Eating, food and the female body in the media and medicine: A feminist analysis of eating disorders

by Eleanor Carey

‘Food is the medium through which women are addressed; in turn food has become the language of their response.’ (Orbach cited in Benson 1997:137)

The above quote sums up the way in which dominant conceptions of femininity filter through social practice and can become literally reflected in one’s physical body and bodily habits. This article will examine how women come to embody social ideals concerning food, eating habits, appearance and ‘femininity’ itself. In particular it will clarify how interpretations of eating and the female body both in the media and in medicine can become embodied and even become synonymous with ‘femininity’. Eating disorders are widely acknowledged to be a phenomenon of advanced industrial countries. Moreover, the great majority of those with eating disorders are women, though the number of men affected is growing. Clearly there is some connection between how women experience these cultures and the development of eating disorders. Though many attempts have been made to interpret and explain women’s bodies, it seems clear that a satisfactory framework for explanation is yet to emerge.

Previous attempts to create a discourse around the female form have culminated in efforts to harness and constrain. In the dualist thinking of the Renaissance period, in which ‘reason’ reigned supreme, women were much more identified with the body, whereas men were associated with intellect and rationality. As a consequence, female bodies have become regarded as somewhat ‘unmanageable’. Even the feminist project has at times devalued the female body. Some elements of second wave feminism viewed control of the body as paramount, which even resulted in calls for medical interference in conception and pregnancy in order for women to regulate their bodies. These are just two examples of the way that the female body has been devalued in society. The constructionist view, popular today in our post-modernist thinking, sees the body, especially the gendered body as socially constructed, that the perpetual acting out of femininity or masculinity completely creates our concept of the body. For example, the idea that women’s bodies are weaker is widely held, and so is transferred into social practice, a self-fulfilling prophecy if you will. The difficulty with social constructionist theory though is that it discounts agency and does not recognise the possibility of girls accepting or rejecting discourses.

The central thing to understand is that eating disorders can be considered both a rejection of and compliance with the dominant ideal of femininity. Reading this through Foucauldian notions of power, subjects can simultaneously comply with and resist dominant ideals. Therefore, those with eating disorders could be seen as attempting to comply with the feminine ideal of thinness while at the same time resisting the construction of femininity as weak. Perhaps this becomes clearer if we consider the feeling of power and control that women with eating disorders gain from restricting their intake of food and adhering to rigorous exercise routines. Control is traditionally thought of as a male attribute and so gaining control by restricting food intake could be seen as the reclaiming of an attribute with which women are not usually identified. Moreover, it has been suggested that food denial could be a protest, albeit an unconscious one, against the dominant ideals of femininity encompassing diet, exercise and self-control.

Through a close study of the growing cyber-community of those with eating disorders this article will examine eating disorders through phenomenology- (a school of thought that values lived experience) and Foucauldian notions of power and socialisation. It is proposed that discourse and social practice have constructed male and female bodies in such a way that bolsters pre-existing power relations between men and women. However, dominant discourse on any issue can actually be at odds with lived experience and/or can help to frame experience of the body. Thus the lived experience of the body must be taken into account. This will be shown through an analysis of the medical discourse on eating disorders and how this actually helps to shape the identity of those suffering with the disorders. In addition to this an examination of the media and the family as disseminators of dominant discourse, and ideals about femininity will also be observed.

The following research encompasses both secondary readings and primary research. The primary research relates to magazine advertisements, which are used to show how the female body is both depicted and interpreted in the media; and ‘pro-ana’ websites in which mainly girls with anorexia, bulimia, or other eating disorders discuss their conditions. These sites grant valuable insight into how eating disorders are lived and how medical interpretations are either accepted or rejected. Secondary research has concentrated mainly on theory of the body and on theories relating to power and control. Overall this article will illustrate that the current ways of reading the female body are inadequate and that this can contribute to the formation of eating disorders among women.

Medical discourse on eating disorders; the media; and the family as disseminators of dominant concepts of femininity.

As medical professionals have become an almost revered source of authority in our society it is not surprising that the scientific interpretations of eating disorders are the most readily accepted in industrialised countries. What is often overlooked however is that these interpretations and diagnoses are not formed outside of the dominant discourses of a society. Medicine has traditionally viewed eating disorders as a result of individual pathology, with little recognition of the socio-cultural factors contributing to these disorders. So because some women have eating disorders while others do not, it must be a ‘problem’ with the individual and not symptomatic of wider societal issues. Within this field eating disorders are regarded as one of, or a combination of, the following: an attempt to construct an identity where there previously was none; or a failure of the subject to individuate and create appropriate boundaries around the self- i.e. that the subject is too dependent on other people. I will elaborate on this theory of autonomy and connectedness at a later stage. The medical way of viewing the female body is problematic because it measures whether or not a person is dangerously thin or dangerously overweight and treats that state of the body as the condition to be diagnosed and treated, it usually does not determine whether a person has an adverse or unhealthy relationship with food or has a distorted body image or why this may be the case.

Medical discourse claims merely to diagnose bodies, and their various states are considered ‘natural’. However, these interpretations, largely because of the authority attached to them, can actively produce the lived experience of bodies. By prescribing the parameters, which posit the attributes historically associated with males (reason and autonomy) as normative, the quality of connectedness that has been historically thought of as female becomes viewed as a deficiency and inauthentic. Eating and rejecting food is a metaphor for this dilemma of connection and separation. It is about trying to possess the power that autonomy presupposes, but also to at once reject and foster the connectedness which women are often drawn to, but feel they have to fight against in order to be seen as equal. The everyday life of someone with an eating disorder embodies this conflict. On the one hand it can be seen as a cry for help, a way of seeking attention or of reaching out. Certainly the pro-ana websites that will be examined closer below attest to the fact that many of these girls do wish to feel a connection with others going through the same thing. The eating disorders themselves are the topic of conversation which binds them together and the website is a platform for networking. On the other hand, the practices of those with eating disorders are isolating and have the effect of cutting one off from those around them. Many of the girls describe how they feel completely separated from their family and friends. Moreover, the intense exercise routines and limiting of food, along with binging for bulimics are all solitary activities. Paradoxically then these girls are attempting to be successful, whole, rounded and significantly autonomous and solitary individuals and it is through this that they feel they will be able to connect. If they can control and order their bodies and by extension their inner selves, they can form true connections. This perceived imperative to exert one’s will so extremely is the root of the destructive and damaging behaviour.

Thus, while in society women are encouraged to identify with the external, in psychology this is viewed as inauthenticity, which means that inauthenticity becomes feminized. Significantly, in the case of eating disorders, the body is viewed in medicine as ultimately natural, that it must be overcome. For patients receiving treatment, this idea is not only hard to resist coming from an authority figure, but it also reproduces one of the causing factors that contributes to the development of eating disorders, that of the experience of the body as an object to be controlled. Most medical programmes focus on weight gain and behaviour modification (features of which are calorie counting and constant weighing, which clearly those with eating disorders are already concerned with) thereby merely shifting the focus of the eating disorders from weight loss to weight gain. It treats the symptoms of the disease rather than the underlying causes of the disease itself. In effect these are training grounds in which obsessive behaviour is encouraged rather than finding a way to repair the sufferers relationship with food and eating. This explains why the rate of rehospitalisation is so high. Thus medical discourse, while claiming to merely diagnose and treat bodies, actually helps to perpetuate the view that the female body can and should be controlled and that this is ‘naturally’ a hard thing to do.

This concept of the female body as consumers and somewhat ‘other’ to the self can be seen in many media representations of women. Susan Bordo sees the cultural meaning of diet and exercise as communicated through popular representations in the media, and it is from this source that dominant ideas are disseminated. Since the mid-1970s the discourse around diet and exercise has been one of endeavour and suggests that a ‘good’ body is the result of a sound work ethic and not only denotes physical strength but strength of character. Taking Foucault’s theory of a subject adopting the dominant discourses and disciplining themselves accordingly, it is easy to make a case for seeing the media as the main proponent of a harmful ‘beauty myth’ that may cause eating disorders. Bordo goes on to describe how the picture of the ideal body has changed throughout history, evolving to the impossible standards we impose today which is that any part of the body which is not tight, streamlined or contained is seen as problematic. Examples of this body ideal can be found in the popular press. An advertisement for the Bodytrim System, shows how one woman successfully managed to make her “fat and flabby thighs thin” (Bodytrim system 2008). Most importantly in today’s society, being over weight is seen as a sign of some inner turmoil; as representing the emotional, moral or spiritual state of the person. This again feeds into and results from the belief that these disorders signify individual pathology, discussed above. Conversely not showing fat on individual bodies is viewed as an achievement. This trend towards slimness can be viewed as a very dangerous ideal of femininity.

As mentioned in the opening paragraph, eating disorders have become a particular feature of industrialised, capitalist cultures. Bordo illustrates this in her work claiming that eating disorders actually reflect the contradictions in capitalist culture. For the bulimic that gorges her/himself and then disciplines the body by regurgitating what was eaten, they are reflecting the fact that capitalism encourages mass consumption to a point of excess. Its purpose is to produce and its citizen’s role is to consume as much as possible to keep the system in perpetual motion. In juxtaposition it also expects workers, which almost all the population are, to regulate these desires in order to perform tasks without distraction. By implication general fitness is viewed as an expression of competency in managing the relationship between production and consumption. Interestingly it has been found that bulimia and shoplifting are often co-morbid (occur together). Studies have shown that compulsive buyers tend to have a more negative body image and a significant proportion of them were found to have an eating disorder. If it is so imperative to strike a balance in order to be a successful individual then it must be recognised that cultural discourses place women at a disadvantage as the feminine body is characterised as a consuming body, which is limited as it cannot easily work off what has been consumed. Anorexia and obesity are read as an attempt to overcome the “double bind of consumer capitalism” (Bordo 1997:174) with anorexia occupying one extreme of the continuum and over eating occupying the other end. Also mentioned here is that the slenderness ideal is about moving away from traditional ideas of what a woman should look like, a shattering of the hourglass so to speak. Altogether these acts can be seen as resistance of the dominant culture even if they ultimately serve to reproduce women’s oppression. However, as was previously cautioned against in relation to social constructionism, one must be careful not to discount the experience of the lived body. This experience, which can in no way be said to be uniform for all women, must not be dismissed as a socially constructed illusion. The body itself must also be taken into account when thinking about the performance or rejection of gender norms. These gender identities are ways for subjects to experience their individual bodies, not just attempts by the subject to conform to ideals.

Certain social imaginaries especially that of the female body can be damaging. Simone de Beauvoir points out that the discourse around women’s bodies, causes them to be experienced by many girls as problematic, something to be overcome or controlled. Luce Irigaray agrees that new imaginaries of the female body are needed in order to overcome the destructive way in which femininity is currently being lived. With regard to eating disorders then, the social imaginaries could certainly be seen as damaging for those who have the disorders, but agency and past experience of the body can enable women to protect themselves from eating disorders. Overall however, there is currently a general trend of self-control and disconnection between body image and biological reality.

Eating disorders predominantly affect adolescent girls within advanced capitalist societies with only one in ten diagnosed with an eating disorder are male. It has been suggested in this essay that it is in this situation that girls are subject to contradictory expectations of beauty and that eating disorders can be viewed as an attempt to achieve total control (morality; achievement; goodness) and an attempt to reject sexuality, contradictorily doing so by conforming to our contemporary ideal of beauty. The question remains: why do some women get eating disorders while others do not, when they are all subject to the same social pressure, ideals of beauty, theories about the limits of the female body? Race, class, sexual orientation, family and religion all have a part to play in how one experiences one’s body within society. For example a study has shown that females are on the whole more concerned with appearance than males. Non-whites are more concerned with appearance than whites, employed men are more concerned with appearance than unemployed men and interestingly that employed women are less concerned with appearance than unemployed women. In a world that values appearance so highly several deductions can be made from the above findings. Whites being the dominant class in most advanced industrial countries such as in Europe and the USA, may be more secure in their position in the upper classes, the labour market and life in general, that appearance does not matter quite so much to them as it would to non-whites. This group may be attempting to reach the ideal of beauty in order to level the playing field or resist social constructions of them by others. Employed men participating in the highly competitive capitalist culture may feel that a good appearance would give them a slight edge in the market. That employed women are less concerned with appearance than unemployed women may be symptomatic of the importance placed on the decorative function of women in the first world, and if these women are unemployed they may feel that this is one of the only cards they have to play.

Family and home life have a role to play in the development of eating disorders. It has been suggested that the household of an anorexic is usually subject to strong matriarchal control. However, this does not seem to be a sufficient explanation when one considers that the incidence of eating disorders amongst African-American girls (a community which has traditionally been characterised by strong matriarchal control) is lower than that of Caucasian girls. However, it should be acknowledged that though being a member of a minority group may offer some protection against eating disorders these girls are subject to the same pressures from the majority culture. Rather, it is more accurate to say that the extent to which ideals of thinness are emphasised in a certain household can explain why some women develop eating disorders and some do not. Those whose family life are characterised by: a critical family environment; coercive parental control; an unloving parental-child relationship; where the main discourse is about weight are considerably more at risk of developing eating disorders. The above four factors were found to interact in different configurations with the most prominent being that of a critical family environment mixed with a dominant discourse on weight issues. From these findings it can be seen that discourse certainly affects the way one experiences their body and that the family is a principle group through which social discourse is disseminated.

It is necessary to look specifically at how the relationship between women and food is normally characterised. For women food and eating have become bound up with sexuality and sexual desire; with serving a man’s needs; with motherly nurturing; and with love. An advertisement for Ben and Jerry’s low fat ice-cream carries the headline ‘more love, less handle’ (Ben and Jerry 2008), thus intertwining the concepts of love and food but also promoting the imperative for women to not have body fat.

The inclusion of lived experience: shaping new discourse for an eating disordered identity

Having discussed how discourse can affect women in general and how medical discourse can affect women in clinics, it is time now to consider how these women actually experience their own bodies. Only through the inclusion of lived experience can a more rounded picture of how dominant ideals of femininity are filtered by those with eating disorders be obtained.

A large volume of the work based on the testimonies of sufferers of eating disorders point to a negative body image, a fear of fat, and a feeling of powerlessness and insecurity as major components of an eating disorder. Self-image is connected to the subject’s image of other bodies and to the image that others have of the subject’s body. Body image however, is almost always a distorted view of the current state of the subject’s body. For an anorexic for example, the body image will remain at the pre-anorexic level. Thus just as reality is always filtered through one’s perception, the anorexic’s perception of her body will override the fact that she has become dangerously thin. In many cases the girls admit to knowing this fact but not truly believing it. One anorexic described it:

“when I look in the mirror I don’t really see a fat person there… but I can tell the minute I eat certain things that my stomach blows up like a pig’s… and it’s disgusting” (Bordo, 1997:168).

This quote suggests that the body image while not totally disconnected with reality it is most definitely out of step with it. Many testimonies of sufferers refer to the feeling of power that they have when they have the eating disorder, and that this power sets them apart from others, contributing heavily to their identities. In this way the disorder can be read as a rebellion against a discourse in which women are still considered the weaker sex, even if paradoxically this makes them weaker physically. More so it is about control over the body and its functions.  One girl said:

“I found out how to do what everyone else couldn’t: I could lose as much or as little weight as I wanted. And that meant I was better than everyone else” (Bordo 1997:175).

Another stated:

“I truly believed that my role in this world… was to be anorexic. Because you have the dominants, the leaders, the thinkers, I was just the anorexic, that was who I was” (Rich 2006:298).

A profile picture on a pro-anorexia website read:

“sometimes I’m hungry. I’m always hungry. But when I don’t eat I feel good. Pure. I feel empty and it’s wonderful. I feel so powerful like I could fly’ (Live Journal 2008).

Clearly the notion of power and control are integral to the experience of the body for those with an eating disorder. But to what extent does the disorder become part of identity?

“It (anorexia) shows that you have a strength that others don’t, because, let’s face it, not many people have the ability to starve themselves to death all the girls seem to, I don’t know, idolise it… and because now everyone is aware of anorexics even if they do not understand them, everyone’s just so interested” (Rich, 2006:298-9).

This last statement could be read as attention seeking, that the girl in question simply wanted the interest of those around her. However, the need is more sophisticated. It is about otherness, specialness, which comes to form part of the subject’s identity. Even within a group of those with eating disorders there is competition to have the ‘best’ anorexic, bulimic etc. identity.

As has been previously discussed the female body has been constructed as alien to the self, and something to be controlled. One patient described her experience of her body through anorexia as primarily one of numbers. “I feel like a number of calories, a unit of weight, a measurement not a person” (Gremillion 2002:408). The experiences of the body here outlined, i.e. as an object to be controlled; as the site where a sense of control and achievement can be created; and as a source of body image and identity formation, all point to the fact that the prevalent social discourse on femininity is failing when it comes to conceptualising the female body. Anorexics feel rather that they are misunderstood or do not have the necessary language they need to adequately explain what is happening to them:

“the issue is here Lydia, you know you’ve got to get better” and I’m like “shut up”. And you know they don’t really want to know what I think because they’re like “why can’t you eat?” and I’m like “why can’t you understand?”… it’s really really frustrating” (Rich 2006:292).

Perhaps in an attempt to create their own discourse which more adequately reflects their lived experiences, there are a growing number of websites and chat rooms that range from helping people recover from these illnesses to giving advice on the disorders. For example the pro-anorexia movement has primarily taken place through the Internet. While this could certainly be an alarming sign and many view it as such, these ‘pro-ana’ websites claim to offer support to sufferers in a forum outside of the usual discourse on eating disorders. Indeed one websites bio stated that it is:

“An environment where those who suffer the mental disorders associated with Anorexia Nervosa, Bulimia and Ed-Nos can feel free to discuss their disorders with others who know and understand, without being exposed to the constant “just eat more”, “fasting is dangerous” and “purging is dangerous” that causes them to withdraw from society in the real world” (Live Journal 2008).

Moreover, it is stated that the main aim of the site is suicide prevention. It is not a forum where one can ask for hints and tips on how to lose weight, this is expressely forbidden and is policed by the online community. For example one posting asked:

“What do you guys think is the most effective way to loose 2.5 lbs in 4 days? Apart from the obvious fasting.” To which another member replied: “I don’t want to come off as a bitch, but questions like these offend people around here. Mostly because it is like asking for tips and tricks” (Live Journal 2008).

While it could be argued that the mere existence of such a website which is accessible to all could actually promote eating disorders this does not seem to be the case. The philosophy of the website is that people are going to carry out eating disordered behaviour whether it exists or not. So by providing a constantly accessible forum, which allows the discussion of disorders without judgement, they can try to ensure that these practises do not result in death. It is not the disorder itself that results in death but it is the loneliness and lack of connection that comes with such a disorder that drives it to that end.

Conclusion

Eating disorders clearly result from a number of factors. Dominant discourse on the female body and ideals of femininity intersect in the advanced capitalist society in a contradictory way. Overall, western discourse has failed to adequately theorise the female body and it is this failure that causes girls to live the anorexic/ bulimic identity as either a way to overcome or embody the contradictions they encounter. Society therefore is not only a contributing factor in the creation of eating disorders but a productive one. This paper has demonstrated that the theory of the female body as a limitation- as an object in need of control- is damaging and dangerous. In addition, fitness in our culture is synonymous with success and achievement. Thus the female body is posited as particularly problematic and placed at a disadvantage. When her relationship with food is framed in connection with love, motherhood, and serving males, some girls attempt to rebel against this. Medical discourse also views the female body and her attributes as lacking and symptomatic of individual pathology, without recognition of social factors that have such a large part to play. The media is an important tool through which these dominant ideals are disseminated, though clearly the particular family situation has a major role to play in the development of eating disorders. It is here suggested that the emergence of ‘pro-ana’ websites points to the failing of discourse to theorise the female body in line with lived experience. Ultimately these eating disorders are experienced as an attempt to control the body, while the body itself is seen as something that may turn on you if not regulated.

Eleanor Carey graduated from the University of Limerick in 2009. Her research interests include the body and women’s issues, social inequality, development issues, and the history of education in Ireland.

References

Ben and Jerry Ice Cream (2008), ‘More love, less handle’ Magazine advertisement Chic, 15 November, 27.

Benson, S. (1997), ‘The body, health and eating disorders’, in Woodward, K. (ed.), Identity and Difference: Culture, media and identities, London: Sage in association with the Open University, 121-81.

Bordo, S. (1993), Unbearable weight: Feminism, western culture and the body, London: University of California Press.

Bordo, S. (1997),‘Reading the slender body’ in Woodward, K. (ed.), Identity and Difference, London: Sage in association with the Open University, 167-181.

Gremillion, H. (2002) ‘In fitness and in health: Crafting bodies in the treatment of anorexia nervosa’, Signs, 27(2), 381-414.

Rich, E. (2006) ‘Anorexic dis(connection): managing anorexia as an illness and an identity’, Sociology of Health and Illness, 28(3), 284-305.

Live Journal. (2008) Proanorexia [online], available: http://community.livejournal.com/proanorexia, [accessed 16 November 2008].