. “But this time, I had a badge around my neck.”
Tina Rosenberg is co-writer of the New York Times’ Fixes column. For National Geographic, she has written about community health workers in India and women in Ethiopia burdened by the daily chore of hauling water. Kitra Cahana has photographed stories on hunger and the teenage brain for National Geographic.