The Haunting Myth of American Anorexia

2 04 2006

Alex Williams penned a salacious piece in today’s New York Times centered around the “weight anxiety” experienced by girls leading up to Spring Break. That we are, for “sufferers of eating disorders,” moving into “the most dangerous time of year.”

Self-denial and restraint in America? Now that’s dangerous - to our way of life.

Setting aside that the backdrop of alcohol abuse over Spring Break dwarfs any danger of starving oneself into a bikini, I should start by saying that I understand anorexia nervosa can be debilitating and dangerous for those affected by it. Just as I sympathize with people in plane crashes or victims of pit viper bites and lightning burns.

So, I do not intend herein to dismiss the pain and tragedy of the rare individuals and families truly affected; my aim here is to show the disparity between perception and reality.

A few years ago, Cornell University professor Joan Jacobs Brumberg wrote that we must “consider the ways in which different societies create their own symptom repertoires and how the changing cultural context gives meaning to a ’symptom’ such as non-eating.” For sure. Our cultural views on this matter could not be more schizophrenic. The primary threat posed by anorexia is as a dramatic affront to our cherished, biggie-sized way of life.

Xanga’s chief executive, John Hiler, is quoted in the Times article saying it is their corporate policy to delete any “pro anorexia” groups from the system. While that’s certainly their prerogative, they don’t appear to have the same policy about food or alcohol abuse (apparently the “food slut club” and “alcohol is my friend” group do not similarly offend Hiler’s sensibilities). Since these two unquestionably pose dramatically more risk to their participants, this corporate policy represents irrational, institutionalized stupidity.

My personal offhand estimate had been that we might lose about 100 Americans annually to anorexia. My research this morning showed that I was not far off - a 2001 study by the University of British Columbia’s Department of Psychology of every American death for the most recently available five year period showed only 724 people with anorexia as a causal factor - 145 per year. Christina Hoff-Sommers, in her research for the book Who Stole Feminism, came up with a number below half that. In a presentation to the International Congress of Psychology, one expert (Dr. Paul Hewitt) estimated a death rate for anorexia of 6.6 per 100,000 deaths. Even if you assume that sufferers outnumber deaths by a few orders of magnitude, it would still seem that all objective evidence shows the health impact on Americans from anorexia is statistically nil. Now, I know that doesn’t make for very good shock journalism, but it doesn’t change the uncomfortable fact that it’s true.

More Americans die from obesity-related illness in two hours than die from anorexia in a year. Two-thirds of Americans are overweight and one-third are obese. About ten million Americans have “clinically severe obesity” - and ambulance manufacturers are producing new “bariatric ambulances” that can support patients several hundred pounds overweight. Las Vegas, the first city to purchase the units, said that they had handled 75 calls in the past six months involving patients approaching or exceeding 500 pounds. Yet, when we speak of disordered eating, we still don’t seem to be referring to ourselves.

I know several girls whom others consider “anorexic” because they are very lean and don’t have emblematic American appetites. They are in fact not anorexic; but they are more cautious about their intake than most. They are vibrant, healthy, and adequately nourished; they can even run a couple of miles at a good pace. And that’s much more than most Americans can say.

So, please, ladies - the girl who has the body the rest of you wish you had is not anorexic. The girl who delicately refuses the eighteen-ounce wedge of deep-fried cheesecake the rest of you dive into after dinner is not anorexic. The girl who is obsessed with fitting back into those size 1 jeans is not anorexic. She’s just thinner than you, knows how to say no to herself, and it makes you jealous.

And parents - please realize that it is the countercultural idea of self-control and self-denial, backed by the occasional dramatic image, that catalyzes enough fear for us to think anorexia poses some threat to our youth. Much like the War On Some Drugs, however - the threat it poses is to our way of thinking, not our health. It is far, far more dangerous to let your spoiled kids eat what they want.

More broadly, the idea of anorexia threatens our view of our bodies, our consumption-obsessed culture, and our deeply held personal ideas about how much nourishment we “need” (read: “deserve.”) Perpetuating the myth of anorexia helps us demonize denial as some kind of blasphemy, rather than looking at our own dinner plates or in the mirror and asking: am I fat? (Probable answer: yes.)

The moral outrage against the ghost of anorexia is intellectually puddle-deep; it is similar to so many other moral panics of our generation. It hardly represents a statistical blip on our health-care radar - but it’s a dramatic affront to our way of living - and that’s far more dangerous than any 500 calorie-a-day diet could ever be.

Viewing 63 Comments

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    If anybody is still reading this post or the comments. It seems a lot of people are missing some of the points of the article.

    1. This article isn't talking about individuals suffering from anorexia or bulimia, rather, people who are naturally thin or have a healthy understanding of self-control when it comes to diet and exercise. Commenters who are equating self-control to anorexia is taking it to the extreme. It's not so black and white, starvation or binging.

    2. The whole size 1 thing - granted it might have worked if the author had used a more common size. But the point is that everyone has a size they're striving for regardless if that is size 1, 6, 14, etc. Nobody should be continuously buying larger sizes due to expanding waist, unless you are overeating and continuously gaining weight.

    3. Last point, a huge stickler for me is that personally I have a small frame and hasnt gained much weight (maybe 1-3 lbs) since high school. I'm 30. But this is a natural state for me for me. However, people (jealous, concerned, hateful, etc) would make snide comments regarding my weight all the time. As one commenter pointed out, I don't and can't make comments to people who are obese because that would be considered rude to to cultural norms (as this article is emphasizing) and yet calling me names is okay? This point seems to be largely ignored by the commenters who are criticizing this article.

    I think making insincere/critical comments to people of all weights is rude and inconsiderate. Calling someone a fat slob or skeletor are both insulting. If someone truly has a eating disorder on either spectrum, there's a better way to approach them.

    thanks for reading
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    AMEN!!

    With over population and all, can't some ppl learn NOT 2 eat soooo much? There's only so much of it 2 go around.
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    Firstly, I believe that the inherent flaw in your argument lies in the fact that anorexia and obesity have the same root cause within our culture: a consumer ethos that does not allow moderation in anything. While the girl who is concerned with fitting into size 1 jeans may not be anorexic, she is almost undoubtedly fixing an unhealthy amount of attention on being thin--probably underweight, as the waist size of a size 1 is that of the average 10-year-old girl (who, incidentally, is much more likely to already be on a diet than girls of previous generations). If you truly want to see societal change that will lead to less obesity, point your finger at marketing--I'm sure that some of the same companies whose ads convince women that being a size 1 in expensive designer jeans is more important than health and nutrition also are plunking coupons for big, high-fructose-corn-syrup filled burgers and fries in your daily paper. Without obesity, how would the diet industry be funded? Consumerism is at the root of both extremes. Eating disorders have the highest fatality rate of any psychological disorder, and trivializing them, no matter what the cause or purpose of doing so, is far more shameful than being obese.
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    1) Anonymous: ED:NOS is a dangerous eating disorder. I've known several women who found their way into a hospital or DIED as a result of their ED:NOS. You don't have to be clinically underweight or constantly restricting/binging and purging to do physical & possibly fatal damage to your body. Never mind the fact that they suffer mentally, just as much as bulimics and anorexics do. I'm sick of this "my eating disorder is better than yours!" cock-flailing contest.


    2) I actually agree with what this article is saying -- crash-dieting, however unhealthy it is, is NOT the same as anorexia. Eating a salad for lunch and refusing treats doesn't make someone anorexic. The main difference is that dieters are in control of what they eat, while anorexics are unable to control their fear of food.


    And this is coming from someone with an eating disorder.

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    There are eating disorders related to obesity such as the binge disorder. You are being very ignorant in your view of anorexia, its not all about being thin. People are anorexic for personal issues such as sexual abuse, parental fighting, feeling lonely or unaccepted, ect. I am anorexic and people like you make me sick. You have never felt the pain we feel everyday, and its more than just hunger pains, its emotional and mental pain. You have no place to judge us.

    Now I agree on the point where all these wannabe anorexics are looking for attention, but not all of us are like that. There is nothing glamorous about throwing up your food, and passing out. Thats just stupid.
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    anonymous

    For someone who had anorexia you arent very bright else you would know that anorexia nervosa isnt just about the physical side but also the mental processes so i disagree with you when you say EDNOS isnt a dangerous eating disorder! You can be at a healthy weight but be dangerously sick! You can be underweight but still be considered healthy. People with EDNOS are suffering from the same as people with anorexia and bulimia but they may not meet one requirements for diagnoses. A person that eats 3 meals a day who wouldnt fit into anorexia or bulimia but who takes laxatives every day is doing dangerous stuff to her/his body...
    I have been disagnosed with an eating disorder, but it doesnt make me an expert but i do know that it isnt about what i do or dont look like because it is about so much more than that.
    so i completely disagree with your uneducated statement.
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    Also, Amy, the author even said that they weren't discussing people who are actually anorexic. I don't understand why you are getting so worked up over it.
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    And Amy -- EDNOS is not a dangerous eating disorder, unless it progresses into anorexia or bulimia.
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    As somebody who has suffered from anorexia nervosa and had a BMI of 14, I can say that I FULLY agree with this article.

    Wow. Thanks for writing it. There are so many people out there who think that they suffer from an eating disorder, when they really do not.
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    p.s.

    I urge you to look at this and realize that it is going on to way more than 1% of America, and can also end in death.
    EDNOS (Eating Disorder Not Specified) Which includes those girls who are trying to fit into their bikinis and the ones who are "just jealous" of the girl who wears a size one or whatever.

    http://www.something-fishy.org/whatarethey/edno...
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    "My personal offhand estimate had been that we might lose about 100 Americans annually to anorexia. My research this morning showed that I was not far off - a 2001 study by the University of British Columbia’s Department of Psychology of every American death for the most recently available five year period showed only 724 people with anorexia as a causal factor - 145 per year."

    Oh, true, true, good sir. Your estimate was not far off, give or take 45 lives that are lost each year because of ignorance like yours. Give or take all of the people you must have affected so badly because of your biggoted article. You are a self righteous turd, if I do say so myself. If you have daughters, is this what you tell them?

    "and that’s far more dangerous than any 500 calorie-a-day diet could ever be."

    Try a two hundred calorie diet! Try not being able to eat a bite of bread without having a near panic attack. You cannot morph all eating disorders into one big issue and shove it aside calling it "Intellectually puddle deep" in fact, I would consider you as such.

    Cancer does not affect every single American citizen either, it is not as huge of a problem as obesity is either, does that mean you are going to write an article about ignoring their fight also?

    My issues with anorexia ARE about control, they DO have to do with me not eating the cheesecake served after dinner, also not eating dinner at all when it comes down to it. I pity you and your ignorance to this issue, I have to say that though not every girl I know is dying from starvation, every girl I know has at one time considered it. Every girl I know is self concious. Every girl I know could be driven to do something stupid because of your words. Every. Single. One. What I have to say to you is this: I AM the girl who is obsessed with fitting into my size zero jeans. I AM the girl who others think is thin but I can't see it. I AM dying.

    But I'm sure, that's less than a dent in your all knowing radar, isn't it?
    Thank you for firing me up, I needed a way to let out my stress today.

    No love,
    Amy
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    "And you might be able to beat said size one girl in a physical competition, but I don’t know what that teaches us."

    You don't know? Well, think it through then, since you're such a brilliant philosopher: this example teaches us that being strong and robust is better than starving yourself into weakness, to take pride in your body rather than hating it, and that size does not always indicate health.

    And your admission that you have a preference for thinner women puts this article into the opinion section and not news reporter. Why not just say you prefer thin frames and leave the anorexics and other ED-sufferers out of it? And why don't you just come out and say that American overconsumption is bad instead of bashing on people with food issues?

    Criticism and snobbery won't solve the obesity issue; if anything, it will make those who aren't a size 0 a lot more defiant. Have you heard of the Fat Acceptance movement? (And no, it's not the same as the food slut club.) While I understand that obesity and overweight can create health issues, I also know that fat people should be treated with respect as human beings and are not symbols of some "emblematic American appetite."

    And having lived on 500 calorie diets myself, I can tell you they are unhealthy and make you miserable. Just because you can say no to a bowl of ice cream does not make you morally superior.
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    "So, please, ladies - the girl who has the body the rest of you wish you had is not anorexic. The girl who delicately refuses the eighteen-ounce wedge of deep-fried cheesecake the rest of you dive into after dinner is not anorexic. The girl who is obsessed with fitting back into those size 1 jeans is not anorexic. She’s just thinner than you, knows how to say no to herself, and it makes you jealous"

    Obviously you are un educated on the subject of anorexia else you wouldnt say that a girl who is obsessing about fitting into a size 1 pair of jeans isnt anorexic or suffering from anorexia. You are an idiot... get educated or shut up!

    www.mamavision.com
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    I am ana becuase i was sexually abused, not becuase i want to fit into size one jeans. (oh, and for the record, it's size 0 or below, size 1 is for fat girls now).
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    Please stop anorexia and bulimia !!!
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    1. Being slightly underweight is one of the most powerful factors that longetivity studies say correlates to a long life.
    2. Almost all of the health risks when it comes to eating are on the side of overreating.
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    it seems that one definition you suggest for anorexia is "self-denial and restraint." i think this is what another commenter was criticizing because anorexia is neither. for one thing, self-denial and restraint are both very vague concepts -- at least the way they are used in the article. denying one's "self" (whatever that is)? or denying the self something? and restraint is too wide. restraining what? according to what kind of measure or standard?
    anorexia has been framed as a "pathology" about a century ago i think, although arguably the phenomenon dates back much earlier. it has been asociated mostly with women but there are cases of male anorexia as well. there is a turn of the century novel by knut hamsun called "hunger" where a male character deals with what i would call a form of anorexia. having to do more with controlling the urge to eat / rebelling against "nature"/ than with body image.
    consider also the "hunger artist," a phenomenon of the turn of the century again. and also a predominantly male figure. some people gave the example of gandhi who fasted a lot, and also used the hunger strike as a political strategy. hunger strike is not practiced as a form of political resistance in the u.s. so much, but it is frequently used in other places. more often than not, when you are imprisoned and when there is nothing else you can fight with. i, like a couple others, liken anorexia to hunger strike. it is a form of resistance --to that impossible bodily ideal by going so beyond that ideal such that the ideal itself is parodied-- which looks deceptively like giving in.
    this is not to encourage anorexia-- but to de-pathologize it. it is not those who become anorexic who are "sick," but the form of society that pushes someone to that limit.
    there _is_ a body ideal marketed in the mainstream that the bodies of many of us do not fit. (this creates a tremendous amount of self-hatred and fat hatred.)
    and this body ideal changes. it is not static. for this decade it might be size 0 in the u.s.. but half a century earlier, marlyn monroe was the ideal and she was, according to a website on fat pride i surfed today, a size 16. perceptions of what is considered beautiful, healthy or acceptable are not only in constant flux but relative. they also change from one place to another. i am something like size 11 by u.s. standards (i think). so according to some, i am overweight. according to BMI i am "normal." according to some i am voluptuous. according to my family and my lover i am perfect. according to me i am alright. health.. fitness.. similarly these are also culturally-determined constructs.
    and i am really at a loss whether to even define people over 400 pounds "obese" or "abnormal." ultimately it is about whether you feel at peace with where you are, whether or not it fits within a medical or cultural system of belief.
    consider this webpage "for people who do not apologize for their size" : http://www.fatso.com/
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    it seems that one definition you suggest for anorexia is "self-denial and restraint." i think this is what another commenter was criticizing because anorexia is neither. for one thing, self-denial and restraint are both very vague concepts -- at least the way they are used in the article. denying one's "self" (whatever that is)? or denying the self something? and restraint is too wide. restraining what? according to what kind of measure or standard?
    anorexia has been framed as a "pathology" about a century ago i think, although arguably the phenomenon dates back much earlier. it has been asociated mostly with women but there are cases of male anorexia as well. there is a turn of the century novel by knut hamsun called "hunger" where a male character deals with what i would call a form of anorexia. having to do more with controlling the urge to eat / rebelling against "nature"/ than with body image.
    consider also the "hunger artist," a phenomenon of the turn of the century again. and also a predominantly male figure. some people gave the example of gandhi who fasted a lot, and also used the hunger strike as a political strategy. hunger strike is not practiced as a form of political resistance in the u.s. so much, but it is frequently used in other places. more often than not, when you are imprisoned and when there is nothing else you can fight with. i, like a couple others, liken anorexia to hunger strike. it is a form of resistance --to that impossible bodily ideal by going so beyond that ideal such that the ideal itself is parodied-- which looks deceptively like giving in.
    this is not to encourage anorexia-- but to de-pathologize it. it is not those who become anorexic who are "sick," but the form of society that pushes someone to that limit.
    there _is_ a body ideal marketed in the mainstream that the bodies of many of us do not fit. (this creates a tremendous amount of self-hatred and fat hatred.)
    and this body ideal changes. it is not static. for this decade it might be size 0 in the u.s.. but half a century earlier, marlyn monroe was the ideal and she was, according to a website on fat pride i surfed today, a size 16. perceptions of what is considered beautiful, healthy or acceptable are not only in constant flux but relative. they also change from one place to another. i am something like size 11 by u.s. standards (i think). so according to some, i am overweight. according to BMI i am "normal." according to some i am voluptuous. according to my family and my lover i am perfect. according to me i am alright. health.. fitness.. similarly these are also culturally-determined constructs.
    and i am really at a loss whether to even define people over 400 pounds "obese" or "abnormal." ultimately it is about whether you feel at peace with where you are, whether or not it fits within a medical or cultural system of belief.
    consider this webpage "for people who do not apologize for their size" : http://www.fatso.com/
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    What's being talked about isn't anorexia. Control is not anorexia; people can control what they eat and work out and try to look their best and that does not mean they're anorexic. Anorexia is obsession, is looking in the mirror and always seeing fat to lose even if your body belongs in a Halloween funhouse. If you can see how eating oneself into obesity is a problem, then you can see that obsessing about calories to the point of near death is also a problem. I'm not downplaying obesity, I do believe it's become a huge problem and you're right in that it doesn't get as much attention... The way you said what you did is just the issue because people dont see their obsession, they see their control; by supporting those who "control" their food intake to that point, instead of supporting those who are in great shape because they work off more calories then they eat daily to look their best, is just perpetuating the "healthy isn't better skinny is better" standard. It's the same as if obese people who visit a website see the message "Be happy while you're living, for you're a long time dead" and take that to mean that it's okay to devour everything they can since they're as much of a walking corpse as the people excercising a little too much of your "control".
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