[Marxism] The MIM on anorexia

Louis Proyect lnp3 at panix.com
Sun Nov 26 16:53:01 MST 2006

Interesting book review from the Maoist International Movement, who 
were always good for a laugh. But in this case they seem to make some sense:

Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease
Joan Jacobs Brumberg
Cambridge: Harvard University Press
Reviewed by MC2
Reprinted from MIM Notes 35, Jan. 1989

I highly recommend Joan Jacobs Brumberg's book Fasting Girls: The 
Emergence of Anorexia Nervosa as a Modern Disease. Thousands of women 
in the United States die each year by starving themselves to death to 
meet dominant cultural beauty ideals: thin is beautiful; fat is ugly. 
This book is valuable because it traces the origins of anorexia from 
the second half of the 19th century to the 1980s, and compares the 
disease with women's religious fasting during the European Middle 
Ages. This review will focus on the historical methodology Brumberg employs.

Anorexia is found mainly among upper middle-class women in the United 
States, Western Europe and Japan. It is uncommon in the Third World 
except among elite women educated in the United States or Europe. In 
the United States, it is rarely found among working-class white 
women, and almost never among Black women.(1)

Brumberg makes a number of observations concerning historical 
methodology that every reader ought to memorize because they are so 
important to critical social analysis. Some writers have made glib 
comparisons between religious fasting by women and anorexia today; 
these commentators have claimed that such behavior has a biological 
basis in "women's nature." Brumberg writes: "Just because a behavior 
occurs across cultures or times does not necessarily mean that it has 
the same cause or that it is biologically based."(2) She then 
explains: "The story of anorexia nervosa lays bare the extent to 
which disease is a cultural artifact, defined and redefined over 
time, and therefore illustrative of fundamental historical 
transformations. Consequently, my response to the frequent question, 
is anorexia nervosa a new disease must be somewhat ambiguous: 
anorexia nervosa is a historically specific disease that emerged from 
the distinctive economic and social environment of the late 
nineteenth century."(3) Brumberg shows that anorexia is not the same 
disease that it was 100 years ago because society has changed. 
"[T]here are significant new behavioral symptoms that mirror 
contemporary culture namely, pervasive hyperactivity and 
competitiveness. Among affluent young Victorians food and eating were 
at the center of a web of associations that had a great deal to do 
with gender and class identity. The same is true today, but broad 
social and cultural forces, particularly the intensification of 
messages about the female body, have prompted the urgency of appetite 
control and generated a new experience of the disease in the 
twentieth century. Anorexia nervosa used to be an isolated and 
idiosyncratic disorder; over the past few decades it has become both 
more familiar and more formulaic, and its physical symptoms are now 
more acute."(4) Brumberg quotes Charles E. Rosenberg in a pioneering 
study of cholera in the nineteenth century: "A disease is no absolute 
physical entity but a complex intellectual construction, an amalgam 
of biological state and social definition."(5)

There are three major explanations of anorexia: (1) biomedical; (2) 
psychological and (3) and socio-economic (what Brumberg calls the 
cultural model). Brumberg clearly emphasizes the socio-economic or 
cultural model. The only criticism I have of Brumberg is that she 
does not clearly explain the dialectical relationship between culture 
and economic institutions; although in practice she does emphasize 
the relationship between anorexia and class/gender social relations 
in a capitalist economy. Brumberg does an excellent job of tearing 
apart biomedical explanations of anorexia. Some doctors have linked 
anorexia to imbalances in hormones that occur mainly among women.(6) 
Brumberg agrees that women who are anorexic may well have hormonal 
imbalances, but she demonstrates that these biomedical indicators are 
the effect of anorexia rather than the cause. It is hard to argue 
that anorexia is primarily caused by genes or hormones when only 
upper class women in the United States, Europe and Japan get the 
disease. No one has seriously suggested that working class white 
women in the United States have different hormones than upper middle 
class women; although some bourgeois scientists probably would put 
forward genetic explanations for why Black women rarely contract the 

Brumberg demolishes psychological categories of anorexia: "The 
psychological paradigm is incomplete, just as the biomedical model 
is, in that it fails to provide an adequate answer to the same thorny 
problems of social address, changing incidence, and gender. After 
reading the psychological literature, one still asks: Why is the 
anorexia nervosa "epidemic" restricted by class and confined to 
societies like our own? Why are we experiencing more anorexia nervosa 
today than we did fifty or one hundred years ago? Why is it that 
adolescent girls and not adolescent boys engage in this form of 
development struggle?"(8)

Brumberg shows anorexia has changed over the last 100 years as 
class/gender structures have changed in response to socio-economic 
developments in United States, English and French capitalist 
societies, although the main focus since 1900 is on the United 
States. During the second half of the 19th century prosperous middle 
class families could afford to keep their female children out of the 
labor force. Young women stayed at home until they married, typically 
in their early 20s.(9) What we now call adolescence was created by 
the burgeoning prosperity of middle-class families during the late 
19th century. Before this time women married younger and all but 
members of the higher aristocracy performed at least some domestic 
work. Obviously, working-class women started laboring at a very early 
age. Middle-class adolescent women were privileged in one sense 
because they did not have to work or yet reproduce, but they were 
highly dependent and controlled by their parents unlike their 
brothers, who had far greater educational and employment 
opportunities. Starvation was one socially acceptable way for middle 
class young women to rebel against parental control.(10) To some 
extent Victorian women fasted to meet cultural values about beauty, 
but those social pressures were weaker then than they are today.(11) 
Ideal female body size in Victorian culture was larger than today and 
women were required to wear such bulky clothing it was more difficult 
to tell whether a woman was thin or not.(11)

Brumberg provides information on how Amerikan popular culture since 
1900 has put pressure on women to be very thin. The ideal female body 
size as presented by mass media has become much slimmer than it was 
in 1920. Thin movie and television stars have become models for many 
young women.

Brumberg goes beyond mere generalities about cultural ideals in the 
mass media. She points out that food today is usually loaded with 
sugar and fat. Just go eat a Big Mac at McDonald's. Fast food and 
prepared food are loaded with calories.(12) People have the choice of 
getting fat or constantly dieting to stay thin. Dieting itself is big 
business with all kinds of pills and dietary supplements offered to 
help people lose weight. Some of the emphasis on changing diet and 
increasing exercise is positive, but all the media hype about getting 
in shape can lead at least some people into dangerous diets.

Brumberg makes a valuable point about the competitive aspect of 
modern anorexia in the 1980s. Women are entering the labor force in 
record numbers today; although on average they earn far less than 
men. Women today are educated in competitive behavior to get ahead in 
the business world, this is especially true among upper middle-class 
women. It is not surprising that competitive values spill over into 
dieting and beauty. Distorted capitalist values about individualism 
and competition contribute to anorexia.

Beware of bourgeois genetic, hormonal or psychological explanations 
for behavior that is really socio-economic in origin.

1. Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia 
Nervosa as a Modern Disease, Cambridge: Harvard University Press, 
1988, p. 280 n. 14.
2. Ibid., p. 2.
3. Ibid., p. 3.
4. Ibid., pp. 5-6.
5. Ibid., pp. 6-7.
6. Ibid., p. 25.
7. Ibid., pp. 25-8.
8. Ibid., p. 31.
9. Ibid., p. 126.
10. Ibid., p. 188.
11. Ibid., pp. 188, 254.
12. Ibid., p. 260.

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