Anorexia nervosa -sociological perspectives

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 19 th 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 B ody 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 ! Any questions?