Oing a Criticism using (Dramatist) Pentad Analysis

Societys Unhealthy Obsession with Thinness

Table of Contents: Further Readings

The Idealization of Thinness,Ottawa Citizen, June 9, 2002. Copyright © 2002 by Southam Business Communications, Inc. Reproduced by permission of the publisher.

The idealization of thinness can lead to the development of disordered eating patterns, Leonard Stern observes in the following selection. Most experts agree that the medias emphasis on thinness has a significant impact on how women perceive their bodies, Stern writes. When those individuals who are already susceptible to eating problems are exposed to unrealistic cultural expectations about how their bodies should look, they are likely to develop a full-blown eating disorder, Stern reports. He also notes that the glorification of thinness in women is a recent development in industrialized societies; in earlier times, thinness was seen as a sign of illness or starvation, whereas heavier women were considered healthy and strong. Working to change societal attitudes about the ideal body and focusing on building self-esteem in children may help to prevent eating disorders in the future, Stern concludes. Stern writes for the Ottawa Citizen, a Canadian newspaper.

In 1873, the French physician Ernest Lasegue published an account of eight female patients who had developed a bizarre aversion to food and were starving themselves. This disease, however, existed before Lasegue came along. Richard Morton, an English doctor and preacher, wrote in 1689 of a girl with no appetite who resembled a Skeleton only clad with skin,yet who retained a compulsion to exercise right up until dying from her Consumption(consumption being the catch-all label doctors invoked when something baffled them).

In the Middle Ages there were also reports of adolescent girls, Miracle fasters,who, claiming divine inspiration, stopped eating. In later centuries, people travelled far and wide to view oddities such as one Sarah Jacob, The Welsh fasting girl,who starved herself to death in 1869.

Lasegue, though, was the first to study clinically what he called Lanorexie hysterique,or anorexia nervosa as it is known today. It was a strange malady, he marvelled. As his patients slowly starved themselves, skin turning yellow and faces hollow, their frantic parents imploring them to eat, the girls seemed puzzled at the fuss and calmly insisted, ”je ne souffre pas, donc je suis bien portante.” Im not suffering, Im fine. Lasegue concluded that until sufferers recognized they were ill, treatment was hopeless.

Lucyna Neville, who co-founded Hopewell, an eating disorder support centre in Ottawa in 2000, recalls one time there have been many when she brought her daughter Michelle to the Childrens Hospital of Eastern Ontario (CHEO). It was 1999, and Michelle, then 16, had been struggling with anorexia for several years. A CHEO psychiatrist had been seeing her, but that night there was no time to wait for an appointment and Neville took Michelle to the emergency room.

The family had just spent a long weekend on their sailboat, throughout which Michelle did not eat. In the first years of her daughters illness, Neville begged and pleaded with her, just as the parents of Lasegues patients had. Neville remembers awful scenes at the kitchen table: I would cry, she would cry, we both cried.Girls with eating disorders typically dont feel good about themselves, and Neville learned that making Michelle cry only intensified the self-loathing. So on the boat, Neville held her tongue. Id say to her, Michelle, what will you have for breakfast? Shed say, Im not hungry, thank you. This went on for three days. When we came off the boat, I said to my husband, Im taking her straight to CHEO.

Michelle was emaciated, but the nurses, after taking her pulse and listening to her heart, felt she was not in mortal danger. Neville insisted they measure Michelles vitals standing up. By then Neville had become a self-taught expert on the disease and she explained to the nurses that its hard to tell how sick anorexics are when theyre lying down. When Michelle got to her feet, her heart rate accelerated by 70 beats a minute and she swayed like a reed in the wind. Neville remembers hearing one nurse say Oh, my Godbefore sliding an intravenous tube into Michelles arm. Another tube, a force feeder, went into Michelles nose and down into her stomach. All the while Michelle, bewildered at the commotion, repeated, I feel fine.

A Medical Mystery

Eating disorders are medical puzzles. Diagnosis, treatment, prevention experts cant reach consensus on any of these. Its hard even to say what constitutes an Eating disorder.So-called binge eating, for example, is often classified as a distinct disorder. Does this mean you have a disease if you go berserk at the buffet table? Is binge eating a function of how much you eat, or is the defining criterion loss of control? How many times does it have to happen? Or consider bulimia nervosa, characterized by binging and purging, that is, eating huge amounts and then deliberately vomiting or eliminating the food with laxatives. What constitutes a binge a tub of Haagen-Dazs in one hour or in one afternoon? and how often must you purge?

These classification difficulties, as scientists call them, make it hard to estimate the prevalence of eating disorders. It was once believed that only one of every 100 women developed anorexia. But to be considered anorexic, the patient was required to demonstrate amenorrhea (the disruption of her menstrual period and a sign of malnourishment). Many doctors today feel that the amenorrhea criterion should be optional, and that a diagnosis can be made based only on extreme weight loss, a debilitating fear of gaining weight and a disturbed perception of ones body size in which case the occurrence of anorexia doubles to nearly two per cent of the female population. Bulimia nervosa, meanwhile, afflicts anywhere from two to nearly four per cent of girls and women.

So whats the take-home message? About five per cent of young adult females will at some point develop a serious eating disorder,said Dr. Allan Kaplan, who heads the Program for Eating Disorders at the Toronto General Hospital. Dr. Kaplan became interested in the phenomenon during his medical residency 20 years ago and since then has become a principal figure in the Toronto Group, as he and his colleagues are known throughout the world of eating disorder research.

Medical stars, perhaps a reflection of their own competence, are often upbeat when asked what the future holds for the treatment of multiple sclerosis or Parkinsons or whatever their specialty happens to be. Not Dr. Kaplan. Anorexia nervosa remains, for most patients who fall ill, a treatment-resistant, chronic illness with significant morbidity and mortality,he wrote in the April 2002 issue of the Canadian Journal of Psychiatry. Over the past 50 years, little progress has been made in developing new effective treatments for the disorder.

Unusual Diseases

In 1978, the late Hilde Bruch, a 74-year-old professor of psychiatry at Baylor University in Texas, published a book summarizing her experience treating victims of anorexia. A medical pioneer, Bruch began studying eating disorders before the Second World War. It says something about the weirdness of these diseases that, after 40 years in the field, Bruch never lost her morbid amazement that they inspired.

Bruch recounted the defiant 14-year-old who told her, Of course I had breakfast; I ate my Cheerio;the 22-year-old who wouldnt lick stamps because she was terrified of possible calories; the walking skeleton who, with Iron determination,pursued her goal of thinness not only by restricting food but by swimming laps five hours every day. Although anorexics insist they arent hungry, Bruch found that thats not true. The problem is not lack of appetite but a deathly fear of getting fat.

One clue that anorexics suffer hunger like