Sociological perceptions of anorexia nervosa

1. Anorexia nervosa
FdSc. Health and Society
Level 5
IM5001 Social Dimensions of Health
Ewelina Balcerowicz

2. Anorexia nervosa – clinical features
 Eating disorder (mental health condition)
 Refusal to eat an adequate amount of food (self-starvation), severe weight loss
 Vomiting, abusing laxatives and enemas
 Distorted body image
 Intense fear of gaining weight
 Repetitive checking body weight
 Intense and compulsive exercising

3. Anorexia nervosa –comorbidities &
causes
 Depression ( 50 % - 75% of
individuals)
 Obsessive-compulsive disorders
 Anxiety
 Low self-esteem
 Alcohol misuse
 Self-harm
 Heritable
 Obstetric complications
(maternal anemia, diabetes)
 Addiction to chemicals released
during starvation
 Serotonin dysregulation
 Twins

4. Anorexia nervosa – diagnostic criteria
and treatment
 BMI – individual circumstances
( 18,5 to 24,9)
 Pulse and blood pressure
 Assessing muscle strength
 Multidisciplinary approach
 Therapy
 Diet ( calories & weight)
 Medications
 Clinical autonomy
 Clinical gaze

5. Hidden stats
 Conflicting and poor quality data
 DoH only shows inpatient data
 NICE 2004 – 1,6 million people in
UK, 11% male
 NHS 2007 – 6,4 % adults had a
problem with food
 Royal College of Practitioners –
66% rise in male hospital admission
 Homosexuality
 Highest mortality rates of any
mental disorders – discrepancies
 30-40% recover

6. Anorexia nervosa/self-starvation –
historical context
 Classic cultures – ascetic fasting
 Dark Ages –two cases in V and VIII
centuries
 Late Middle Ages – Holy fasting , holy
anorexics
 Reformation – Frauds seeking
notoriety
 19th Century – hysteria, sitophobia,
chlorosis, professional hunger artists
 1873 – full clinical picture of the
disorder ( Gull & Marce)
 Fat-phobia & hiding

7. Anorexia nervosa and feminism
 (Wolf 1991) "a cultural fixation on
female thinness is not an
obsession about female beauty
but an obsession about female
obedience"
 A rebellion against patriarchy
through rejection of one's own
sexuality
 Some liberal feminists believe that
sexism causes anorexia and other
eating disorders
 Radical feminists believe that
women are being exploited
because men profit from the thin
ideal

8. Social construction of anorexia
 Constructed through culturally and
historically-specific discourses
rather than being naturally
occurring disorders
 Gendered, cultural ideas
 Thinness or fatness have no
essential meaning unto
themselves; they are given
symbolic value through cultural
mediation
 Anorexia vs obesity
 Hospital numbers vs real world
 Conflicting messages

9. Psycho-social model and anorexia
 Stress as an onset
 Helplessness
 Perfectionism
 Social comparison
 Feeling secure at school
 Worries about future
 Higher education
 Western ideal

10. Life-course approach and anorexia
 Where an individual lives and the
quantity of food available as
determinants
 Western children influenced by
“Barbie-doll” body shape
 Infant feeding problems
 Previous history of under-eating
 Maternal depression
 An individual’s eating disorder is
originated in the family’s style of
interacting
 Eating-disordered families found
to be intrusive, hostile, and
negating of the patient’s
emotional needs or overly
concerned with parenting in
general
 Relationship difficulties between
parent and child, often manifest
themselves through food.
 Parents who constantly criticize
about their own body image and
shape will influence their children
that having a negative view on
one’s self is the norm

11. Lay perceptions and stigma
 The general public lacks sufficient
knowledge and information
about eating disorders
 Self-inflicted
 Choice
 Attention
 Blame
 Vain, difficult to communicate
with
 Trivalisation
 “Anorexic”

12. Lay perceptions

13. Pro-ana
 Non-judgmental environment for
anorexics
 Support
 Not a mental illness!
 Lifestyle and self-control
 Social media
 Sense of community
 Glamorization of mental illness
 “Wanna-rexic”
 Red bracelets

14. Globalisation
 Fiji and access to TV
 Crossing gender, race
and class lines
 Geographical and
social mobility
 Westernisation ( Japan,
China, Middle East)
 Ethnic minorities
 Immigrants

15. Media
 Body insecurity can be exported,
imported, and marketed–just like
any other profitable commodity
 Mass media pressure linked to
body dissatisfaction,
internalisation of the thin ideal
and eating disorders
 10.5 more ads in women's
magazines
 “Damaging paradox”
 The gap between actual body
sizes and the cultural ideal
 Beauty industry

16. Conclusion
 Anorexia nervosa is not a new disease
 Individual, family and cultural factors
 Paradox
 How to counter-act
 Balance
A mixed approach is still fundamental in this area of research because without
biological treatments of the malnutrition, the health of individuals with eating
disorders would be at risk whilst therapists attempt to ‘un‐bind’ them from
these cultural constructions

17. Thank you !
Anyquestions?