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EATING
DISORDERS
Rachel Simon-Kumar
Department
of Women's and Gender Studies, University of Waikato, Hamilton,
New Zealand
Public awareness of what
are commonly called 'eating disorders' has increased immensely in
the past decade or so. Anorexia nervosa (or the 'hunger disease')
and bulimia nervosa (or the 'binge and purge disease') are among
the more widely known. Part of the reason for its acceptance as a
genuine problem to be dealt with has been the growing number of
celebrities the world over who have admitted to having, at some
point in their lives, been a victim of an eating disorder. The
Princess of Wales, the late Diana Spencer, was among its
sufferers - her biographer wrote poignantly of her tendency to
binge eat and then vomit out repeatedly as a way to deal with the
unhappiness in her life. Karen Carpenter, the talented singer of
the 1970s singing duo, The Carpenters, died of anorexia nervosa
in the early eighties. We are yet to ascertain the extent to
which these diseases are prevalent in Indian society.
It is commonly accepted
that women - particularly adolescent girls - are among its main
sufferers. In fact, these eating disorders have been labelled
'maiden diseases'. It is estimated that one in hundred girls and
women suffer from bulimia whereas anorexics are a little less
common at one in around a thousand girls. Interestingly, some
studies indicate that it is primarily middle-class women who are
most likely to manifest these symptoms rather than the working or
labouring class. The main symptoms of bulimia are (a) recurring
episodes of binge eating (that is, rapidly consuming food in
short periods of time) (b) attempts to purge oneself of the food
that has been consumed, usually by induced vomiting, (c )
feelings of depression and low self-esteem, and (d) an inability
to control the dysfunctional eating even though the person is
aware that it is abnormal. Anorexic sufferers, on the other hand,
avoid eating altogether. A common symptom in both disorders is
the acute feeling that the person is 'fat'. Either by purging or
by starving, the victims attempt to control their weight.
There are several
theories that have been advanced to understand the causes for
eating disorders. The various theories can broadly be classified
as: bio-medical, psychological and socio-cultural. Bio-medical
explanations tend to assert that eating disorders are caused by
biological factors; these may range from imbalance of hormones to
malfunctioning of serotonin in the brain. Some researchers also
point to a possibility of a genetic origin. Bio-medical theorists
suggest a combination of drugs and psychotherapy as treatment.
Psychological
explanations view the disorders as a form of identity crisis, a
sign that the sufferer is blocking emotions, and that there are
repressed emotions in the unconscious which are expressed through
abnormal relationships with food. The emotional crisis may arise
from strained relationships with members of the family - such as
mother-daughter, father-daughter and so on. For theorists who
draw on psychological explanations, the disorder becomes a way
that young girls protest, or blackmail the situations they are in
at home.
Socio-cultural theories
highlight the role that society plays in laying expectations on
girls and women, particularly, on the way they should look. These
explanations focus on western culture's overemphasis on body
shape that is 'thin'. It is said that in western societies, over
the last few decades, the 'ideal' female body shape has been
getting thinner and thinner. Models in advertisements and on the
catwalk in the 1990s are at least 10 kilos lighter (for the same
height) than they were in the 1950s and 1960s. Young girls, in
particular, are likely to see themselves as unattractive unless
they are able to have the popular 'ideal' figure. Their struggle
with food is an attempt to overcome feelings of low self-esteem
that society sub-consciously induces, and to attain a sense of
popularity.
A fourth and interesting
analysis of these eating disorders has been put forward by
feminist researchers. Their argument does not focus on the young
girls and their symptoms as much as the medical profession and
its attitude to the 'maiden diseases'. These researchers argue,
for instance, that eating disorders are not a modern disease at
all but has existed under various names for centuries. Moreover,
eating disorders affect not just young girls, but older men and
women as well. However, doctors and counselors have tended to
focus attention primarily on young girls and their bodies.
Further, this interest is focused at specific moments in history
-- in fact, medical history shows 'waves' of interest and
analysis on the condition of young women's health by doctors. The
first such 'wave' was evident in the sixteenth century when
doctors identified a malady that affected only young girls called
furor uterinus and 'love sickness'. Doctors related symptoms of
loss of appetite and weakness to malfunctioning of the sexual
fluids in women. There was also a lot of medical writing on young
women's ailments in the eighteenth and nineteenth century -
'chlorosis' or 'green sickness' (the symptoms again were a
paleness of complexion, and disinterest in food) was intensely
studied. In the twentieth century there are two periods when
doctors start talking and writing about young women's diseases.
Anorexia nervosa was 'discovered' in the 1970s and Bulimia in the
1990s. Why does the medical profession have these moments of
interest in young women and their health?
These feminist
researchers argue that the 'discovery' of maiden diseases is
linked to the prominence in public life that young girls have
been having. In the nineteenth century, for instance, women were
entering universities and the work force in a big way. Post-World
War 2 was again a time that women were very visible in society.
By drawing attention to eating disorders as a malady of young
women, doctors (and in a broader sense, society itself) are, in
fact, labeling young girls as 'nervous', 'neurotic' and
'overemotional' -- almost as a reason to deny them a place in
public life. One researcher asks if girls in puberty and
adolescence are really biologically, psychologically and sexually
so imbalanced, unstable and fragile (compared to boys) that they
cope less with the pressure of society and the family? Or, do
physicians, psychologists, counselors, and parents try to make
some reactions of young girls seem particularly unnatural? Is our
understanding of 'eating disorders' a reflection of young girls'
unease with society, or society's unease with young girls? This
last perspective highlights the 'creation' by society of girlhood
and a specific class of 'girlhood diseases'. The description of
girls as highly prone to vulnerability is, in a sense, a means to
confine young girls to specific roles that are approved of by
western, patriarchal societies where gender inequality still
prevails. Disease creation, therefore, becomes a way of gender
control.
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