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First published: October 2000

Disordered Beauty: Anorexia

by Michael Sones

In the mid-nineteenth century successful Western businessmen and politicians "tummy bulged." Their relative obesity in societies in which the scourge of potential famine had only relatively recently been overcome was a sign of their high status and social success. Eating disorders were relatively rare then. They have now become much more common and are quite possibly increasing in the developed countries where there is relatively ample food. Only in countries where there is ample food can there be a cultural fashion for thinness.



Almost all women everywhere are concerned with being attractive within the terms of their cultures and in Western cultures now almost all women are self-conscious about their weight. Most believe themselves to be overweight and the diet industry is enormous.A survey of 5,000 women in the UK by Real magazine published in November 2002 has some rather depressing statistics. 91% of women were unhappy with their hips and thighs and 60% were depressed by their body image. 84% of those who were normal weight wished they were lighter. Only 3% of women were happy with their bodies. However, anorexia nervosa is a serious mental health disorder which is characterised by an exaggerated preoccupation with the appearance of the body. It can be considered a disorder of beauty in that the sufferer believes, despite all evidence to the contrary, that he or she is too fat and therefore unattractive. The anorexic wishes to be thinner. The disorder is typically characterised by a refusal to attain or maintain a normal body weight (body weight of less than 85% of the norm). There is a terror of becoming fat or gaining weight. In girls and women menstruation is not attained at an appropriate age or ceases (amenorrhoea). It has one of the highest mortality rates of all mental disorders with a long term mortality of over 10%.

The first medical case history was published in 1689 by Richard Morton. It was named in the 1868 by Sir William Gull and the name means "nervous loss of appetite" but actually loss of appetite is rare. It has more to do with control of appetite and therefore with self-control. The anorexic is preoccupied with their appearance and body image. While there are male anorexics, and the incidence of male anorexics may be increasing, most anorexics are female. She will wear baggy clothes to both hide fat, and in a curious paradox, hide the signs of emaciation from others and to stay warm. She might spend a lot of time in front of a mirror inspecting the different parts of her body particularly those which have some significance for female reproduction, sexuality, and the nurturing of children-the breasts, the hips, the thighs, the stomach and the buttocks.

In our ancestral past the food supply would not have been constant-there were no 24 hour supermarkets or Internet food delivery services to the door. Our ancestors were hunter-gatherers for hundreds of thousands of years and our bodies evolved in adaptation to that lifestyle and those environmental conditions in which the availability of food varied. Primitive agriculture only began about 10,000 years ago and that is a small fraction (.16%-not even one per cent-check our maths! 10,000 is only 1% of 1,000,000) of the 6,000,000 years that humans have been evolving. Anatomically modern human bodies have only been around for about 150,000 years (about 2.5% of the time). Bodies which could not cope with periods of relative scarcity and abundance did not survive to pass on their genes. It would have been adaptive in days gone by to binge eat when food was available and for as much of that food as possible to have been stored in the body. Especially those foods which were sweet, fat, or salty tasting. Women, in particular, need to have bodies which are capable of storing up food reserves as fat in order to be able to feed their children. It would also have been The 'Venus of Willendorf' about 30,000 years oldadaptive to develop mechanisms to be able to control the body in the absence of food and to control the appetite. In anorexia some of these evolved mechanisms have clearly gone awry. The photo is of the Venus of Willendorf, a prehistoric 'Venus' about 30,000 years old. The exact meanings of this and the many other 'Venus' figurines of prehistoric Europe has been a matter of considerable debate among archaeologists but, if it represents some kind of feminine ideal of prehistoric European hunter-gatherer societies, it is a vastly different feminine ideal than that of today's world.


The author of this article is a qualified and experienced psychotherapist with many years experience working for the NHS in the UK. Information in this article is purely for educational purposes. If you suspect you may be suffering from anorexia or other eating disorder please seek appropriate help from your doctor or a properly qualified mental health clinician.


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