Lecture on the relationship between stigmatisation, femininity and anorexia nervosa.

1. Anorexia Nervosa: Culture
and the Stigmatisation of
Femininity

2. 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

3. Four types of stigmatisation
 Stigmatisation of:
 Fat
 Women’s bodies
 Femininity
 “Anorexics”

4. 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

5. 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

6. 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).

7. 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

8. 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

9. 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)

10. 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

11. 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

12. 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

13. 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)

14. 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

15. 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.