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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.