How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
Kristina Nguyen
Virginia Commonwealth University
This Paper was prepared for UNIV 112 taught by Professor Boaz.
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How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
Annette, a patient in Bruch’s (1982) study has suffered from anorexia nervosa, and was a
pure anorexic, meaning she lost weight as a result of food restricting and exercises. Annette grew
up in the capital of a Western state, and is the youngest of a large family. For Annette, her family
played an essential role in her life. Most of her family members were tall and slim, and after her
older sister has gained weight while living in boarding school, the importance of staying slim
was ingrained into Annette’s mind. According to her pediatrician, she was a healthy child
growing up, but Annette described herself as “chubby” when she was 9 years old (Bruch, 1982,
p.2). At the age of 13, Annette experienced her growth spurt, though she failed to gain weight
that corresponded to their increase in height. From this point, anorexia took a stronger hold in
her life, and she was in and out of treatment, with her lowest weight being 70 pounds. However,
after being released from treatment and visiting friends and family for several weeks, she went
down to 80 pounds because she wanted to maintain her image of one who does not eat much.
She had realized from a young age that men could eat as much as they desired, while women
were expected to be dainty and slim. Thus, like many others who suffer from anorexia, Annette
felt social pressure from the women gender role, which ultimately caused the development of her
anorexia. Anorexia is an eating disorder that can affect both genders, though it has been socially
constructed to be feministic by the medical community.
While anorexia has been around for a long time, it was not medically discovered until
1874 by William Gull (Till, 2011, p. 2). William Gull, a physician, coined the term anorexia
when he noticed the symptoms of emaciation, and failed to find a biological reason for the
appearance. As a result, Gull concluded it was a mental illness that caused the emaciated
appearance. Since then, more studies and observation has been done, and there is a better
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How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
medical symptoms and results from anorexia. Anorexia is an eating disorder and characterized
by extreme weight loss due to starvation of oneself, and can ultimately be fatal (Smith and Segal,
2014, p. 1). At the mention of anorexia, the image typically associated is a severely underweight
girl. In reality, according to Anorexia Nervosa (2013), 90% of those suffering from anorexia are
female, and 10% of those suffering from anorexia are male, a less commonly known fact (p.1).
There are two different types of anorexia, restriction of food or purging (Smith and Segal, 2014,
p. 1). Anorexics that restrict their food will only permit themselves to eat a certain amount of
calories a day and exercise constantly, where as anorexics that binge, vomit often or use
laxatives (Smith and Segal, 2014, p.1). No matter which form of anorexia a person suffers from,
they all share a “fear of gaining weight, low self-esteem and their inability to grasp the
seriousness of their eating disorder” (Smith and Segal, 2014, p. 1). Lastly, of mental health
conditions, anorexia is one of the main causes of death, typically appearing during the teenage
years. Anorexia is a deadly eating disorder with many theories about its origin.
From the discovery of anorexia, the first major theory about anorexia that was accepted
by scholars was hypothesized by Hilde Bruch (Till, 2011, p. 2). Bruch was a German born
psychoanalysis, who immigrated to the United States in 1934. After having studied many who
suffered from anorexia, she theorized that anorexia is caused by a conflict of internal and
external factors. According to Bruch (1982), the internal factors include the psyche of the person
and their personal dilemmas, while the external factors include the society the person lives in and
the Western society’s culture (p.2). These claims of Bruch were derived from the “mother’s
failure to recognize and confirm the child’s expression of independent needs,” which caused the
conflict that the person was dealing with. Indicated in Till’s (2011) article, Bruch were derived
from the “mother’s failure to recognize and confirm the child’s expression of independent
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How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
needs,” which caused the conflict that the person was dealing with (p.2). In directly placing the
blame on the mother’s inadequacies, Bruch made her theory easily adaptable to femininity
because the mother figure in a family is associated with femininity. Bruch’s theory was the
beginning, but it was later used as the foundation for the medical community and feminists.
Medicine is based on science, which relies mainly on numbers, however observation are
also used. For this reason, when it was found that 90% of those who suffer from anorexia are
female, leaving 10% of those who suffer from anorexia male, it suggest “there was a growing
consensus that some relationship between anorexia and femininity existed” (Till, 2011, p. 6). Till
(2011) focuses on the abundance of studies and research attempting to link anorexia to
femininity, though there is still no conclusive link between femininity and anorexia. Psychiatrists
created gender identity scales as one of the attempts to link anorexia to femininity. Rather than
focusing on the social and cultural forces that may cause the development of anorexia,
psychiatrist concentrated on individuals who showed personality traits that are associated with
femininity. Terman and Miles created the first gender identity scale, and many more have been
created since to accommodate the inadequacies of the previous scales. The most popular gender
identity scale is the Bem Sex Role Inventory (BSRI), created by Bem. Bem developed an
inventory of characteristics that were considered to be desirable for men or women based on
American culture. However, the main issue with the gender identity scales is that at its core, it
still categorically constructs femininity and masculinity in relation to the culture of the society.
These gender identity scales were also biased in the sense that they facilitated the relation
between anorexia and femininity. From these various gender identity scales, it has been found
that those who suffer from anorexia have a lower masculinity score compared to the controls,
those who did not suffer from anorexia. In general, the medical community has followed the
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How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
same path as feminist in attempting to use science to say that those who are more feminine are
more likely to be anorexic.
The medical community is trusted and highly respected by the general population. Thus,
the medical community being affected by the social and cultural norms contradicts the
objectivity that is expected in the field of science. The subjectivity of the medical community
results in an unethical treatment when dealing with those who suffer from anorexia. In a study
by Murray and Touyz (2012), it was found that those in treatment who are classified and told that
they have either anorexia or an eating disorder typically stay in treatment longer (p.3). These
patients stay in treatment longer because they have now been labeled anorexic and will continue
to exhibit the anorexic symptoms and characteristics because that is what they believe is
expected of them. In addition, attempting to link anorexia and femininity together has caused the
general population to connote anorexia with women and women gender roles. As a result,
females are highly criticized and judged about the amount of food they eat. For example, a
female who eats very little will be considered to be thin and possibly anorexic, which makes
diagnosing her easier, but girls and women then are more critical of what they eat and how it is
perceived by society. Inversely, a male who eats very little is not obvious, which means that
diagnoses becomes harder, and it becomes harder to receive treatment. The difficulty of
diagnosing anorexia in males apparent in McVittie et al. (2005) experiment, 12 college boys
were interviewed , and McVittie et al. discovered that diagnosing anorexia in men “presents a
double challenge to masculine identities” (p. 9). It poses as a challenge because men are
expected to accept their symptoms stoically rather than seeking medical intervention and it is
considered feminine to have a “women’s condition” (McVittie et al., 2005, p. 9). The
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How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
subjectivity of how the medical community has caused unethical treatment of both genders in
treatment and diagnoses of anorexia.
Similar to the medical community, feminists took Bruch’s theory and altered it in such a
way to support their perspective. Sociologically, feminism is about how society and culture is
constructed in such a manner that it is disadvantageous to women. In most societies, the social
expectations results in two distinct genders, man and women. It is important to note that when
talking about feminism, feminists focus on the disadvantageous that women have due to social
norms and gender roles. The first part of Bruch’s theory states that one who suffers from
anorexia is dealing with conflict that result from internal and external factors, with the external
factors being society and culture. The feminists responded to this theory by stating that the
eternal factors were specifically media and the expected gender roles of women in Western
societies. In Western societies, women are expected to be slender, since there is a negative
connotation to being obese or overweight, and to please men, either through staying slender or
being sexual attractive. All of these expectations of how women should appear and act are
primarily transmitted through the media, such as magazines, movies and music videos. Feminists
argue that given the gender roles of women in Western societies, women are disadvantaged and
more prone to develop anorexia.
Now, one who argues that anorexia is a feminine eating disorder could take on the
feminist approach that the media has created an unattainable image and expectation for women.
From a young age, girls are bombarded with what they are supposed to become and what looks
“sexy” from magazines and the ideals passed from older girls and friends. For example, the
popular magazines like People and USA Today have pictures and pictures of models with the
“perfect body,” and articles about how women are supposed to behave (McVittie et al, 2005,
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How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
p.5). About 25% of kids at the tender age of 8 are dissatisfied with a part of their body (Murray
and Touyz, 2012, p. 4). The bombardment of women with perfect bodies in the media, when in
reality they are airbrushed and photo shopped, along with certain characteristic might lead to the
dissatisfaction of the body, eventually leading to anorexia. As Till (2011) emphasizes from
recent studies and the gender identity scales, it is believed that femininity predisposes a person to
anorexia, while masculinity protects a person from anorexia (p.5). The gender identity scales
support this theory, and the statistics also support this, but recent research has shed some light.
McVittie et al (2005) experiment found that the number of males who are dissatisfied with their
body is increasing, and nearly equal to that of women who are dissatisfied with their body (p.1).
In fact, 95% of males in college are dissatisfied with their body. In an experiment, when men
where asked about the pictures in the media, they responded by saying that while they do look at
the picture, they do not compare their body to the picture, but rather use it to keep on fashion
trends and such. While feminists attempt to blame media for the development of anorexia in
females, there is empirical data that proves otherwise.
Similar to how anorexia is socially constructed for females, Murray and Stephens’ (2012)
experiment found that muscle dysmorphia is on the rise, and it is socially constructed for men.
Muscle dysmorphia is similar to anorexia, but manifests in the dissatisfaction with the amount of
muscles a person has. Rather than starving themselves, those who suffer from muscle
dysmorphia will constantly work out because they believe they do not have enough muscle, and
go beyond the point that is healthy. 90% of those with muscle dysmorphia are male, leaving 10%
of those with muscle dysmorphia female. The statistics for anorexia and muscle dysmorphia are
opposite, and it shows that while femininity is a predisposition to anorexia, it protects against
muscle dysmorphia. On the other hand, masculinity may protect one from developing anorexia,
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How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
but make it more likely to develop muscle dysmorphia. The socially construction of muscle
dysmorphia further strengthens the argument that anorexia is socially constructed because both
anorexia and muscle dysmorphia are drive by their respective gender roles. Women are expected
to be dainty and thin, resulting in anorexia, while men are expected to be strong and stoic,
resulting in muscle dysmorphia.
In conclusion, from the beginning, anorexia was inadvertently socially constructed by the
medical community to be feminine. Starting from Hilde Bruch’s theory to the numerous studies
done about anorexia, it has all been centered on trying to find the link between anorexia and
femininity. To this day though, there still is no conclusive relationship between the two. As cited
in McVittie et al. (2005), “there are limited data concerning the prevalence of this (anorexia)
disorder in males” (p.1). Thus from the medical community and the feminists theory, anorexia
will continue to be perpetuated as a feminine based on the social construction of the gender roles
of women.
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How Anorexia is a Socially Constructed Eating Disorder by the Medical Community
References
Anorexia Nervosa. (2013). Retrieved November 4, 2014, from National Eating
Disorder Association website: https://www.nationaleatingdisorders.org/
anorexia-nervosa
Bruch, H. (1982). Psychotherapy in Anorexia Nervose. International Journal of
Eating Disorders, 1(4), 3-14. Retrieved from http://web.b.ebscohost.com/
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McVittie, C., Cavers, D., & Hepworth, J. (2005). Femininity, Mental Weakness,
and Difference: Male Students Account for Anorexia Nervosa in Men. Sex
Roles, 53(5), 413-418. Retrieved from http://web.b.ebscohost.com/ehost/
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Murray, S. B., & Touyz, S. W. (2012). Masculinity, Femininity and Male Body
Image: A Recipe for Future Research. International Journal of Men's Health,
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Smith, M., & Segal, J. (2014, October). Anorexia Nervosa Signs, Symptoms,
Causes, and Treatment. Retrieved November 4, 2014, from Helpguide.org
website: http://www.helpguide.org/articles/eating-disorders/
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Til, C. (2011). The quantification of gender: Anorexia nervosa and femininity.
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