- The Washington Times - Friday, November 24, 2000

Joan Jacobs Brumberg, professor of history, human development and women's studies at Cornell University, recently published "Fasting Girls," a book that examines the evolution of anorexia nervosa. Mrs. Brumberg discussed her findings with Sonya Chawla of The Washington Times.
Q: What has been the history of female fasting in the Western world?
A: Anorexia nervosa was named and identified in the 1870s, more than a century before the American public really discovered it. Physicians have known about it for a long time, but rarely saw it in clinical practice until after World War II. People blame anorexia on today's popular media, and my book is meant to correct that assumption.
There have been other forms of fasting behavior. With medieval saints like Catherine of Siena, it's not correct to call them anorexic in the modern way. They did stop eating, and some eventually died of self-starvation. Their bodies became emaciated. But diseases are more than physical symptoms. We have to ask about the pathway into the symptoms. With the saints, there were deep cultural differences. She was fasting for religious reasons, as part of a larger penitential program. She was not an adolescent.
There were also some very interesting cases of anorexia in the 19th century, specifically Sarah Jacob, the Welsh fasting girl of the 1870s. She was young and claimed that she didn't need food to eat. People came to see her and worship her as the wonderful little girl who didn't eat.
But doctors could not believe someone could survive without eating. To make their point that there was something duplicitous going on here, the doctors set up a watch that was scientific and controlled, and in fact, she dies. Is this an example of a religious miracle or a case of a hysterical young woman who was deceiving her parents and her community? At that point, there was some tension around women refusing to eat.
Q: What is the fine line of difference between dieting and anorexia?
A: There is a very big difference between being a dieter, a restrictive eater and being an anorexic. There is a full-blown psychopathology of anorexia.
An anorexic is somebody who has engaged in an unrelenting pursuit to become thinner and thinner and thinner. These days, that is generally combined with a very rigorous exercise program. That is a very big difference between anorexics in the 19th century. It looks like women with anorexia today are actually sicker because of the exercise component and our increased tolerance for thinness.
Q: In today's society, is anorexia more a product of nature or nurture?
A: It's interactive and a multi-determined disorder. It involves individual biology, individual psychology family issues as well as temperament and then it involves culture. The media prompts an emphasis on dieting and an extremely young body.
All young women have been exposed to obesophobia (a desire to be skinny), but we don't all develop anorexia. So there clearly are some intervening behaviors that have to do with the psychology of family, psychosexual issues and possibly some biology.
Q: What effect, if any, do celebrity anorexics have on young women?
A: Every woman who is extremely thin these days is accused or subjected to questions about their eating. Celebrities have gotten what appears to be too thin, but we're obsessed with the dieting of others: Rosie O'Donnell, Oprah, Delta Burke. And that is what had an impact on American girls [and] the amount of attention we give to women as opposed to men. There was even a lot of commentary about Hillary and Chelsea when Clinton first became president.
There is a lot of impact of the culture on girls coming to age. The amount of depression and demoralization girls experience about their bodies and why so many of them are body-obsessed and preoccupied with the body may have to do with culture.
Q: You say "refusal of food is understood as an expression of the adolescent's struggle over autonomy, individuation, and sexual development." Why is a fear of womanhood and sexuality expressed through a refusal of food? What is the link here between food and maturity?
A: This is my summary of what contemporary psychologists are saying. The disease will be understood differently at different points in time. Today, largely as a result of Hilde Bruch, who wrote "The Golden Cage," an inside look at anorexia nervosa, [we] connect the disease to the developmental process in young girls.
It may be connected to a certain kind of family. One of the problems is: Do the parents really want this young woman to be independent or not? Girls are using the appetite as a voice to say something about themselves. Girls simply express their unhappiness in the family by refusing to eat the food. Their rebellion is in the form of a very simple vocabulary: "I will not eat, I will eat."
Q: Are you indicating that anorexia sometimes has nothing to do with a young woman longing to lose weight?
A: I think they are connected because that's what perfection is for women in America these days. Symptoms always come from a culture. People latch onto these symptoms. In this culture, someone who wants to have control or say something about herself makes dieting her vocabulary.
Q: Are there certain people who have more aptitude toward anorexia than others? Biologically speaking, do some people have an easier time surviving without food than other people?
A: It could be possible that some young women are more fed up with their bodies than others and therefore become anorexic. It may be that certain young women, when they start to diet, actually get addicted and get caught up in the feeling; the sensation of emptiness and nutritional deprivation. And then, of course, it may lead to anorexia and may become difficult to stop.
Q: Do men have anorexia?
A: The number of men's cases with anorexia has grown since 1988 because of the dieting and fitness cult and because pressure to have a more perfect body has spread.
Q: Why do mostly middle- and upper-class females suffer from this disorder?
A: Increasingly, by the end of the 19th century, upper-class women came to associate a thin body with high social status. So the old relationship between fat and wealth was being overturned. Women don't want to look like the milkmaid anymore.
So it began in the 19th century, but it continues today. Because if you are poor, someone else in the family eats what you won't eat. You don't have anorexia in Third World countries. I mean, you have people who don't eat because they're depressed or have some physical problem. But this particular form of fasting [anorexia] is related to affluence and Westernized ideas of beauty.
There is also a connection in Victorian culture between having a healthy appetite and carnality. If you eat too much meat, in particular, you're oversexed. What you've got is a situation where "Women do not really want to be seen eating," said by Lord Byron.

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