Real Quick: The definition of insanity.*

By | March 9, 2011

This image is a reproduction of two photographs taken around 1868 and 1872 (photographer unknown). It depicts Miss B, an unnamed patient of William Withey Gull, before and after treatment for anorexia nervosa. Gull used these images to illustrate his 1873 paper "Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica)" in which anorexia nervosa was described and which first established the name of the condition.

An anorectic patient of William Withey Gull, before (1868) and after (1872).

Quelle suprise, y’all: it seems eating disorders are more common amongst teenagers than we thought, according to a new study published on Monday in the Archives of General Psychiatry.

There are a few factors that make this study instructive, besides the increased rates themselves. First, the study found that boys and girls are equally at risk of developing anorexia, though girls still lead in bulimia and binge eating. Second, the study found that eating disorders are strongly associated with suicidal ideation, and with social isolation and “disconnection.” Third, the median—the median!—age for the onset of an eating disorder is twelve. Twelve. Years old.

Release the blockquotes!

“The prevalence of these disorders is higher than previously expected in this age range, and the patterns of [co-existing illnesses], role impairment and suicidality indicate that eating disorders represent a major public health concern,” the researchers wrote. (Source)

The trillingly-named “eating disorder not otherwise specified,” otherwise known as EDNOS, is also markedly more popular than previously thought, moreso than any of the disorders with real names.

Many teens had behaviors that mimic eating disorders.  This means they may have serious eating behaviors, but their symptoms do not meet all the criteria to fit the diagnosis for anorexia or bulimia as outlined in the Diagnostic and Statistical Manual of Mental Disorders, a manual for mental health disorders. This study found 0.8% of the participants had symptoms that came close to anorexia and 2.5% had symptoms resembling binge eating disorder. (Source)

You know who falls into this commitment-phobic EDNOS category? Among others, this category comprises many of the fat kids with EDs. Because willfully starving yourself is not anorexia unless you can get below 85% of the expected weight for your age and height, and have ceased to menstruate, according to the DSM.

So what we have here is a comprehensive study instructing us that anorexia is as common in boys as girls, that children are developing eating disorders at 12, and that eating disorders are extremely dangerous to kids’ health both medically and emotionally. Also, while anorexia rates have remained stable, the instances of binge eating disorder and bulimia have doubled since the 1990s. In a complete coincidence, the fearful cultural rhetoric regarding an alleged obesity epidemic has also doubled—at least—since the 1990s. But this is totally unconnected, I’m sure.

This study is bad news, any way you slice it, but what has really made my blood boil is the shock and horror with which I’ve seen and heard it being discussed on the news. How dare anyone be shocked? When virtually every facet of our culture conspires to create an environment in which being fat is the very worst thing a person can be, and that one must ward off fatness with every Machiavellian contrivance, how is it surprising that children would develop “an obsessive fear of gaining weight”, and would self-injure as a result of overeating, either via purging, excessive exercise, internalized self-loathing, or extreme guilt?

The New York Times is kind enough to furnish us with exhibit A: a new “diet” in which women inject themselves with hCG, a hormone that normally only occurs in pregnancy. Yes, this is a real thing.

The regimen combines daily injections with a near-starvation diet, and patients, mostly women, are often enticed by promises that they can lose about a pound a day without feeling hungry. Perhaps even more seductively, they are frequently told that the hCG will prompt their bodies to carry away and metabolize fat that has been stored where they least want it — in their upper arms, bellies and thighs.

Oh, and where do they get the hCG? Here’s a hint: it’s not synthetically made. Here’s another hint: it’s derived from pregnant women’s pee. I’ll admit my first thought was: wait, so pregnant women can sell their piss now? And like, not on eBay? To be fair, this hormone is FDA approved as a treatment for infertility, so the pee-collection is already happening for less disturbing reasons, but still.

And did we mention the “near-starvation diet” consists of 500 calories a day?**

Then there are the nutritional concerns about a diet that some say mimics anorexia. “The average person is going to eat 1,800 to 3,000 calories,” said Kristen Smith, a bariatric surgery dietitian at Montefiore Medical Center.

“I don’t think it promotes healthy long-term eating habits,” she added.

No fucking shit, Dr. Smith. But, of course, nobody who goes on this diet is interested in healthy long-term eating habits. The people who shoot up with pregnant-lady piss for dieting purposes are people who simply don’t like their back fat, or people who want to lose a few pounds prior to a bridesmaid stint, both of which examples are included in this article. I also enjoy the delicate language here: “some say” it “mimics” anorexia. Considering some research puts the average calorie intake of an anorectic person at 600 to 800 calories a day, I’d say 500 calories is more than mere mimicry.

I make fun, my friends, because sometimes it’s all I can do; because sometimes I have to make fun or I will just cry and yell and kick people. This “diet” is preposterous, not least because abuse of hCG is linked with cardiovascular risks—as pretty much all weight-loss drugs are—and it is not worth your life to be thin. No matter how unhappy you are, no matter how ugly you feel, it is not worth your life to conform; you have alternatives. You have hope.

Because it’s all fun and games until someone loses a mind:

[Kay] Brown, a theater administrator who is 5-foot-8, said she was thrilled to lose six pounds in seven days, and hopeful about reaching her goal of losing 30, which would bring her close to her ideal weight of 135. She said she did not feel hungry and did not obsess about food as she had years ago, when suffering from anorexia.

“A lot of people have a lot of opinions,” Ms. Brown said, “but I don’t want to be a person who feels like my weight is not under my control.”

Today’s twelve year olds are tomorrow’s middle aged women injecting themselves with pregnancy hormones, and so it goes. This is just a wheel that keeps turning, and turning, and all the hand-wringing in the world won’t stop it. It will only stop when we smash the culture telling us what is normal and acceptable for a body to look like, and when we quit fearing our bodies and hurting ourselves in the name of our better health.

* …is doing the same thing over and over again and expecting different results.

** Worth noting: The World Health Organization identifies starvation in famine-stricken nations as a diet of less than 800 calories a day. The FDA, on the other hand, recommends that adult female humans eat approximately 2000 calories per day.


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