Anorexia Nervosa: Culture and the Stigmatisation of Femininity

Aims of the lecture

Outline Psychiatric/Psychological Theories of Eating Disorders

Show relationship between eating disorders and women/femininity

Outline feminist/sociological theories of eating disorders

Discuss relationship between eating disorders and stigma

Four types of stigmatisation

Stigmatisation of: Fat Women’s bodies Femininity “Anorexics”

Stigma and fat Historically fatness associated with prosperity and

thinness with disease or poverty Overweight and obesity became social problem in

20th century Associated with:

lack of control slothfulness gluttony

more recently low social status femininity

Women and mental Illness Psychiatry often focused on women

and girls More likely to be diagnosed with a

mental illness More mental illnesses that only

females can be diagnosed with than vice-versa.

Masculinity associated with Rationality Control Mind

Femininity associated with Irrationality Lack of control Body

Current diagnostic criteria from DSM-IVR

Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g. weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).

Intense fear of gaining weight or becoming fat, even though underweight. Disturbance in the way in which one's body weight or shape is experienced, undue influence

of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)

Two subtypes: Restricting Type: during the current episode of anorexia nervosa, the person has not

regularly engaged in binge-eating or purging behavior (that is, self-induced vomiting, or the misuse of laxatives, diuretics, or enemas). Weight loss is accomplished primarily through dieting, fasting, or excessive exercise.

Binge-Eating Type or Purging Type: during the current episode of anorexia nervosa, the person has regularly engaged in binge-eating OR purging behavior (that is, self-induced vomiting, or the misuse of laxatives, diuretics, or enemas).

Early History of Anorexia Nervosa

Richard Morton 1689 reported a wasting disease of nervous origins.

Charles Lasegue 1873 L’Anorexie Hysterique and William Gull 1874 Anorexia Nervosa

Women and girls more “nervous”. Hysteria also associated with women but

was possible for men to develop but required greater trauma (Link- Heer, 1999).

Men had a more robust constitution that could withstand stress of the modern world

Psychoanalysis Psychoanalysis

Drives and desires repressed by society become manifest in other ways

Unconscious mind can be uncovered by psychoanalyst via interpretation

AN AN seen as fear of fatness Underlying fear of oral

impregnation AN as refusal of adult

femininity Eating symbolically connected

with sexuality

Hilde Bruch and dynamic psychiatry

Still considered it to be feminine condition AN is-

unwillingness to adopt the accepted adult role over-willingness to conform to accepted cultural norms Deficient sense of self Anorexics do not accurately perceive and interpret stimuli

eg body size, cultural messages about desirable bodies AN occurs in people who have “failed to incorporate

those traditionally “masculine” traits…that are now particularly essential for optimal functioning by a woman in Western society” (Sitnick and Katz 1984: 82)  

Team sports as “protection” against development of body image concerns (Halperin, 1996)

Early 2nd wave feminism

Rejection of the individualising character of many theories which used either: biomedical explanations a problem with the woman not being able to accept prescribed

gender roles. MacLeod and Chernin

Identity crisis central to AN Don’t develop autonomous identity Conflict arises from simultaneous desire to, and guilt of,

transcending the mother Orbach

Anorexia as a “metaphor for our age” response to a confusing social identity

Later 2nd wave feminism

Emphasised impact of culture which stigmatises fatness and associates thinness with success, autonomy and beauty

Bordo Femininity associated with domesticity and

oppression Slender body associated with empowerment Larger body associated with traditional

femininity and oppression

Feminist critiques of Bordo Bray

Women portrayed as weak and “infected” by media Lester

Previous feminist theories reified split between culture and individual

Anorexics do not feel separated from their bodies Anorexics hold contradiction in themselves,

thinness as Power and autonomy Fragile and invisible

Anorexic subcultures

“Pro-ana” websites and online communities Provide ‘anti-recovery’ stance Counter to medical, sociological and feminist

models Exchange “thinspiration”, techniques for

“management” of AN, encouragement and support For participants, AN seen to provide power and

control but.. Emphasise safety in managing dangerous condition See AN as a “lifestyle” and disease

(See Fox, Ward and O’Rourke, 2005)

Conclusions

Contemporary culture stigmatises fatness Psychiatric theories position women’s

bodies as weak or feminine identity as overly determined by outside influences

Feminist and sociological theories critiqued psychiatry to suggest patriarchal culture is responsible

Subcultures formed around anorexic identity

References

Bordo, S. R. (1989). The Body and the Reproduction of Femininity. Gender/body/knowledge: Feminist Reconstructions of Being and Knowing. A. M. Jaggar and S. R. Bordo. London, Rutgers University Press: 13-33.

Bray, A. (1996). "The anorexic body: Reading disorders." Cultural Studies 10(3): 413-429. Bruch, H. (1962). "Perceptual and Conceptual Disturbances in Anorexia Nervosa." Psychosomatic

Medicine 24(2): 187-194. Chernin, K. (1986). The Hungry Self: Women, Eating and Identity. London, Virago. Fox, N., Ward, K. and O’Rourke, A. (2005) ‘Pro-anorexia, weight-loss drugs and the internet: an ‘anti-

recovery’ explanatory model of anorexia’ Sociology of Health and Illness 27(7) 944-971 Halperin, E. N. (1996). "The Role Of Socialization in Male Anorexia Nervosa: Two Cases." Child Psychiatry

and human Development 26(3): 159-168. Hepworth, J. (1999). The Social Construction of Anorexia Nervosa. London, Sage. Lester, R. (1997). "The (Dis)Embodied Self in Anorexia Nervosa." Social Science and Medicine 44(4): 470-

489. Link-Heer, U. (1990). ""Male Hysteria": A Discourse Analysis." Cultural Critique 15: 191-220. MacLeod, S. (1981). The Art of Starvation. London, Virago. Orbach, S. (1986). Hunger Strike: The Anorectic's Struggle as a Metaphor for our Age. London, Faber and

Faber Sitnick, T. and J. L. Katz (1984). "Sex Role Inventory." International Journal Of Eating Disorders 3(3): 81-

87.