Imagine a disease without a clear diagnosis or cure, a disease caused by neither a virus nor a cancer, a disease with no enemy to trace and root out of the body. Imagine a self-inflicted disease that haunts you minute-by-minute—a disease that you control, just as it controls you.
Anorexia nervosa, a psychological disorder with physical consequences, is such a disease. As of 2004, according to the National Academy of Anorexia Nervosa and Associated Disorders, this eating disorder currently plagues more than 8 million American teenage girls.
In its online article “Anorexia Nervosa,” the American Academy of Neurology (2004) describes anorexia as “a pathological fear of weight gain leading to faulty eating patterns, malnutrition, and usually excessive weight loss.”
Many theories about the cause of anorexia have been proposed. Some experts blame the advertising and entertainment industries for their startlingly thin models and actresses. Others argue that girls monitor their food intake because they lack control in other areas of their lives.
Still others blame perfectionist families or cite depression and low self-esteem as causes for anorexia. All these theories, however, lack a key element—the complex relationship that teenage girls have with sexual desire and desirability.
Blaming the media’s thin role models is an especially popular explanation for anorexia in teenage girls. Sleek, slim, 5 ft 10 in., 115 lb women, are not good role models for girls just coming into an understanding about their bodies, say feminists and parents. As they reach their early teens, girls begin to flirt, date, and worry about their physical appearance. When the only images they have to compare themselves with are grossly disproportioned, it is not surprising that many girls develop unrealistic goals for their appearance.
Further, teens encourage each other to uphold and follow the standards set up by the media. Exercise and dieting are common topics of discussion among teenage girls, as are grooming and dating. While boys are encouraged to compete in football or hockey, girls tend to compete for the best bodies and boyfriends. The popular “blame the media and peer pressure” explanation, however, does not by itself fully address the reasons why girls value beauty and sexual desirability so highly.
A different theory about teenage anorexia cites the drastic changes during adolescence as a source of anxiety and illness. According to this theory, teenagers feel out of control as they make the shift from childhood to adulthood, so they seek to control the only thing they think they can: their bodies. Undoubtedly, girls (and boys) face many changes during adolescence; shifts in relationships with parents, new social standing and worries about the future, introduction to dating and sexuality, as well as physical and hormonal changes.
So much upheaval could certainly lead one to feel panicked, helpless, or out of control. Such feelings, coupled with sexual peer pressure and the idealized female image described above, likewise could certainly lead some girls to starve themselves. They want both to reach the new standard that has been set for them (a 5 ft 10 in., 115 lb toned body), and hold on to and shape some part of their lives.
A more specific pressure that many anorexic girls may be responding to is family. Statistically, anorexics tend to be high-achieving “good girls [and] dutiful daughters”. Their families are strict, close-knit, and success-driven, and often it is difficult for these daughters to separate psychologically from their parents.
Anorexia, then, becomes both a way to strive for high goals (female beauty expressed through extreme thinness) and means to act autonomously. As Melissa Dean, a former anorexic and the daughter of a successful business owner, explains, “My parents were really strict. I did everything [for them]. I accomplished everything. I felt like I had to do all this stuff, but dieting was the one thing I could do by myself… I could make myself not eat.”
The theory of familial pressure has become very popular during the 1980s and 1990s, and deservedly so, since so many anorexic girls come from traditional middle-and upper-class homes. Like the theory of media pressure, however, it does not explain why girls choose starvation and/or beauty to seek their autonomy.
Still another theory is that anorexia stems from depression or low self-esteem. Proponents of this theory suggest that uncertainty about physical, emotional, or relational changes may cause many teenagers to lose self-confidence and, possibly, to collapse into depression. Once these girls feel depressed or inadequate, they look for a way to redeem themselves: physical perfection.
Although depression and low self-esteem might be present in an anorexic, they do not necessarily cause anorexia. Depression, for example, sometimes causes people to overeat rather than to starve themselves. Furthermore, this theory, like the control theory, does not consider why physical perfection becomes the chosen means of dealing with depression or feelings of inadequacy. The question still remains: Why is being physically desirable so intensely important to some adolescent girls?
Perhaps a fuller understanding lies in a different direction. Perhaps anorexics don’t pursue desirability but are rather avoiding it. Part of the traumatic shift from girlhood to womanhood is a movement from a pre-sexual “neutral” self to a sexualized self that is an object of desire. During adolescence, American girls learn that in order to be good, successful women, they must inspire male desire while repressing their own; they are introduced to a double standard that favors male sexuality and represses women’s desires. On the one hand, girls learn to seek male attention because having dates and boyfriends can increase their popularity or social status. But on the other hand, giving in to sexual pressures can turn them into outcasts.
Further, they learn that since men cannot be expected to control their sexual appetites, women must use mental willpower to overcome male pressures, as well as their own physical desires.
The shift from a largely desexualized girlhood to a highly sexualized adolescence and womanhood can easily lead to confusion, upset, and anger. Such stress can also compound anxieties about changes at home, school, and in the body. In deed, it can create a need to control something, to hold onto something; and sometimes that thing, whether victims know it or not, is girlhood.
It has been argued that anorexics starve themselves in an unconscious effort to stunt their growth in order to remain girls and, certainly, teenage anorexia does interfere with maturation and hormonal development.
The thing that such girls resist, however, may not simply be physical change but rather the shift from a neutral self to an object of desire. Sarah Lasseter, a former anorexic, related, “I hated the thought of sex. I didn’t want a gender. I didn’t want a body. I just wanted to be me” (Anorexia Nervosa).