ABSTRACT
Anorexia nervosa, often shortened to just anorexia, was first documented medically in 1874, entering the popular vocabulary from the 1980s onward when cultural evaluations of fatness changed significantly. The value placed on being slim was promoted and maintained in popular CULTURE, particularly by a fashion industry that projected images of waiflike models as ideals. It was thought that an exaggerated sense of being fat impelled between 1 and 4 percent of the female population toward one of the two main EATING DISORDERS (with an increase in anorexia occurring primarily in white females between the ages of fifteen and twenty-four years). Only a small minority of men had eating disorders-an estimated 10 percent of the total reported cases. Research has revealed no hereditary basis for eating disorders, and
there appears to be no pattern in family background. Subjects with eating disorders commonly have disturbances of MOOD or EMOTIONAL TONE to the point where DEPRESSION or inappropriate elation occurs; but no causal link between the two has been found, only an association. The disproportionately high number of women affected has invited an interpretation of anorexia as a striving for empowerment: Women with such disorders are not usually high-achieving and financially independent professionals and, as such, have few resources apart from the ABILITY to CONTROL their own bodies. But, in this respect, they have total sovereignty. Rachel Bachner-Melman has introduced the idea of VICARIOUS
AGENCY into the debate, suggesting that parents set out to compensate for their ‘‘own lack of success by way of their children’’ and the children’s PERCEPTION of their need to overachieve works as a predisposing factor. Explanations of eating disorders in sports rely on the similar cul-
tural factors, but include additional sports-specific constituents. Monitoring weight is normal in most sports: In some, leanness is considered of paramount importance. Sports that are subject to judge’s evaluation, like gymnastics, diving, and figure skating, encourage participants to take care of all aspects of their appearance. About 35 percent of competitors have eating disorders and half practice what researchers term ‘‘pathogenic weight control.’’ In some sports, looking young and slender is considered such an
advantage that competitors actively try to stave off the onset of menstruation and the development of secondary sexual characteristics or to counterbalance the weight gain that typically accompanies
puberty. Menstrual dysfunction, such as amenorrhoea (abnormal absence of menstruation) and oligomenorrhoea (few and irregular periods), frequently result from anorexia. In endurance events, excess weight is generally believed to impair performance. Athletes reduce body fat to increase strength, speed, and endurance, though they risk bone mineral deficiencies, dehydration, and a decrease in maximum oxygen uptake (VO2max). While it is not a recognized medical term, ‘‘orthorexia nervosa’’
was used by Stephen Bratman and David Knight to describe the obsession with fastidiously healthy eating. Orthorexia bears similarities to other eating disorders: Sufferers fixate on their food. The emphasis on ostensibly healthy food, including fresh, organic, and the avoidance of all food considered ‘‘bad’’ (fast food, pizzas, ice cream, and so on) leads to a pathology in its own right: a compulsion to eat pure and superior ingredients.
