6 - Continuity and change in symptom choice: Anorexia

Summary

The post-1960 epidemic of anorexia nervosa can be related to recent social change in the realm of food and sexuality.

Joan Jacobs Brumberg (1988, p. 268)

In the past two decades, anorexia nervosa has become an increasingly prevalent disease in the United States, and eating disorders are regarded as commonplace among women students on our nation's campuses. Patients with anorexia nervosa are drawn largely from the middle and upper classes; they are Caucasian, female, and largely adolescent and young adult. Despite many confusions (and lapses) in the historical epidemiology of the disorder, most medical and mental health observers agree there has been a real rise in incidence in the number of patients with anorexia nervosa since the 1960s. Since the 1970s, the number of women patients seeking help with eating disorders has increased steadily in clinical settings across the country (Brumberg, 1988).

These changes in incidence and presentation of symptoms are of concern to social historians and mental health professionals. For historians and psychologists, the current situation prompts an important theoretical question: Why does a psychopathology become more prominent in one time period than another? What one thinks about the causes or etiology of this particular disease will obviously determine an answer. For the purposes of this essay, however, we will set aside the discussion of etiology and proceed from the following shared assumptions.

First, in mental illness, basic forms of cognitive and emotional disorientation are expressed in behavioral aberrations that mirror the deep preoccupations of a particular culture.