Miley Cyrus took to Twitter yesterday to refute claims that she's suffering from an eating disorder. Instead, she says, her weight loss is due to a shift toward gluten-free and lactose-free eating for health reasons.
"For everyone calling me anorexic I have a gluten and lactose allergy," she wrote. "It's not about weight it's about health. Gluten is crapppp anyway!"
While her fans are most certainly aware that Cyrus is not a medical professional, it's valuable to fact-check her statement anyway. First of all, it is impossible to be allergic to gluten. Those who have difficulty digesting gluten have either a condition called celiac disease or non-celiac gluten sensitivity. About 1 percent of the population suffers from celiac and about 10 percent have a less specific sensitivity, according to the Mayo Clinic.
Celiac sufferers have an immune response to gliadin, a gluten protein found in wheat, rye and barley. Symptoms range from chronic fatigue, diarrhea, bloating and headaches to "failure to thrive" in young children. Weight gain is not as common clinical symptom of gluten sensitivity as weight loss is.
Celiac disease is diagnosed through a tissue biopsy, but non-celiac gluten sensitivity is both diagnosed through an elimination diet after patients report likely symptoms to their doctors. Gluten is gradually removed from a person's diet and doctors monitor patients' self-reported symptoms to see if they subside. But according to a recent editorial in the Annals of Internal Medicine, some clinicians are worried that the elimination diet is not an effective way to diagnose the condition. They argue that a "nocebo" effect causes patients to feel alleviation of symptoms because of the popularity of gluten-free eating and celebrity endorsements from people like Cyrus. Instead, they urge double-blind testing in which patients try two different diets, without knowing which is gluten-free and which contains gluten.
The power of suggestion is particularly strong when so many celebrities swear by gluten-free eating. And while Cyrus may suffer from celiac or non-celiac gluten sensitivity, her svelte physique is most likely the result of regular exercise and careful eating. Note that the first photos of her changing figure were captured as she left the gym. And if the new gluten-free diet is responsible for some weight change, it may be because Cyrus can no longer indulge in favorite junk foods. Another Tweet shows the actress and singer inhaling deeply into a bag of fast food, and she wrote, "I can't eat it. So I'm just gonna smell the shittttt out of it! My mouth is LITERALLY watering."
She wouldn't be the first gluten-free eater to speak wistfully about favorite, but forbidden foods.
That we are talking about Cyrus' body at all -- and that she felt the need to appease us with a medical justification for her weight loss on Twitter -- is an unfortunate consequence of the way we talk about celebrities and celebrated women in particular. This was most eloquently stated by the actress Ashley Judd, who recently wrote about speculation related to her own appearance (most centrally, slight puffiness in her face) on The Daily Beast:
The Conversation about women’s bodies exists largely outside of us, while it is also directed at (and marketed to) us, and used to define and control us. The Conversation about women happens everywhere, publicly and privately. We are described and detailed, our faces and bodies analyzed and picked apart, our worth ascertained and ascribed based on the reduction of personhood to simple physical objectification. Our voices, our personhood, our potential, and our accomplishments are regularly minimized and muted.
Cyrus' body and what she puts into it are her business. But her medical statements are another matter.
Here are more celebrities with food allergies and sensitivities:
CLARIFICATION: Language has been removed that confused the diagnostic tests for celiac disease and non-celiac gluten sensitivity.