Categories
Eating Disorders History

The Shut Mouth & Forced Ingestion: Women’s Suffrage

On the 5th of July 1909, Marion Wallace Dunlop initiated a hunger strike in Holloway Goal. Suffragettes famously embarked upon this strike in order to protest their confinement for public acts of physical insubordination that included breaking windows and chaining themselves to railings.

Their rejection of food was a reaction to the government’s refusal to grant them the status of political prisoners.1

Rather than taking notice of and meeting the hunger strikers’ demands, however, the authorities responded with forced-feeding. 

Women ought to eat less than men, while certain foods were considered altogether unsuitable

These hunger strikes were not isolated incidents, but were a product of the Victorian debate surrounding female eating habits. Women’s dietary requirements were monitored throughout the 1800s when there was much discussion upon the subject of what was appropriate for a woman to consume. According to newspaper articles and etiquette guides, women ought to eat less than men, while certain foods were considered altogether unsuitable.

These restrictions that were placed upon the female body possessed a moral dimension since appetite was connected with sexuality. Woman’s hunger and consumption were therefore subject to constant regulation.

The suffragette movement campaigned for sexual equality and to alter patriarchal perceptions of women, an agenda to which bodies were central.

The nineteenth-century woman was defined in terms of her body and imprisoned within the domestic space of the home. Her exclusion from the ‘masculine’ social and political spheres was justified by men who pointed to the female body’s natural physical weakness. According to the Victorian patriarchy, a woman’s energy should be preserved for bearing children.

Women’s bodies that had been exploited for their reproductive capacities were thereby reclaimed by the suffragettes, who, like their mothers and grandmothers before them, aimed to achieve emancipation from domestic life.

The suffragettes therefore endured hunger and forced-feeding in order to improve the lives of other women. Their capacity to maintain their fasting, despite the violent force-feeding, glorified them as strong, determined individuals.

While medical practitioners and government officials considered hunger striking to be rebellious or suicidal, in reality its aim was to call attention to the political motive for what were judged as criminal offences.

The reasons for the hunger strike are recounted by suffragettes themselves in fictional and autobiographical writings, such as K. Roberts’ ‘Some Pioneers and a Prison’, published in 1913. In her work, Roberts reveals that since petitions proved useless in gaining first division status:

It was determined to make a protest by politely and quietly declining to wear the prison clothes and eat the prison food.2

The narrator does not consider her actions to be ‘an offence at all’, but merely a demonstration against the inequality of government law. Self-starvation was a protest against injustice.

A report published in 1909 states that they are fighting for a political idea:

For this they are being treated as common criminals, in a way that men never are, and forcible feeding is resorted to because that is the only way in which the Government can make the continuance of their punishment as common criminals possible.3

By diagnosing suffragette behaviour as criminal, the government was able to discount women’s appeal for political power. Women’s efforts to challenge the status quo through political protest or by attempting to gain ownership of their bodies were therefore dismissed, and their actions defined as abnormal, dangerous and requiring imprisonment and medical treatment.

Hunger striking was extremely uncomfortable. It was referred to by one suffragette, Lady Constance Lytton, as ‘“the weapon of self-hurt.”’4 The experience is described by Sylvia Pankhurst who speaks of pains in the back, chest and stomach; lack of circulation and palpitations as ‘gradually the feeling of weakness and illness grows.’

Every day she is able to perceive that she:

has grown thinner, that the bones are showing out more and more clearly, and that the eyes are grown more hollow.5

Following release from prison, many suffragettes continued to experience problems with digestive functions and suffered from headaches and nervous symptoms.6

The sacrifice involved in the suffrage campaign did not only include self-starvation, but even extended to suicide. In June 1912 during a mass force-feeding in Holloway Goal, Emily Wilding Davidson threw herself down a staircase. and the following year she cast herself under the King’s horse and was crushed to death.

These efforts were undermined, however, by the introduction of forcible-feeding in 1909. The Home Secretary stated that ‘force feeding was instituted to keep the prisoners in health.’ and assured that it was ‘unattended by danger or pain,’7 yet both were found to be untrue. It was in fact was injurious and painful.

By utilising forcible-feeding, patriarchal authorities refused to acknowledge the political dimension of the suffragettes’ starvation. The prison doctor judged that treatment had been successful and the patient ‘normalised’ when her body no longer displayed signs of emaciation.

Only the symptoms of the hunger strikes were treated, revealing that patriarchal perspectives upon women and their bodies underwent little alteration during the second half of the nineteenth century and into the twentieth.

Authorities only saw emaciated bodies that could die under their supervision

In the struggle against political exclusion, the suffragettes’ bodies were bruised and battered in their arrest; then subsequently imprisoned, starved and force-fed. Yet, the authorities only saw emaciated bodies that could die under their supervision.

The process of force-feeding is graphically described in contemporary journals and works of fiction. In ‘Forcible Feeding of Suffrage Prisoners’ (1912), the authors disclose that ‘[t]he feeding cup method is frequently forcibly administered solely by the wardresses, without the supervision of a qualified medical practioner.’8 This procedure was often carried out by women. Women’s bodies were held down and restrained by other women’s bodies: the very bodies that the suffragettes fought to liberate.

The force-feeding was violent and brutal, a power struggle of physical strength that symbolised the suffragettes’ political and social battle: [d]uring the struggle before the feeding, prisoners were held down by force, flung on the floor, tied to chairs and iron bedsteads. As might be expected, severe bruises were thus inflicted.9

The prisoner’s arms that were ‘held firmly, so that she could not move’10 represent the restraints placed upon women by early twentieth-century society; while the bruises are visible marks of their suffering, both mental and physical.

This process also had many side effects such as headache, earache, neuralgia and severe gastric pain. Choking, vomiting, palpitation, faintness, and cold temperature were common, while in one case food was accidentally injected into the lung.

In accounts of forcible-feeding, the mouth is often the focal point of the procedure:

When the oesophageal tube was employed the mouth was wrenched open by pulling the head back by the hair over the edge of a chair, forcing down the chin, and inserting the gag between the teeth.11

During the feeding the lips, inside of the cheeks, and gums were frequently bruised, sometimes bleeding and sore for days after.12

Instruments used for forcible-feeding

The mouth was therefore stopped up with food in order to prevent speech, its bleeding a symbol of how the female voice was damaged by those who did not heed its words, and instead demanded its silence.

On October 21st 1913, Emmeline Pankhurst delivered a speech in New York entitled ‘Why We Are Militant’, during which she referred to the suffrage campaign and subsequent imprisonment as a ‘battle’.

Emmeline Pankhurst

The battle for control of the female body at the outset of the twentieth century came to involve the diametrically opposed behaviours of female hunger striking and masculine forcible-feeding. Speaking of the ‘joy of battle and the exultation of victory, Emmeline Pankhurst expressed the enjoyment of fighting to reclaim women’s minds and bodies.13

Suffragettes used their bodies to fight for their minds: they were ‘women fighting for a great idea’.14 Their cause was social, aiming ‘for betterment of the human race’, even though the methods that they chose to achieve it were considered anti-social and rebellious.15

The battle for control of the female body was injurious to the bodies of those who fought, yet it was in order to secure a better life, for the minds and bodies of the women who were to follow:

The battle cost the lives of a few, and the health of most of those who went through it: but it has secured slightly better conditions and a different status for political prisoners in the future. It is a thing that we can always be proud that even—even after forcible feeding was permitted, or, rather, ordered by the Home Secretary—not one of our women gave in.16

The suffragettes who engaged in the hunger strikes of 1909 did not act in vain because in 1928, women over the age of twenty one were granted the vote.


  1. Susan Kingsley Kent, Sex and Suffrage in Britain 1860-1914 (London: Routledge, 1990)
  2. Norquay, Voices and Votes, from K. Roberts, ‘Some Pioneers and a Prison’ (1913)
  3. C. Mansell Moullin, J. S. Edkins, L. Garrett Anderson (October 9th 1909) ‘Fasting Prisoners and Compulsory Feeding’ 1098 The British Medical Journal Vol. 2, No. 2545
  4. Lytton, Constance and Jane Wharton, Prisons and Prisoners: Some Personal Experiences (New York: George H. Doran, 1914)
  5. Marcus, Suffrage and the Pankhursts, Sylvia Pankhurst, 11th April 1914
  6. ibid
  7. Savill and Horsley, ‘Preliminary Report on the forcible feeding of Suffrage Prisoners’
  8. Williams, McIntosh and Sayer, ‘Forcible Feeding of Suffrage Prisoners’, The British Medical Journal Vol.2, No.2701 (October 5th, 1912)
  9. Savill and Horsley ‘Preliminary Report on the forcible feeding of Suffrage Prisoners’
  10. Norquay, Voices and Votes, from K. Roberts, ‘Some Pioneers and a Prison’ (1913)
  11. Savill and Horsley ‘Preliminary Report on the forcible feeding of Suffrage Prisoners’
  12. ibid
  13. Emmeline Pankhurst, ‘Why We Are Militant’: Speech Delivered in New York, October 21st, 1913 in Marcus, Suffrage and the Pankhursts
  14. Marcus, Suffrage and the Pankhursts, Sylvia Pankhurst, 11th April 1914
  15. ibid
  16. Norquay, Voices and Votes, from K. Roberts, ‘Some Pioneers and a Prison’ (1913)

Categories
Body Image Dieting Eating Disorders Exercise Fitness Competitions

Perfectionism, Eating Disorders & Fitness Competitors

According to The Eating Disorders Review, perfectionism is a term ‘used to describe a psychological trait with associated behavioural tendencies. It is applied to individuals who believe that perfect states actually exist in certain domains…and that one should try to attain [them].1

Drawing from research studies and personal experience, I have found the perfectionist mind set to be common in both fitness competitors and in individuals with eating disorders, particularly anorexia nervosa.

Perfectionism occurs alongside eating disorders in 2 guises:

1. There are such things as perfect states. In the case of anorexia, the perfect state is to be thin.

2. Individuals with eating disorders follow what they consider to be the ‘perfect’ diet.

These 2 perfectionistic traits also apply to fitness competitors:

1. Their aim is to attain the perfect physique, which is typically lean and muscular.

2. This is achieved by ‘perfectly’ adhering to their nutrition plan and training.

While perfectionism is often seen as a desirable quality, when it is directed towards manipulating the body it can have damaging, and even fatal consequences.

If someone starves themselves perfectly, for example, they will not survive.

PERFECTIONIST TRAIT #1: ACHIEVING THE PERFECT BODY

As a former Bikini Competitor and recovering anorexic, I have pursued two different versions of what I considered to be the perfect body.

When I first developed an eating disorder age 11, it was 1994 and the era of slender supermodels Kate Moss and Gisele Bundchen.

The trend was for thin arms, prominent collar bones and a perfectly flat stomach. Consequently, my vision of the perfect body was the skeletal fashion model. Today, for anorexics, thin and perfect remain synonymous.

In my late 20s, when I entered the competition world, my concept of the perfect body shifted. Perfect body number two was still thin, but now it was rebranded as lean. It also developed muscles.

The similarities between these two versions of the perfect body are highlighted by Susan Bordo in her work Bodies. Here she observes that many bodybuilders, ‘talk about their bodies in ways that resonate disquietingly with typical anorexic themes.’2

Like people with eating disorders, fitness competitors are driven by the need to eliminate physical imperfections. Guidelines for the UK’s largest bodybuilding and fitness federation (UKBFF) state that competitors should present ‘a balanced, symmetrically developed, complete physique.’3

The winning trophy will only be awarded to the perfect body.

Bodybuilders talk about their bodies that resonate with anorexic themes

During my own competition career, it was 2015 when my body finally matched the judge’s vision of perfection and I won the coveted title of Pro Bikini Athlete.

However, as was the case when I was extremely thin during my teens and early 20s, achieving this figure came at great mental and physical cost.

Physically, the two versions of what I considered to be the perfect physique were impossible to maintain. This is because restricting food intake places the body in a state of starvation.

High standards of physical perfection can lead to self-criticism, body dysmorphia and depression

The body responds to any calorie deficit, no matter whether it is the result of an eating disorder, or more ‘normal’ dieting by making physiological adaptations. These include increasing appetite, lowering metabolism and driving up set point weight as insurance against future famine.

In terms of mental cost, the high standards of physical perfection set by both fitness competitors and individuals with anorexia can lead to self-criticism, body dysmorphia and depression.

PERFECTIONIST TRAIT #2: THE PERFECT DIET 

As is often the case with eating disorders, fitness competitors typically have an ‘all or nothing’ approach.

When comparing the psychological profiles of athletes and those with anorexia, one study found that both had elevated levels of anxiety, obsessive behaviours, and perfectionism.4

This was certainly my experience of preparing for a competition. I was extremely regimented with my nutrition and training. My workouts were precise: I lifted weights at the strict tempos stated on my programme; I timed my rest periods to the second; and I panicked if the gym was busy and I was unable to perform my exercises in the correct order.

More importantly, my nutrition had to be exact. I believed that following my complicated diet plan to the letter (which involved accurately weighing food to the gram, and eating at specific times) was the way to avoid failure.

This is in keeping with Brene Brown’s definition of perfectionism. In her work, The Gifts of Imperfection, Brown describes perfectionism as a self destructive and addictive belief system that fuels this primary thought:

If I look perfect, and do everything perfectly, I can avoid or minimize the painful feelings of shame, judgement, and blame.5

Perfectionism is a shield that protects us from being hurt.

I believed that having the perfect body would grant confidence, happiness, and social approval. Instead, however, this ideal kept me locked in a never ending cycle of self-criticism and despair if I failed to meet my own impossibly high standards.

BLACK AND WHITE THINKING

Most perfectionists think in terms of black and white. We either do something 100%, or not at all.

For example, do any of these statements sound familiar?

It’s all gone wrong so I might as well give up

I can’t start anything unless I understand it perfectly

I’ve made a mistake so have to start all over again

It wasn’t perfect, therefore I have failed

Perfectionists have such high expectations that falling short of achieving a goal, or making a mistake along the way leads to catastrophizing:

Not achieving perfection may be experienced as utter failure.6

This often occurs with eating disorders where there is any form of dietary restriction. For example, if we impose rules such as ‘chocolate is forbidden’, then eating even a small piece of chocolate will lead us to believe that we have crossed some invisible line – from nothing: ‘I’m not allowed to eat any chocolate’, to all: ‘I may as well eat all the chocolate.’

Overeating then leads to feelings of guilt and despair, and often compensatory behaviours such as even more restriction, or purging. These behaviours then perpetuate the binge-restrict cycle.

CONCLUSION

Believing in and striving for perfection, whether it’s the perfect body, or the perfect meal or training plan, will set us up for failure.

Therefore we need to challenge the perfectionist mind set, and instead try to embrace the grey in-between states of being that are our imperfections.

Whether your idea of the perfect body is being as thin as possible, or looking like a bikini model, it is just an idea, an idealistic standard that by its very definition does not exist.

This concept is neatly summarised by Stephen Hawking:

One of the basic rules of the universe is that nothing is perfect. Perfection simply doesn’t exist…..Without imperfection, neither you nor I would exist.


  1. http://eatingdisordersreview.com/nl/nl_edr_12_1_8.html
  2. Bordo, Susan, Unbearable Weight: Feminism, Western Culture, and the Body (University of California Press: London, 1995)
  3. http://www.ukbff.co.uk/pdfs/bikini_category_rules.pdf
  4. http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/
  5. Brene Brown, The Gifts of Imperfection
  6. http://eatingdisordersreview.com/nl/nl_edr_12_1_8.html

Categories
Dieting Eating Disorders History

Why Women? Theories of Anorexia Nervosa

Cases of eating disorders have risen dramatically over the last decade. Between 1.25 and 3.4 million people in the UK are affected by an eating disorder.1 The majority of these are women.

This gender bias is especially true of anorexia nervosa, which is one of the most common psychiatric disorders amongst young women.

The Diagnostic and Statistical Manual of Mental Disorders (DSMV) informs that ‘[m]ore than 90% of Anorexia Nervosa occurs in females.’2 There are also more women diagnosed with bulimia nervosa, the National Eating Disorders Association reporting that 80% of sufferers are female.3

More than 90% of anorexia nervosa occurs in females

While men do suffer from eating disorders, there are significantly fewer reported cases. For more details on this, please click here.

Cases of anorexia amongst males are also believed to have different causes, and are differently expressed to those experienced by the female population. This concept is supported by theorists such as Joan Jacobs Brumberg who writes that men with anorexia ‘exhibit a greater degree of psychopathology, tend to be massively obese before becoming emaciated, and have a poorer treatment prognosis.’4

Historically, anorexia has presented more commonly in women. The reasons for this can be discovered by exploring the origins of this type of eating disorder.

There is evidence of abnormal food-related behaviours throughout the ages: from the fasting female saints of Medieval Europe to the hunger striking Suffragettes.

It was not until the end of the 1800s, however, that anorexia was formally diagnosed simultaneously in England and France. While the French Earnest Lasèque named the condition anorexie hystérique, the term anorexia nervosa was coined by English physician William Gull.

Dr Gull claimed that anorexia resulted from a perversion of the ego

Gull’s description of extreme self-starvation first appeared in a medical journal in 1874.5 He claimed that anorexia resulted from a ‘perversion of the “ego”, and credited his patients’ refusal to eat to psychological affliction. 

Modern medical conceptions of anorexia continue to draw on this work. While the current edition of the DSMV now distinguishes two sub-types of anorexia: binge-eating/purging type; and restricting type which does not involve binging or purging, these behaviours are still attributed to a pathological cause.6

According the modern diagnostic criteria for anorexia, there must be evidence of:

  1. ‘energy restriction leading to significantly low body weight’7
  2. ‘fear of weight gain or behaviour interfering with weight gain’8
  3. ‘disturbance in self-perceived weight or shape’9

In addition, the individual must refuse ‘to maintain, or to reach, 85% of the expected body weight for someone of that age and height.’10

The severity of the condition is based on Body Mass Index (BMI). For an adult, a normal BMI score ranges from 18.5-24.9.11 Mild cases of anorexia are classified as having a BMI score of more than 17, while at the other end of the spectrum, extreme cases have a score of less than 15.12

The term anorexia is misleading, however. This is because the Latin word anorexia literally translates as ‘lack of appetite’; or, in the case of anorexia nervosa, ‘loss of appetite owing to nervous causes’.

Women diagnosed with anorexia, however, are not necessarily lacking in appetite. On the contrary, most individuals who engage in self-starvation experience incessant hunger and are constantly preoccupied with food; resulting in a desperate battle to suppress these urges.

Women diagnosed with anorexia are not necessarily lacking in appetite

Even though they were initially identified as predominantly medical conditions, eating disorders have subsequently been viewed using a variety of non-pathological discourses.

In their attempts to ascertain a cause, theorists have developed several concepts of eating disorders including:

  • psychosexual
  • familial
  • sociocultural

PSYCHOSEXUAL THEORY

At the end of the nineteenth century, a new diagnosis of anorexia emerged that used psychoanalytic technique.

Equating lack of appetite with loss of sexual desire, the psychosexual model was propounded by the founder of psychoanalysis, Sigmund Freud. He conceived the idea that food refusal derived from a desire to maintain the body in a state of pre-sexual adolescence.

In 1895, Freud wrote that anorexia was ‘“a melancholia where sexuality is undeveloped.”’13 His theory relating loss of appetite to disturbed sexual development was reiterated in his report of 1918, where he states ‘“[i]t is well known that there is a neurosis in girls…which expresses aversion to sexuality by means of anorexia.”’14

Freud believed that his patient’s rejection of their bodily appetite was communicated through self-starvation. This resulted in an extremely slender figure, whose postponement of womanhood symbolised a lack of physical desire for both food and sexual interaction.

Food refusal was interpreted as expressing anxieties and and fantasies of a purely psycho-sexual nature, such as fear of pregnancy

This psychoanalytic model continued to be drawn upon throughout the twentieth century. In the 1970s, food refusal was once again interpreted in terms of Freudian theory ‘as expressing anxieties and fantasies of a purely psycho-sexual nature, such as fear of pregnancy or of attracting the sexual attention of men.’15

In 1978 feminist writer Hilde Bruch described ‘genuine anorexia’ as ‘characterized by the avoidance of any sexual encounter, a shrinking away from any bodily contact.’16 Fearing sexual maturation and impregnation, at the onset of bodily changes during puberty ‘[t]he girls react with severe anxiety to what they sense are indications of losing control.’17

Lack of sexual desire is also associated with anorexia nervosa in the modern DSM which states that ‘[w]hen seriously underweight, many individuals with Anorexia Nervosa manifest depressive symptoms such as…diminished interest in sex.’18

Contrary to Freudian theory, however, I would argue that this reduced sexual desire is a result of self-starvation and greatly reduced body fat. It is a symptom of starvation, rather than a cause.

In order to address the sociocultural dimensions of disorderly eating, new concepts were developed throughout the 1970s and 80s. During this period, there was a resurgence of interest in eating disorders, and the psychosexual model was joined by Family Systems Theory and various feminist interpretations

FAMILY SYSTEMS THEORY

This theory regarded self-starvation as ‘a sign of disturbed structure and interactions within the family.’19 It is unclear, however, whether this disturbance was considered to be a cause or an effect of self-starvation.

 Amongst feminist accounts of Family Systems Theory, focus is often upon the mother-daughter relationship. Hilde Bruch ‘argued that the anorexic’s home was often “too good” because her mother often anticipated her daughter’s needs.’

This ‘led to the development of dysfunctional feeding practices and the child’s self-awareness of hunger and satiation did not fully develop.’20 Anorexics therefore remained dependent upon their families, particularly upon their mothers. 

A decade later, Susie Orbach (1986) confirmed Burch’s argument, stating that anorexics have difficulty ‘with developing an independent identity that is separate from her mother’s.’21

SOCIOCULTURAL THEORY

Feminist analyses of the late 1970s were therefore amongst the first to challenge dominant pathological interpretations of eating disorders. Departing from traditional medical conceptions, they proposed alternative theories that focused on women’s social position within the Western world.

External pressures and judgement of the body came into consideration as possible causes of female anxiety. It is possible to argue that disorderly eating originates in the patriarchal subjection of women and the pressure to accord with an ideal vision of the female body.

Self-starvation was a form of protest in response to oppressive social structures

Early feminist interpretations drew on social theories. Susie Orbach (1978) argued that eating disorders, particularly self-starvation, were a form of protest in a response to oppressive social structures.22

I would say, however, that patterns of disorderly eating are not a protest against these structures, but are symptomatic of their internalisation.

The story of the cultural ideal regarding women’s bodies over the past century is deeply political. Women’s increase in power throughout history correlates to an increasingly slender ideal. The thin ideal serves as a backlash against the feminist movement: it an ideal that aims to keep women thin, frail and weak.

This backlash has been expressed through society’s efforts to influence and control the shape of women’s figures and consequently, their eating behaviours. This therefore results in a power struggle over the female body.

Disorderly eating and food obsession is so culturally widespread that it has become a normal part of female existence. These requirements of body shape and weight are imposed for the purposes of female subordination and socio-economic gain.

While eating disorders are a product of external oppression; women are themselves the agents of its enforcement, moulding their own bodies in a desperate attempt to accord with sociocultural ideologies. Why do we adopt society’s vision that thin is better? Because of its physical and social rewards: because we want to belong.  

Why do we adopt society’s vision that thin is better?

One critic, however, argues that the ideal of slenderness can also be a source of female power. This theory is proposed by Hesse-Biber in her work, Am I Thin Enough Yet? Here she writes that ‘dieting and physical fitness are not methods for the subordination of women, but ways that women can feel powerful’.23

Yet, other feminists, such as Susie Orbach, argue that while women who conform to the slender ideal perceive themselves as powerful, they are in fact subordinating themselves to a masculine ideal which connotes thin with attractive and ‘good’, and fat with unattractive and ‘bad’. These associations are internalisations of patriarchal forms brought about by the prevailing norm of representation.

Orbach continues to argue that fat is feminist because it opposes social and cultural norms of the attractive, slender body.

The feminist approach to body size lies in women’s ability to choose to shape their bodies according to their own volition

However, uniting Hesse-Biber and Orbach is the belief that whether fat or thin, the feminist approach to body size lies in women’s ability to choose to shape their bodies according to their own volition.

NOT ALL WOMEN DEVELOP ANOREXIA

Women within the Western world are exposed to the same cultural environment, yet not all women develop an eating disorder. Some are more vulnerable to social influence than others. The extent to which a woman is affected by ideologies of bodies and female beauty depends upon the individual.

There is no institution solely responsible for creating patterns of disorderly eating: they arise from various factors, including economic, psychological, familial and biological.

Eating disorders are embedded in a discourse of femininity

The fact that women are more affected by eating disorders than men suggests that these disorders are culturally, rather than pathologically created. Eating disorders are embedded in a discourse of femininity, arising from the pressures upon women to accord with a physical ideal.

From a cultural standpoint women are more judged in terms of their physical appearance and, according to Susan Bordo are ‘more tyrannized by the contemporary slenderness ideal than men are.’24

Therefore, until we are able to resist the social ideal of thinness, as women we will continue to be more obsessed and dissatisfied with our bodies.


  1. https://www.beateatingdisorders.org.uk/how-many-people-eating-disorder-uk
  2. Abraham M. Nussbaum, M.D., The Pocket Guide to the DSM-5 Diagnostic Exam, American Psychiatric Publishing (Washington; London, 2013)
  3. https://www.nationaleatingdisorders.org/anorexia-nervosa
  4. Bruch, Hilde, Fasting Girls: The History of Anorexia (Vintage: 2000)
  5. E.L. Bliss and C.H. Hardin Branch, Anorexia Nervosa: Its History, Psychology, and Biology (New York: Paul B. Hoeber, 1960)
  6. Abraham M. Nussbaum, M.D., The Pocket Guide to the DSM-5 Diagnostic Exam, American Psychiatric Publishing (Washington; London, 2013)
  7. ibid
  8. ibid
  9. ibid
  10. http://www.b-eat.co.uk/about-beat/media-centre/facts-and-figures/
  11. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/
  12. Abraham M. Nussbaum, M.D., The Pocket Guide to the DSM-5 Diagnostic Exam, American Psychiatric Publishing (Washington; London, 2013)
  13. J. Strachey (ed.), The Standard Edition of the Complete Psychological Works of Sigmund Freud Vol. 1, Pre-psychoanalytic Publications and Unpublished Drafts (London, 1996), pp.200-201, in Brumberg, From Fasting Saints to Anorexic Girls
  14. Jacobs Brumberg, June, From Fasting Saints to Anorexic Girls
  15. Bordo, Susan, Unbearable Weight: Feminism, Western Culture, and the Body (University of California Press: London, 1995)
  16. Bruch, Hilde, The Golden Cage: The Enigma of Anorexia Nervosa (Harvard University Press: Cambridge MA, 2001)
  17. ibid
  18. Diagnostic and Statistical Manual of Mental Disorders 4th Edition, Text Revision (Arlington, VA: American Psychiatric Association, 2004)
  19. Jacobs Brumberg, June, From Fasting Saints to Anorexic Girls
  20. Julie Hepworth, The Social Construction of Anorexia Nervosa (Sage Publications, 1999)
  21. ibid
  22. ibid
  23. Hesse-Biber, Am I Thin Enough Yet?
  24. Bordo, Susan, Unbearable Weight: Feminism, Western Culture, and the Body (University of California Press: London, 1995)

Categories
Body Image Dieting Eating Disorders Exercise Fitness Competitions History

Is Your Body Alien?

In her book, Unbearable Weight, Susan Bordo writes that ‘[m]any body-builders, like many anorectics, unnervingly conceptualize the body as alien.’1

Individuals who push themselves to their physical limits with restrictive eating disorders or extreme training regimes often view their bodies as separate from their true selves: as alien.

This division between body and ‘self’ has dominated Western thought for thousands of years. Greek philosopher Plato was the one of first to distinguish the mind as being separate from (and superior to) the body.2

This idea was later reinforced by René Descartes’ in 1641 when he famously wrote

‘I think, therefore I am’

Descartes confirms his existence based on the fact that is able to think. This statement therefore echoes Plato’s concept that what constitutes the self resides in the mind, rather than in the body.

Also like Plato, Descartes asserts that the body is inferior to the mind, claiming that it prevents the acquisition of truth and wisdom.

The notion of body’s inferiority has long been an element of patriarchal culture. In our modern society, the rhetoric employed by women to describe their bodies is still founded upon shame and disgust. During my research on this topic, I interviewed 50 female fitness competitors, who all spoke of their bodies in these terms, describing them as ‘swollen’; ‘gross’; ‘fat’; and ‘all wrong’.

A weight that burdens the soul

Throughout history, the body has been subject to various interpretations. It has been seen as a prison within which we are incarcerated; a being that rages beyond our control; a weight that burdens the soul; and an enemy against which we must do battle.

Competitors I spoke to perceive their bodies in many ways: as functional machines; as projects to be moulded and sculpted; and as physical symbols of their hard work.

Yet the idea that our bodies are separate from our true selves remains constant.

THE BODY AS MACHINE

During my research, I asked participants to complete the sentence ‘my body is…’

Some referred to their bodies as ‘machines’ or ‘tools,’ viewing them in terms of their functionality. They used positive language to describe them such as, ‘awesome’, ‘amazing’ and ‘extremely efficient’.

This type of mechanical body can also be controlled by the individual, who is able to improve the way it functions with the correct training and nutrition.

Input = food; output = muscle

In order to achieve the best results, competitors calculate the optimum number of calories and macronutrients that they need to consume. They therefore perceive their bodies as machines that are able to transform food into flesh, in a simple equation of input = food; output = muscle.

THE BODY AS PROJECT

We work on our bodies. Whether we are dieting, applying cosmetics, or literally working out, our bodies can, to a certain extent, be moulded according to our volition.

Bikini competitors I spoke to referred to the body as an art project: as a ‘canvas’, and a ‘form of artistic expression’; an object that was being ‘chiselled to perfection.’

Because of this, most competitors I interviewed spoke about their about their body as a ‘work in progress.’ One bikini competitor related that her body was ‘always under construction’ because her ‘mind is never happy.’

The sense of the mind being dissatisfied with the body was a recurring theme. Others stated that there is ‘always room for improvement’ and revealed that they are constantly working towards ‘evolving’ their physique.

In the competition world, bodies are built up, then stripped down. Right before a show, they are dried out, slathered with orange tan, and finally adorned with bright stage jewellery and a glittering bikini.

Fitness competitors are judged on the outcome of these projects. Their stage ready bodies are the final result of months, maybe years, of hard work.

THE BODY AS SIGNIFIER

The body is a bearer of signs. The clothes we wear, the posture we adopt, how we style our hair, our musculature, whether we have tattoos, piercings or other physical modifications tell the world something about us.

As Susie Orbach writes in her book Bodies:

Our body is judged as our individual production…our calling card, vested with showing the results of our hard work and watchfulness or, alternatively, our failure and sloth.3

And whether we like it or not, we are always being judged on our appearance.

In the world of competitions, athletes display their bodies for the sole purpose of being judged. Their lean, muscular physiques are signifiers of their hard work, will power and dedication.

Miami Pro European Championships, 2015. I am second from left

When I asked bikini competitors what their bodies symbolised, one said that her phsyique is crucial to how she is perceived. Others agreed, revealing that their body is a reflection of their choices, and a visual marker of their achievements.

Placing value upon the body looking a certain way, however, can also have drawbacks. If your body changes this can cause various psychological problems such as body dysmorphia, low self esteem, and disorderly eating.

Competitors often experience anxiety about losing their lean competition physique

After the competition season is over, athletes enter what is known as the ‘off season’, or ‘bulking season’. During this time, calories are increased in order to facilitate muscle growth. This also leads to an increase in body fat, which can cause distress since competitors are anxious to maintain their competition physique.

Since they fear they will be judged negatively if they are no longer stage lean, during the bulking season, competitors often conceal their bodies in loose clothing.

Anxious that they are gaining too much body fat, some engage in rituals such as constant body checking; and may even begin to restrict their calorie intake.

CONTROL OF THE BODY

Individuals who diet and exercise in preparation for a competition treat their bodies as separate from the self. The body becomes an object to be regulated and controlled.

Control is facilitated through mental discipline:

Both individuals with eating disorders and competitors aim to free themselves from physical urges, such as hunger and fatigue, that may prevent them from achieving control of the body.

This control often attracts admiration and respect. Kim Chernin writes:

We admire the success of their efforts to impose upon the natural body a shape and form which is the product of culture…[and] not appropriate for it.4

This praise, however, further reinforces the resolve to subject our bodies to punishing exercise and nutrition regimes.

Pushing ourselves to our physical limits in these ways exacerbates the disconnection between the mind and body. Rather than paying attention to our bodies’ requirements, we continue to train when injured; we ignore signs of fatigue; and we become disconnected from our bodies to the point where we are unable to recognise our hunger and satiation cues.

Since we refuse to give our bodies what they need, after a time, we don’t even know what that is.

RECONNECTING WITH OUR BODIES

In order to bridge the gap between mind and body, we have to listen to what our bodies want. This may include having rest days from training so that muscles can grow and recuperate; stretching after a work out; having a sports massage; and taking taking time off to recover when injured.

In terms of nutrition, eat what works for you and feels best for your body. You can do this by paying attention to how your body reacts to certain foods. Avoid restricting calories, cutting out food groups, or creating rules around food e.g. no sugar, no food after 6pm. Otherwise you will experience hunger and cravings, which may lead to feelings of guilt if you break your self-imposed ‘rules’ and have a takeaway.  

We need to reconnect with our bodies. Instead of trying to control them and force them into an unnatural shape, we should instead work towards appreciating what they do for us; and the way that through them, we are able to experience our lives.


  1. Bordo, Susan, Unbearable Weight: Feminism, Western Culture, and the Body (University of California Press: London, 1995)
  2. Plato, Phaedo, in Five Dialogues, trans. by G.M.A. Grube, 2nd edn (Indianapolis, IN: Hackett Publishing, 2002)
  3. Orbach, Susie, Bodies (Profile Books: London, 2009)
  4. Chernin, Kim, The Obsession: Reflections on the Tyranny of Slenderness (Harper Collins: New York, 1994)

Categories
Body Image Eating Disorders Fitness Competitions Recovery

Mirror, Mirror on the Wall: Body Dysmorphia

BODY IMAGE

Body image is defined as ‘the subjective personal interpretation of an individual’s body.’1 It consists of our thoughts, feelings and perceptions of our own bodies.

More than 75% of us have some kind of body obsession

Most of us are unable to ‘see’ our bodies as they really are. Distortion of body image is a pervasive cultural dysmorphia, with more than 75% of us having some kind of body obsession.

In some cases, body dissatisfaction may develop into Body Dysmorphic Disorder. This occurs in approximately 1% of the adult population2 and is defined as ‘intrusive images, thoughts, or urges centred on body image.’3

Body dysmorphia is the most widely known contributor to the development of disorderly eating behaviours, affecting 39% of inpatients with anorexia nervosa.

WHY WE ARE SO BODY OBSESSED

From a sociocultural perspective, our perception of how we look may become distorted because we are constantly exposed to images of ‘ideal bodies’.

In 2021, value is placed upon the slender, fit bikini body, a physique which is portrayed as the ticket to wealth, success and social approval.

The widespread distribution of this body ideal across print and online media inevitably stimulates comparison: we are socially conditioned to evaluate and measure ourselves against this idea of perfection.

There is often a mismatch between what society dictates we should look like, and how our bodies really appear

This comparison leads to body dissatisfaction since there is often a mismatch between what society dictates we should look like, and how our bodies really appear.

Dissatisfaction with appearance is one of two disturbances in body image that will be addressed in this article.

DISSATISFACTION WITH APPEARANCE

During my research on the subject of body image, I asked 50 women: ‘if it were possible, which part of your body would you change?’

The most common answer was ‘stomach,’ a physical aspect with which I have also had a lifelong fixation. My midsection is where my body tends to store fat; and, having had an eating disorder for 26 years, I also suffer from chronic bloating and distension.

Anorexics can feel relaxed only if the stomach is completely flat

This obsession with my stomach began aged 11 when I first developed anorexia nervosa. This is typical of this form of eating disorder, with many anorexics suffering from ‘persistent anxiety that eating may stretch the stomach or make it bulge; they can feel relaxed only if the stomach is completely flat.’4

The women who I interviewed also expressed a desire to change their legs, particularly their thighs; their breasts that were believed to be either too big or too small; their glutes that needed to be ‘firmer’; and their bingo wings. Three women said that would change everything.

Of the 50 interviewees, only one said that she would not change any part of her body.

BODY CHECKING

For those of us who are unhappy with aspects of our physiques, we may manage our appearance by excessive body checking. This includes measuring, weighing and constantly looking in the mirror.  

Keeping bodies under surveillance through mirrors can develop into a compulsion. For as long as I can remember, I have always checked my appearance (particularly my stomach) every time that I catch my reflection in a mirror or shop window.

The reason why we look in the mirror multiple times a day is to seek reassurance that we are still the same: to check that our bodies have not suddenly gained 10llbs in the last half hour.

If we feel like we are bigger, or more wobbly than we imaged, however, we then take action to ‘correct’ our bodies in the form of dieting and exercise.

Many of us are aware that there is a disjunction between how we perceive our reflected image, and the reality of our appearance

For those who suffer from body image distortion, many of us are aware that there is a disjunction between how we perceive our reflected image, and the reality of appearance. One woman I spoke to admitted: ‘even though I know I’m not overweight, when I look in the mirror I see a much larger person looking back at me.’

APPEARANCE AS IDENTITY

The second aspect of body image distortion is defining our identity in terms of our appearance.

So strong is our desire for social belonging that we alter our bodies to meet the physical ideal

Modern society holds beauty in high regard as a necessary trait; and so strong is our desire for social belonging that we alter our bodies to meet the physical ideal.

This need to be accepted within our social group is driven by a biological urge, and positively reinforced by the encouragement we receive when our bodies conform to cultural standards.

For example, in Western society, weight loss is often praised, with an individual’s ‘after’ pictures often receiving ‘likes’ and compliments. In addition, in the world of fitness competitions, many federations include a transformation category where the prize is awarded to the most drastic physical change. The more weight lost, the better.

This attention served to validate my efforts to emulate the beauty idea, and strengthened my resolve to work even harder

This type of appearance-based approval can be very seductive. In 2015, I was in the best physical shape of my life and became a Pro Bikini Competitor. Subsequently, I received frequent compliments on my physique; and comments praising my willpower and dedication. This attention served to validate my efforts to emulate the beauty ideal, and strengthened my resolve to work even harder.

Being a competitor became my identity.

Basing your identity and self esteem on something as transient as your appearance, however, is a risky business: something that I discovered the hard way.

After being starved and dehydrated for show day, returning to a more ‘normal’ diet following a competition causes the body to react by storing water and rapidly gaining weight.

This weight gain can exacerbate a competitor’s body dysmorphia since they compare their now now heavier, softer physique to what they looked like onstage. Many of my fellow competitors told me that during this post-competition period they usually ‘feel fat,’ and some even ‘hate’ their bodies.

They also reported being concerned about other’s people’s judgements of their figures: they fear that they will fail to live up to others’ expectations of how they ‘ought’ to look.

Basing your identity on your appearance makes you incredibly vulnerable

Basing your identity on your appearance, therefore, makes you incredibly vulnerable. In my case, losing my stage physique had a direct effect on my confidence; and triggered my most severe relapse into anorexia nervosa to date.

CONCLUSION

Now, 5 years into my recovery, I would like to share four things that I have learnt during my ongoing journey towards body acceptance:

  1. The way that we perceive our bodies is not necessarily reality.
  2. We tend to fixate on aspects of our bodies that cause us concern. The more we hone in on these aspects, however, the worse they will seem. So take a step back and look at your body as a whole; or, better still, avoid looking at your body at all.
  3. The closer I became to achieving my idea of a perfect body, the more miserable and anxious I felt. Having the ‘ideal’ body does not make you happy: in my case, it had the opposite effect.
  4. Happiness and self-worth need to come from something other than your appearance. For me, this is still a work in progress but I am getting there.  

In conclusion, it all comes down to the way we feel. When we look in the mirror, the reflected image is distorted by how we feel about our appearance.

It is not our bodies that require alteration, but our perceptions of them

While we are waiting for society to shed the beauty ideals that inform these feelings, we can remind ourselves that it is not our bodies that require alteration, but our perceptions of them. And we can change these by done by working on accepting our bodies, just the way they are.


  1. The Journal of Psychology
  2. Phillips, Katherine, ‘Fixing the Broken Mirror: Body Dysmorphic Disorder’, http://www.psychweekly.com/aspx/article/ArticleDetail.aspx?articleid=112
  3. Nussbaum, Abraham, The Pocket Guide to the DSM-5 Diagnostic Exam, American Psychiatric Publishing (Washington; London, 2013)
  4. Bruch, Hilde, The Golden Cage: The Engima of Anorexia Nervosa (Cambridge: Harvard University Press, 1978; 2001)

Categories
Dieting Eating Disorders

Weighed Down By Weighing

In our quest to become a certain weight or shape, we have become experts in self surveillance: in weighing, measuring, tracking and counting.

This constant monitoring of our bodies, food and exercise not only takes up a significant amount of time and energy, it can also lead to obsessive practices and behaviours.

The most common method of tracking our bodies is to step onto the scales. Whether we jump on and off as quickly as possible, or gingerly tiptoe while clinging to the towel rail, many of us engage in this daily ritual.

For decades, this behaviour has been reinforced by the diet industry, particularly by weight loss support group Weight Watchers.

With regular ‘weigh-ins’ as its central premise, after 60 years, Weight Watchers is still the world’s most popular diet.

This moment was the catalyst that would lead to 25 years of eating disorders and body dysmorphia

My relationship with the scales began aged 11 when I weighed myself for the first time. I didn’t know it then, but this moment was the catalyst that would lead to 25 years of clinical eating disorders and body dysmorphia. 

How is it possible that what is essentially a piece of metal can wield such power in determining our psychological health? From a scientific perspective, weight is neutral fact: merely the calculation of the body’s mass against gravity. Yet, for many of us, the number on the scale signifies much more.

Even for those who do not suffer from extreme patterns of disorderly eating such as anorexia and bulimia, knowing how much weigh can determine our mood and level of self-esteem.

In modern diet culture, body weight is inextricably linked with morality. When we have lost weight, we feel ‘good,’ virtuous and in control. Conversely, if our weight has increased, we experience self-loathing and guilt.

More recently, however, tracking our bodies has become more involved than just the morning weigh in. Weight Watchers’ re-branding as WW ‘Reimagined’ includes colour coded meal plans and a system of tracking with a ‘daily ‘SmartPoints’ allowance to ‘spend’ on any foods you like’ and ‘at least 100 ‘ZeroPoint’ foods.’ The also allows ‘‘rollover’ up to 4 of your daily SmartPoints to facilitate weekend indulgences.1 Fortunately, this is all calculated for you by an app.

Modern technology has made it easier than ever to track our food and daily activity thanks to Smartphone health, fitness and diet-tracking apps. In 2017, 325,000 mobile health apps were available in major app stores.2 In this year, MyFitnessPal was downloaded 50 million times from the Android market alone.

My eating was militarily regimented

MyFitnessPal was my weapon of choice when I was preparing for a fitness competition: and I use the term ‘weapon’ because my eating was militarily regimented. It involved calculating my 5 daily meals to the gram; consuming the exact proportions of macronutrients; and setting multiple alarms to remind me when to eat.

I would also rotate my meals every 3 days and had a calendar to remind me which tablet or powder from my supplement mountain I needed to take at which time of day; whether it was to be taken with or without food; and if I had to consume pre-, intra- or post- training.

There are several problems, however, with these methods that we employ to measure food and weigh our bodies:

1. They are often unreliable

Scale weight does not take into account lean muscle mass; and daily fluctuations such as hormone levels, water retention and undigested food.

2. WEIGHT & ACTIVITY TRACKERS ARE SUBJECT TO INACCURACIES

Weight and activity trackers are also subject to inaccuracies. According to a 2017 study, MyFitnessPal tends to ‘underestimate micronutrients like calcium, iron, and vitamin C.’

One medium apple can set you back 30 calories or 120

Even worse, the app relies on user accuracy when inputting foods. Since many items in the database are user-generated, they may not be correct. Women’s Health Magazine reports that ‘one medium apple can set you back 30 calories or 120.’

3. Monitoring our food & weight can lead to guilt & shame

Believing that we ‘should’ monitor our food and our weight can lead to guilt and shame if we eat more than our allotted calories, or if the number increases on the scale.

I have been stuck in this trap where I have weighed myself before and after every meal; tracked each lettuce leaf; and felt ‘bad’ for exceeding my allotted macros, even only by a few grams. Conversely, I have felt virtuous or happy if I met my daily target.

Validating our sense of moral worth in this way can be psychologically damaging and spiral into eating disorders such as anorexia, orthorexia, and bulimia. To read more about ‘clean’ eating and orthorexia, click here.

Having a goal weight implies that there is an objective ‘ideal’ weight or shape for your body

Having a goal weight, waist size or body fat percentage implies that there is an objective ‘ideal’ or ‘correct’ weight or shape for your body that is quantifiable and measurable.

Even if this were true, any kind of restriction or manipulation to meet an ‘ideal’ is ultimately futile because diets don’t work.

Our bodies will always work against any type of restriction and will stabilise at a weight that they are comfortable with

Therefore, attempting to reduce your scale weight may work temporarily, but your body will eventually decrease its metabolism and drive up hunger cues in order to bring your weight up to a more sustainable level.

Tracking and measuring only perpetuates the underlying diet mentality that will inevitably lead to frustration, guilt, and a backlash from your body as it tries to keep you alive. For more on this topic, click here.

CONCLUSION

So delete MyFitnessPal and smash your scales (or, like me, opt for the sadly less dramatic battery removal.) Abandon rules and restrictions. Take back power from the scale and do not permit yourself to be defined by a number.

Your best weight is the one that makes you feel the most alive, healthy, and grants the freedom for you to live your life to its full potential without having to do anything extreme to maintain it.


  1. https://www.weightwatchers.com/uk/launch-delicious-way
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543803/ 2

Categories
Dieting Eating Disorders History

It’s Not Just Us! A Brief History of Restrictive Eating

Eating disorders are now a widespread problem. Between 1.25 and 3.4 million people in the UK are affected: around 10% of these suffer from anorexia nervosa.1

The current Diagnostic and Statistical Manual of Mental Disorders (DSMV) defines anorexia as:

  • restriction of energy intake relative to requirements leading to a significantly low body weight
  • intense fear of gaining weight
  • persistent behaviour that interferes with weight gain.2

Restrictive eating practices are not new, however. Self-starvation has a long history, dating right back to the fifth century.

The first evidence of self-starvation comes from the Middle Ages. During this time, food restriction was commonly practiced a form of religious observance. This occurred particularly during Lent, where the control and reduction of food intake was culturally institutionalised. This provided women with the means of experiencing bodily suffering through spiritual fasting.

In her book Holy Feast and Holy Fast, Caroline Walker Bynum explores the role of women role in divine practices that involved abstaining from bodily desire. This included renouncing their appetite for food.3

These women would fast in order to prepare themselves for Christ’s body and blood. They derived nourishment from prayer and the Eucharist, rather than from real food items.

In England this practice lasted until 1534. With the advent of the Protestant Reformation, worship of saints was abolished and ‘[t]he renunciation of food, once experienced and explained as a form of female holiness, was increasingly cast as demonical, heretical, and even insane.’4

A century later, however, the development of scientific and medical understanding shed new light on restrictive eating behaviours.

Rejection of food was thought to result from a lack of appetite caused by other illnesses

The first medical account of self-starvation is credited to the seventeenth century physician Richard Morton. He observed that rejection of food that resulted from a lack of appetite was the symptom of other illnesses, including tuberculosis and chlorosis (anaemia). Morton named chlorosis the ‘Green-Sickness’ and in 1694 described the case of an eighteen year old girl, ‘who resembled ‘“a skeleton only clad with skin.”’5

He writes that she: ‘fell into a total Suppression of her Monthly causes … her Appetite began to abate, and her Digestion to be bad; her flesh also began to be flaccid and loose, and her looks pale.’6

Further evidence of this green sickness came 150 years later in 1838. A medical adviser in The Penny Satirist described a common disease ‘to which the tender sex is subjected, particularly in the large towns of over-refined countries’, which was identified as ‘chlorosis or green sickness.’7

The medical establishment responded by perceiving this susceptibility as a female trait and as further evidence that women were the ‘tender sex’. The advisor continues to observe that: ‘in the streets of large towns there are young ladies with a pale yellow complexion, mixed with a peculiar greenish tinge, a bluish circle around the eyes, an air of languor and debility.’8

They had cravings for strange substances such as chalk, dirt, ashes, or vinegar

These symptoms were thought to result from the patient’s ‘capricious’ appetite. Sometimes they exhibited symptoms of pica, cravings for ‘strange substances such as chalk, dirt, ashes, or vinegar’. At other times they lost their appetite altogether, sometimes refusing to eat.9

Chlorosis was diagnosed in psychosomatic terms. It was thought to arise from ‘bad physical and moral education’, which was the result of ‘[w]ant of proper exercise, improper dress, tight lacing, too much sitting, improper development of the imagination at the expense of the reasoning faculties, boarding-school education, play-going, and novel-reading’ (!)10

At this time, other ‘morbid mortifications of the appetite’ began to be diagnosed alongside chlorosis. In 1840 physician Thomas Laycock added ‘“[b]ulimia and pica’ to the list and claimed that these conditions were all characteristic of the pregnant, chlorotic, and hysterical female.”’11

Even though Morton and Laycock established a specific pathology of self-starvation, however, anorexia would not be formally named for almost two hundred years.

In 1873, anorexia nervosa was simultaneously diagnosed in England and France

By the nineteenth century, the physicians’ social status and power increased as medical authorities grew secure in the scientific validity of their own assumptions. This coincided with the official medicalisation of appetite in 1873. This was when anorexia nervosa was simultaneously diagnosed in England and France by Sir William Gull and Ernest Lasèque.

Sir William Withey Gull

While Lasèque named the condition anorexie hystérique, the term anorexia nervosa was coined by Gull, whose description of the malady first appeared in Transactions of the Clinical Society of London (1874). In an 1888 issue of the Lancet, Gull credited his patients’ refusal to eat to a psychological, rather than a physical affliction. He stated:

That mental states may destroy appetite is notorious, and it will be admitted that young women at of sixteen to twenty-three are specially obnoxious to mental perversity.12

Yet, while Gull noted the psychological cause of anorexia, he chose not to engage with his patients’ subjective mental states. By concentrating upon the physical effects of the condition, rather than psychological causes, Gull thereby dismissed the emotional states of his female patients.

In 1883, anorexia was divided into two sub-conditions: anorexie gastrique and anorexie mentale. Anorexie gastrique applied to patients with digestive complaints. ‘Hysteria was believed to cause a physiological disturbance leading to impaired gastrointestinal absorption.’ Anorexie mental, on the other hand, occurred in patients with ‘“pure” psychiatric conditions and involved mental rather than digestive problems.’13

Despite a more detailed definition of anorexia, however, this did not significantly alter methods of treatment, or the way in which female mental health was regarded. Patients diagnosed with anorexie mentale were still treated by controlled or forced feeding in order to overcome the physiological effects, rather than by engaging with the underlying causes.

In conclusion, from this brief history of restrictive eating it evident that it’s not just us. Self-starvation and other similar eating practices have occurred throughout history in various guises.

For more information on how theories of anorexia continued to develop into the 20th century, please click here. {link to why women theories of anorexia when its published!}


  1. https://www.beateatingdisorders.org.uk/how-many-people-eating-disorder-uk
  2. Abraham M. Nussbaum, M.D., The Pocket Guide to the DSM-5 Diagnostic Exam, American Psychiatric Publishing (Washington; London, 2013)
  3. Walker Bynum, Caroline, Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women (Berkeley, 1986)
  4. ibid
  5. R. Morton Phthisiologica: Or a Treatise of Consumptions 2nd edition (London, 1720), pp.8-9, in R. M. Bell, Holy Anorexia (London: University of Chicago Press, 1985)
  6. ibid
  7. Anon., ‘The Medical Adviser’, The Penny Satirist, iss.43 (London, 1838)
  8. ibid
  9. Victorian Literature and the Anorexic Body, p.2, Noted by Samuel Ashwell, in A Practical Treatise on the Diseases Peculiar to Women (Philadelphia, PA: Lea and Blanchard, 1845)
  10. Anon., ‘The Medical Adviser’, The Penny Satirist, iss.43 (London, 1838)
  11. T. Laycock, A Treatise on the Nervous Diseases of Women (London: Longman, Orme, Brown, Green and Longmans 1840), p.73, in A. Krugovoy Silver, Victorian Literature and the Anorexic Body (Cambridge: Cambridge University Press, 2002)
  12. W. Gull, ‘Anorexia Nervosa’ (apepsia hysterica, anorexia hysterica), Transactions of the Clinical Society of the London 7 (1874)
  13. E.L. Bliss and C.H. Hardin Branch, Anorexia Nervosa: Its History, Psychology, and Biology (New York: Paul B. Hoeber, 1960)
Categories
Dieting Eating Disorders

5 MORE Thoughts that are Making You Binge, and How to Change Them

This is a continuation of my previous blog post, 5 Thoughts that are Making You Binge, and How to Change Them.

When we binge or overeat, it is often because we entertain certain thoughts. These thoughts, however, are not true.

Here are 5 MORE examples of these types of thoughts, and how you can change them. 

My eating hasn’t been perfect so I might as well binge

Thought: This is similar to the ‘I have blown it’ thought mentioned in the previous blog post, but this thought comes from a place of perfection. Perfectionism involves black and white, all or nothing thinking. This is when we believe that if we don’t do something perfectly, there is no point doing it at all.

This mindset is often applied to eating. For example, if we implement a food plan or food rules and we break these rules, we feel like we have failed. We then believe that there is no point continuing to follow the plan or rules at all.

Being a perfectionist when it comes to eating just creates a wagon for us to fall off!

How to change this thought: If we adopt a more flexible approach to eating and dispense with rigid food rules, then we will be able to eat something that we don’t consider to be ‘perfect’ and just move on with our day.

I can’t cope so I might as well binge

Thought:

‘I’ve had a bad day / ‘I’m exhausted / I’m stressed, so I’m going to raid the fridge.’

Does this sound familiar? It is common practice to turn to food to alleviate negative emotions. Yet, binging does not work as a coping mechanism. If we are feeling stressed and then binge, not only will we still feel stressed afterwards, we will also feel terrible from the mental and physical effects of the binge.

How to change this thought: When we are upset, we need to remind ourselves that binging won’t make anything better: in fact it will make us feel worse. Eating only improves our mood temporarily; or perhaps not at all since we don’t even enjoy the food if we are feeling guilty about eating it. Instead, we need to try and sit with the negative emotions, know that it is okay to feel these things, and that they will pass. 

My weight has gone up

Thought: Sometimes, if our weight has increased, we think we might as well binge because we are already heavier.

Smash the scale!

How to change this thought: Smash the scale! Weighing yourself is never a good idea. Whether we have lost weight, gained weight, or stayed exactly the same, stepping onto the scales will cause anxiety or depression.

If our weight has increased we will panic; if it has decreased, we will either reward ourselves with eating, then restrict again; or we will panic trying to maintain it. If our weight is the same, then we will be afraid to eat in case our weight creeps up.

My weight has gone down

Thought:

I have lost weight, so I can afford a binge.

If we have restricted for a while, and our weight has decreased; or if we feel like we have been ‘good’ with our eating, then we might think that we can ‘reward’ ourselves by overeating, or treating ourselves to ‘forbidden’ foods. Afterwards, however, the feelings of guilt and regret will cause us to restrict, and once again we will be back in the binge / restrict cycle.

How to change this thought: Again, smash the scale and free yourself from being enslaved by a piece of metal and plastic!

I need to be stricter with my diet

Thought: With every new diet that we try, it becomes increasing difficult to lose weight. This is because chronic dieting leads to a decrease in the body’s metabolic rate and an increase in its set point weight. For more information on this topic, please see my blog post Why Diets Don’t Work.

The more you restrict, the harder your body will fight back.

Frustrated with the diet’s diminishing returns, we resolve to be stricter with our calorie intake, or the type of foods that we eat. Yet, the more you restrict, the harder your body will fight back. Therefore these tighter rules and deprivation backfire and lead to even bigger binges.

How to change this thought: In order to break this binge / restrict cycle, we need to ditch the diets and the food rules.

Instead, we need to permit all foods, and allow ourselves to eat as much as we want. This does not mean, however, that we won’t be able to stop eating: it will simply help to dispel the cravings and the urges to binge if we can reassure ourselves that the food is available any time that we want it.


If you find yourself thinking these types of thoughts, remind yourself that they are not true.

Follow the ‘how to change this thought’ advice above and know that it is within your power to eat, or not to eat.

Categories
Dieting Eating Disorders

5 Thoughts that are Making You Binge, and How to Change Them

Do you ever forbid yourself from eating certain foods such as chocolate or cheese, then ‘give in’ and eat huge amounts of them?

Afterwards, do you make a promise to yourself that this will never happen again?

Do you vow to start again tomorrow and with another diet?

Every time that we binge, it is because we have a thought that we believe that isn’t true

I have done all of these things. Every time that we overeat or binge, it is because we have a thought that we believe that isn’t true.

Here are 5 of these thoughts, and how you can change them.

This is the last supper

Thought: This is what we think when we resolve to start a new diet. When we are planning to restrict our food choices or calories, our brain goes crazy thinking this is the last chance to eat. We stuff ourselves with chocolate, cake, crisps, pizza; all the foods that we are never going to have again.

How to change this thought: Get rid of the dieting mentality: eat today as if you’re not going to start a diet (because you’re not!)

I will only allow myself to have x amount of calories 

Thought: If we restrict our calorie intake, we will eventually overeat. When we under eat, our bodies  go into starvation mode and respond by driving up hunger and cravings to ensure that we seek out food. This will cause us to overeat. It is the body’s way of keeping us alive. In this way, we will end up eating more calories overall, than if we didn’t restrict our calorie intake in the first place. For more on this, please visit my blog Why Diets Don’t work.

How to change this thought: Do not place restrictions on the amount of food you eat. Know that when we limit our calories in order to lose weight, this will lead us to overeat and actually cause us to gain weight in the long term.

I am not allowed to eat x y z

Thought: We crave whatever types of food we cut out of our diets. For example, implementing rules such as ‘I am not allowed to eat ice cream’ drives up cravings for ice cream. This then leads us to consume far more ice cream than we would if we hadn’t limited it in the first place.

How to change this thought: Permit all types of foods! This means that we won’t feel deprived and therefore won’t experience an urge to binge.

I am never going to binge again

Thought: This puts us back in the cycle of restriction and binging. If we resolve never to binge again, then we renew our diets, feel deprived, experience cravings and insatiable hunger, and end up binging.

How to change this thought: Do not make any promises to yourself; and allow yourself to eat without restriction. Remember that under eating or omitting food groups makes it more likely that we will binge. Promising ourselves that we will never binge again means that we almost certainly will.

I have blown it

Thought: If we eat something that was off our food plan, or we eat something that we consider to be ‘naughty,’ we think that we have blown it, so we might as well binge. Sometimes even if we eat just a little bit of something that we have designated as ‘forbidden’ food, then we feel like we have somehow crossed a line, so we might as well go all the way over the line.

How to change this thought: Know that if you eat a cookie, or a chocolate bar, that does not mean that you need to eat all the cookies in the packet, or a huge foot long Toblerone. Consider this: if you accidentally cut your hand, you would not think, ‘oh well now I might as well chop it off.’  You are allowed to have a little bit of something, or a lot of something. Just because you eat a bit of chocolate, does not mean that you now have to eat it all. It is your choice: you can choose to eat it, or you can choose not to.


The power lies with you

Consider whether you are thinking and believing any of these 5 thoughts. When they come up for you, remember that they are not true!

Follow the ‘how to change this thought’ advice above and know that you have the choice to eat, or not to eat. The power lies with you.

Categories
Body Image Eating Disorders Exercise Men Recovery

Freddie Flintoff: Men and Eating Disorders

CW: details of purging behaviours.

In the BBC One documentary ‘Living with Bulimia,’ former England Cricket Captain Andrew ‘Freddie’ Flintoff speaks openly for the first time about his 20 year struggle with the eating disorder bulimia nervosa. In the programme, he gives an honest account of his experiences with body dysmorphia, self-induced vomiting and compulsive exercise, which began during his cricketing career when his weight came under scrutiny from the British media.

Today 1.5million people in the UK are reported to have bulimia, 25% of which are men. The actual number of male sufferers, however, is likely to be much higher: a 2007 study suggests that it is closer to 40%.1

Eating disorders are often considered to be female illnesses

The reason why this condition often goes unreported is owing to sex-related stigma. Eating disorders are often considered to be female illnesses, meaning that only 10% of men pursue treatment. Flintoff himself was prevented from disclosing his bulimia owing to his dietician’s discriminatory attitude towards men and eating disorders.

Until being interviewed for this documentary, Flintoff kept his eating disorder secret for 2 decades. Ashamed of his condition, he still finds it difficult to even say the word, ‘bulimia.’ Instead, he refers to it as ‘being sick’.

The secrecy and shame associated with bulimia gave him the sense of having a duel identity. Publicly, Freddie Flintoff is a famous TV presenter and international sportsperson; but privately, he suffers from such low self-esteem that he is compelled to vomit after every meal.

When he began his sporting career age 16, Flintoff had what he describes as a ‘skinny’ physique.2 At this time he became aware of the difference between his own teenage body and those of his teammates, who, in comparison, were more muscular.

The British press christened him ‘The Fat Cricketer’

Over the next few years, Flintoff consequently attempted to increase his size in order to have ‘more presence’.3 Yet, he was not fully aware of how much weight he had gained until his appearance caught the attention of the British press who christened him ‘The Fat Cricketer.’ It was this weight shaming that was the trigger for his 20 year long struggle with bulimia.

By shaming Flintoff for his weight gain, the media reinforced the idea that a professional sportsperson should have a certain type of body, i.e. lean and athletic. Because he did not accord with their aesthetic ideal, Flintoff was publicly humiliated.

This type of discrimination has been documented as posing a significant threat to psychological and physical health; and is also a risk factor for depression, low self-esteem, and body dissatisfaction.4

It is often weight stigma that causes eating disorders

As in Flintoff’s case, it is often weight stigma that causes eating disorders. It was only after the press commented on his appearance that he became concerned about his size. Constantly under the scrutiny of the public eye and known as ‘Fat Flintoff’, Freddie consequently began engaging in destructive behaviours in order to lose weight, making himself sick after every meal.

This behaviour was reinforced by a subsequent improvement in his cricket performance and positive attention from the previously critical British media. This, therefore, confirmed his idea that a trimmer physique was his ticket to increased sporting performance and social approval.

Flintoff also admits that he derived a ‘perverse’ enjoyment from the act of purging itself. He describes it as being addictive, a descriptor commonly used by patients with bulimia since purging activates the opioid (or addictive) part of the brain.5 For many individuals, being sick often provides feelings of comfort, euphoria or instant relief, which makes it difficult to stop.6

Although Flintoff states that he currently has his vomiting under control, he still purges via excessive exercise by carrying out an hour of fasted cardio every morning, becoming anxious if he is unable to train.

Amongst male athletes like Flintoff, purging can lead to serious outcomes that may affect their particular sport. These include ‘increased susceptibility to injury, inconsistent performance, problematic recovery [and] muscle deficiencies.’7

He still experiences guilt and an urge to make himself sick

Although his eating disorder is now functional, in addition to carrying out compulsive exercise, he still experiences guilt and an urge to make himself sick after eating.

Despite these symptoms, however, Flintoff questions whether he is in need of treatment. His claims that he is in control of his eating disorder and can stop whenever he wants, however, are inconsistent with his previous comments that he feels out of control and isn’t able to stop.

Despite bulimia’s medical diagnosis, Flintoff continues to perceive the condition, not as an illness, but part of who he is. It is perhaps owing to his strong identification with his eating disorder that he has not yet made a full recovery. Believing that it is an inherent aspect of his personality means that he will not be open to change.

 ‘Gaining weight would be his worst nightmare’

Flintoff’s reluctance to seek help also seems to be driven by the fear of renouncing his purging behaviours since, as he states, ‘gaining weight would be [his] worst nightmare’.8 Yet, this help can be vital, since ‘almost half of all people with bulimia will not recover without treatment’.9

The importance of Freddie Flintoff sharing his story is that not only is it a stepping stone towards his own recovery; but it will also help to break the stigma surrounding gender stereotypes and eating disorders, and encourage more men to seek the help that they need.


  1. https://www.nationaleatingdisorders.org/blog/males-dont-present-females-eating-disorders [accessed 30 September 2020]
  2. Freddie Flintoff: Living With Bulimia, BBC Television, 28 September 2020
  3. Freddie Flintoff: Living With Bulimia, BBC Television, 28 September 2020
  4.  Andreyeva, T., Puhl, R. M. and Brownell, K. D. (2008), Changes in Perceived Weight Discrimination Among Americans, 1995–1996 Through 2004–2006. Obesity, 16: 1129–1134. doi:10.1038/oby.2008.35
  5. https://eating-disorders.org.uk/information/bulimia-nervosa-a-contemporary-analysis [accessed 30 September 2020]
  6. https://mirror-mirror.org/eating-disorders-2-2/bulimia-nervosa [accessed 30 September 2020]
  7. https://journals.sagepub.com/doi/full/10.1177/1941738120928991 [accessed 30 September 2020]
  8. Freddie Flintoff: Living With Bulimia, BBC Television, 28 September 2020
  9. https://eating-disorders.org.uk/information/bulimia-nervosa-a-contemporary-analysis/ [accessed 30 September 2020]