Anorexia and Bulimia

An eating disorder can be defined as a severe disturbance in eating behavior characterized by a [Page 59]lack of appetite (anorexia) and restrictive eating, or an insatiable appetite and overeating (bulimia), or some combination of these behaviors. Eating disorders are one of the contradictions of a society in which eating depends heavily on a fast food industry offering “supersized” meals as good economics and good nutrition. Eating satisfies a basic human need, but it is also subject to individual, social, and cultural influences. In a society such as that of the United States, the “supersized” culture of food intersects with and contradicts the culture of the beautiful svelte body, especially for females. How one eats, what one eats, and the frequency and quantity of food are controlled not only by individual appetite and food availability but also by factors such as family, peer, and cultural norms about food and body size. Restrictive eating behaviors and overeating are widely supported, and both can result in eating disorders that lead to health problems and, in extreme cases, premature death.

Eating disorders involve behavior that negatively affects physical and mental health; examples include excessive dieting, binge eating, and anxiety due to a negative perception of body image. The correlates of eating disorders include gender, race or ethnicity, childhood eating and gastrointestinal problems, elevated shape and weight, negative selfevaluation, sexual abuse, and a variety of individual psychologically based problems. Despite the risks, however, the practice of restricting food intake to control weight and/or body shape is followed by a substantial number of young women. The two most commonly known eating disorders are anorexia nervosa and bulimia nervosa.

The American Psychiatric Association recognizes anorexia nervosa as an abnormally low body weight (15#x0025; below normal body weight for age and height), combined with a fear of gaining weight or becoming fat, preoccupation with body weight and shape, and amenorrhea or the absence of three consecutive menses. Although anorexic patients may engage in compulsive exercising, restrictor-type anorexic patients are distinguished by their resolute refusal to eat above a bare minimum. Bulimic-type anorexic patients regularly engage in binge eating and purging. Those who suffer from bulimia nervosa engage in binge eating followed by feelings of guilt, depression, and selfcondemnation. The sufferer typically engages in behaviors referred to as “purging” to counter excessive eating; this behavior includes vomiting; fasting; using laxatives, enemas, diuretics, or other medications; and overexercising.

Theoretical Explanations

Early biological-medical theories of eating disorders emphasized individual factors, tracing the origins of eating disorders to chemical and hormonal imbalances that cause metabolic changes in the body, including depression and anxiety. Psychological models similarly recognize the biological origins of eating disorders but emphasize the impact of family and peer dynamics in childhood and adolescent psychosocial development. From this perspective, young women and girls develop disordered eating patterns as a way of coping with changes in their bodies that occur within the context of stressful social interactions and developmental environments involving families, peer groups, and educational and religious organizations.

Sociocultural models trace eating disorders to factors in the wider social environment, including the media and commercial interests that create social, cultural, and economic pressures on women to lose weight in order to conform to what may represent unrealistic standards of beauty and body size. These wider social forces are believed to be at the root of most eating disorders. They are powerful forces in shaping the behaviors of young girls and women precisely because females are rewarded for thinness both socially and economically. There are, for example, welldocumented biases against “fat women” in the job market. By linking women's successes, their perceived value, and oftentimes economic survival, to culturally constructed standards of beauty, women are diminished and controlled in society. Within this wider sociocultural system, Hesse-Biber notes that the mind/body dualism in Western thought, as well as capitalist and patriarchal systems, encourage females to focus on the aesthetic value of their bodies and to neglect the development of their minds. Young females with anorexia, bulimia, and binge eating disorders thus become victims of a consumer-oriented culture that emphasizes the maintenance of a weight that lies below standards of good health.

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