Over the last 20 years, the word "debate" has been reclassified. Where once it meant two or more sides presenting an argument with a clear line, and then establishing by vote who has won, it's now more likely to mean someone having a slanging match against someone they don't like but wanting to make it sound classy. 

On the surface, the latest 'debate' has been around Ariana Grande, the singer and actress who this week withdrew from the revival of Stephen Sondheim's Sunday in the Park with George, due to start in 2027. The consternation around how thin she looks in the Wicked films, and even more so in the music video for her single Petal, released last week, has been impossible to ignore. 

In reality, it's rampant disapproval for appearing to show how the sausage is made in Hollywood, but taking it too far. When celebrities start looking unwell, it's a breaking of the unspoken contract: you get fame in exchange for making it look enjoyable and easy, and making the public want to spend their money on the products you sell. Any sign of unnatural effort is to be punished. 

But effort there must be: in the mid-2010s, the effort was around Kardashian-levels of makeup, even, and perhaps especially, for civilians going nowhere more glamorous than the shopping centre. Now, the baking and contouring has been dialled down considerably, but the drip-feeding of unrealistic control feels very much present. Now, the Kardashian face has been swapped for the Kardashian butt, but without the surgery: protein targets, lifting heavy, the Instagram obsession with cottage cheese. The high street is rammed with girls wearing gym leggings with an inbuilt thong. Macros, collagen, recovery days, strong not skinny. 

Kaia Gerber, who has spent her career being compared to her mother Cindy Crawford's body, put it plainly earlier this week in interview with Vogue. "We're clearly in one of those cycles right now where people are very, very, very thin. I've had disordered eating in my life. People are like, 'you look terrible,' and it doesn't exactly make you go, 'oh good, let me get over this mental illness then.' Negativity has never saved someone's life." 

People may be willing to use mental health issues or addiction as third-party whipping boys, but there is a curious omertà around health in the public eye. Look at Donald Trump: visibly unwell in a variety of ways but, having apparently armed himself with the Dr Nick of personal physicians, signed off as being in the pink of health. The New York Times journalists Maggie Haberman and Jonathan Swan, whose bestselling new book Regime Change covers the first 18 months of Trump's second term in office, found that the President's health was the one area in which they could find absolutely nobody willing to speak, on or off the record. This is particularly extraordinary given the number of sources gaily willing to reel off the most cringing detail of what did and did not occur during senior administration meetings, but it also ties in to what we have been repeatedly shown over the last century: ill-health as a moral failing. 

Physical appearance continues to be that intangible beast we might best call baby bear's porridge: it's got to be just right, whatever right means at that stage. The arbiters of just right change every few years, meaning that even those who are just right are never that: too gay, wrong hairline, difficult or, shudder, prone to ageing a full calendar year every 365 days. Even the most ravishing actors in Golden Age Hollywood had full and extreme makeovers, from their history to their appearance, including surgery, to ensure they fit the narrative that the studios, and the public, wanted to hear. 

And seeking to be just right is what happens when you don't have the power to make things happen, only to ride on someone else's wave. In her book Women vs Hollywood, Helen O'Hara charted the removal of women from directing and writing in the 1910s to in-front-of-the-camera-only once men decided cinema's value was more than a women's interest. As arts funding and support for people on low wages diminished, people started hoping to win a career and makeover their lives on reality shows. 

Without dismantling society completely, it's unsurprising that people seek to control how they appear. It's part of the social contract that gets us in the workplace, in friendships, and in communities. The people with the real power need never make the slightest effort unless it pleases them: look at Elon Musk, his terrible wardrobe and deathless communication style. And look too at the people financing the films: the absence of cosmetic surgery, the very insignificant way they look, the lack of attention to what they wear unless they suddenly decide to date someone in the public eye. They are the ones who look just like us, whatever that means these days, but who ensure that we aspire to something utterly unattainable. 

When you have all the power, you don't need to worry about how you look. After all, you're the one holding the purse strings, and they speak louder than any volume of filler. The debate isn't about you. 

To talk in confidence to an adviser from eating disorders charity Beat, call 0808 801 0677. The number is free and will not show up on your phone bill. beateatingdisorders.org.uk