Anorexia nervosa is characterized by severe and prolonged inability or refusal to eat because of emotional conflict. It is not caused by physical illness. This condition leads to significant weight loss. The person​—usually a young woman—​is intensely fearful of becoming obese and feels too fat even when emaciated. Menstruation ceases. She refuses to maintain her weight above the minimum normal for her age and height.

On the Increase

Most authorities report an increase in eating disorders, some even calling them an epidemic. In an article entitled “Eating Disorders: Implications for the 1990’s,” researchers explained that these disorders “have increased dramatically in frequency since 1970 and are now commonly encountered in clinical practice.” Reportedly, 150,000 die annually from complications associated with anorexia nervosa and bulimia.

Ann, however, fully recovered. She was fortunate. As many as 21 percent of those who develop anorexia nervosa die from the disorder. Suicidal thoughts are common in those with bulimia, and several doctors report that one third of their patients have tried to take their own lives.

These eating disorders affect all age, ethnic, and racial groups and cut across all social levels. This growing plague has invaded many economically developed lands. In Japan the increase reportedly “has been dramatic” since 1981. Sweden, Britain, Hong Kong, South Africa, Australia, and Canada all have had increases.

But why have eating disorders, though reported for hundreds of years, become epidemic in the 20th century?

“The Shrine of Slimness”

After 40 years of research, Dr. Hilde Bruch explains: “I am inclined to relate it to the enormous emphasis that Fashion places on slimness. . . . Magazines and movies carry the same message, but most persistent is television, drumming it in, day in day out, that one can be loved and respected only when slender.”

Before the year 1900, dressing in fashionable clothes was primarily the concern of the wealthy. But after World War I (1914-18), the advent of department stores, women’s magazines, and fashion photography created an increased interest in fashion among the masses of women. Chic new fashions were mass-produced in standard sizes. But to wear these, a woman had to have the “right” figure. Thus, figure flaws became a source of frustration and embarrassment for women who could not fit into such stylish clothing.

Then, in 1918, America’s first best-selling diet book linked weight control to self-esteem. Overweight in women became viewed as a character flaw and a social impediment. In her book Fasting Girls, Joan Brumberg explains the result: “In effect, by the 1920s outward appearance was more important than inner character because sexual allure had replaced spirituality as woman’s ‘shining ornament.’ . . . Many internalized the notion that the size and shape of the body was a measure of self-worth.”

Thus, an obsession with dieting and physical beauty developed. Today, an estimated 50 percent of the women in the United States are on a diet at any given time, most of them for appearance’ sake! A poll taken by Glamour magazine asked 33,000 women: “Which would make you happiest?” Forty-two percent answered, “Losing weight.” That was nearly twice as many as for any of the other selections offered by the poll, such as “Success at work.”

As we enter the 1990’s, thinness has become a symbol of strength, achievement, and attractiveness. “Given our longstanding and extravagant collective worship at the shrine of slimness, it is no wonder that so many contemporary young women make dieting an article of faith,” explained Brumberg. One apparent result? An epidemic of eating disorders.

Anorexia Nervosa

Blood disorders, abnormally low blood pressure, abnormal drowsiness or weakness, irregular heartbeat, sudden heart failure, yellowing skin, hormonal disorders, cessation of menstruation, bone-mass loss.