During the two most severe depressive episodes I've experienced, when I lost weight in the rapid and involuntary manner characteristic of this kind of emotional disorder, I found myself the object, for a surprising number of women, less of sympathy than of envy: "Oh," they'd sigh, "aren't you lucky to be so thin." Since, at these points, my health and even my survival were in some jeopardy, such a response could only reflect not an accurate assessment of my physique but a macabre but pervasive social attitude: Staying well has become, for most modern women, less important than staying thin. This and related attitudes toward food, appetite, and the female body create the environment within which eating disorders, among them anorexia nervosa, are flourishing in the United States and other postindustrial societies.
In "Fasting Girls," Joan Jacobs Brumberg, who is director of women's studies and associate professor in the department of Human Development and Family Studies at Cornell University, examines the practice and significance of food refusal from the Middle Ages to the present. As suggested by the fact that the book originally was published by Harvard University Press, and also by the 75 densely printed pages of notes, this is not a self-help or pop-psych book for the casual reader. A social historian of some sophistication, Brumberg draws not only on historical documents and medical archives but also on studies in psychoanalysis, semiotics and feminist theory in tracing and analyzing the shifts in attitudes toward and interpretations of the process she believes best described as "addiction to starvation."
The usefulness of the "dependency-addiction model," according to Brumberg, is that it permits anorexia nervosa to be divided into two stages: "sociocultural context, or 'recruitment' to fasting behavior," and "the subsequent 'career' as an anorexic," which "includes physiological and psychological changes that condition the individual to exist in a starvation state."
The first stage falls within the purview of the historian, and thus of "Fasting Girls." In terms of "recruitment"--that is, the motivation for refusing food--the anorexia mirabilis (miraculously inspired loss of appetite) of the female saints of medieval Europe who claimed to subsist solely on the Eucharist differed from later forms of abstinence, although all have shared "the use of food as a symbolic language" to articulate ideals and conflicts inexpressible in words. "From a historical perspective," Brumberg states, "certain social and cultural systems, at different points in time, encourage or promote control of appetite in women, but for different reasons and purposes."
In laying out these reasons and purposes and their transformations over the centuries, Brumberg produces a wealth of fascinating information about the behavior both of women who have refused food and of the priests, family members, doctors and others involved in their care. Female fasting behavior, once considered holy, gradually came to signify first wickedness and perversity and eventually sickness, both physical and mental, in a movement reflecting the secularization and medicalization of society. Not until the 1870s, with the increased medical capacity for discriminating one pathological condition from another, was anorexia nervosa identified and labeled as a separate illness with a distinct set of symptoms. In that sense, it is a thoroughly modern manifestation, in spite of the venerable tradition behind it.
Thus, Brumberg demonstrates, "today's anoretic is one of a long line of women and girls who have used control of appetite, food and the body as a focus of their symbolic language." In its modern form, the disease seems to be on the increase, afflicting as many as a million young women and girls in the United States. The reasons for this upsurge are complex and not entirely clear, but Brumberg relates them to the anthropological theory that "rapid social change and disintegrating social boundaries stimulate both greater external and greater internal control of the physical body. In short, disorder in the body politic has implications for the individual body."
Moreover, although anorexia nervosa strikes young women almost exclusively, it is not an isolated illness but reflects wider social pathology: "In effect, capitalism seems to generate a peculiar set of human difficulties that might well be characterized as consumption disorders rather than strictly eating disorders." Thus, we may ignore its implications at our own peril, not merely that of our sisters and daughters.
Brumberg is at her most intriguing in such speculative passages. In recounting trends and case histories, her pace sometimes slows, weighted down by repetitious detail, and occasionally she lapses into history-for-history's-sake, as in the thumbnail biographies of minor medical figures included in her notes. On the whole, however, her presentation, thoroughly researched and closely reasoned but never pedantic, provides lively and absorbing reading for scholar and serious lay reader alike.