I feel conflicted about what to make of this book. Firstly, I suppose, to clarify, I was reading it, and thinking through it, as an individual with a diagnosis of AN for 10+ years, having spent the majority of my twenties in that cyclical roundabout of inpatient/daycare/outpatient/inpatient/daycare/outpatient ad nauseum. I am also from the UK, where we have the NHS, and our media & cultural landscape, although similar in parts due to the commodified and globalised world that we find ourselves collectively being subjected to in late stage capitalism, is not exactly the same.
Whilst I recognised the immense harm that our misogynistic mass media has on the young, especially women, I do not necessarily see this as the core reason, or indeed any reason, for why an individual goes on to develop an eating disorder. An eating disorder is, first and foremost, a mental health diagnosis, and, whilst labelling can be largely transitory, and in some cases, iatrogenic in nature, it is important, I think, to clarify the difference between body dysmorphia, one being on the receiving end of ableism/ misogynism/ sexism etc, and a mental health condition. There needed to be stronger clarification between disordered eating, and, an eating disorder. Whilst I think both are serious, and require medical intervention, they are not the same severity.
Whilst I understand the contemporaneous nature of the book in question, I think it could have been helpful to contextualise eating disorders in history, especially the emergence or so called, of orthorexia. Whilst it has, undeniably, been fostered & heightened by the “wellness” epidemic, and, in some cases, almost carte Blanche legitimised, individuals with an eating disorder operating on the pretence that they are pursuing “health”, is not new. Indeed, I have read of Victorian reports of patients avoiding meat and dairy due to “un-purity” of the foods in question. The core of how an eating disorder operates is, I think, largely stagnant, but the cultural sphere of which it is operating in changes, meaning that the language adapts, but the idea largely remains intact.
There was also little coverage of the genetic. In some studies, doctors place eating disorders as up to 60% genetic, and 40% environmental. I come from a family of people suffering from addictions, depression, suicide etc, whilst I do not know if this accounts for genetic predispositions to developing an eating disorder, or is the more the case of inter-generational trauma being passed down (the ghosts in the nursery), I think from personal experience that it must play a large role in how predisposed an individual is to developing an eating disorder. There is also interesting research emerging about metabolism and eating disorders which I think was given little attention.
From my own experiences in eating disorder services, I actually think there is far too much emphasis placed on the media and cultural landscape, and not enough placed on the individuals history, and other contributing factors. In my experience of treatment, too much emphasis was spent on corroborating the ideal female narratives that our society imposes on people, namely, I should recover so I could “have children”, “get married”, etc etc, which, whilst they might be “motivating” factors for some, certainly aren’t for me, and made me disdain and look down upon the “idiotic” nurses and doctors who were suggesting such a thing. There is was a sense, in my own eating disorder, that the world around me, and everyone in it,couldn’t see the wood through the trees, and sometimes I wonder if the alienation and loneliness epidemic that our society is currently experiencing, is in some way responsible for individuals turning inwards, creating and living through their own fantasy worlds in their heads, creating rules and order in amongst a world that is either too chaotic for them to handle, or has rules that they can’t abide by, because it makes them too sad.
Overall, I do think that this was an book with interesting parts, and perhaps my aversion to it stems largely from my own experiences, and my disdain for tying my own experience of an eating disorder into a narrative about pernicious cultural stereotypes. A year into my diagnosis I actually deleted all my social media accounts, and got a Nokia brick phone. I turned away from mainstream culture, and yet, my eating disorder still persisted.