How Not to Prevent Anorexia

Kelsey Osgood’s idea is not original. Ethan Watters argued it in his book: Crazy Like Us.

Yet, Osgood lived the experience that Watters and some social psychologists call symptom selection. Osgood chose to become anorexic.

In one chapter of his book Watters explained how, up until the late 1990s there were no cases of anorexia in Hong Kong. Then, a teenage girl starved herself to death and the media took up the cause of stopping anorexia. Experts came flying out of the woodwork. Potentially anorexic girls were featured in the press and on television. The result: an explosion of anorexia.

Why did this happen? Watters suggested that when troubled young girls who were suffering from a generalized, non-specific malaise learned that society offered attention and treatment to anorexics, they chose the symptoms that would get them taken them seriously.

If we read Osgood’s Time Magazine story in this context, it becomes more indicative.

She wrote:

When I was thirteen, I decided I would become anorexic. By devoting myself to the illness, I believed I could morph from an emotionally confused adolescent into the anorexic girls I had seen on Oprah who were, by contrast, models of self-regulation. I read everything I could find about eating disorders—from Steven Levenkron’s fictional The Best Little Girl in the World in which the anorexic character is unflappably disciplined, to the bestselling memoir Wasted by Marya Hornbacher, whose 202 calorie-a-day diet plan is routinely emulated. Armed with my acquired knowledge, I eventually succeeded and over the next eight years of my life, I was hospitalized four times.

She explains that the campaign to increase awareness of anorexia pushed her into the illness. It needs to be noted, yet again, that these grandiose public campaigns to raise consciousness about psychological conditions often produce more of what they are trying to fight.

Osgood understood the point:

But the explosion of awareness has become a double-edged sword. The number of people hospitalized for eating disorders has risen 24 percent, from 2000 to 2009, about the same length of time that Eating Disorders Awareness Week has been a mainstay on high school and college campuses since 2001. 

More awareness meant more anorexia.

In her words:

I believe that so many young women want to be anorexic because our society has communicated not the horrible consequences of eating disorders, but what might seem to be the benefits of them, namely, that they make you skinny and special. 

Finally, Osgood asked another salient question: is there a difference between someone who chooses to become anorexic and someone who becomes anorexic because of underlying psychological issues?

Describing the young women she met in the hospital, Osgood writes:

But after being admitted to the hospital, I quickly realized that I wasn’t the only one who had sought out anorexia.  A number of my fellow patients in treatment attested to having read memoirs prior to their illness and becoming enamored with the idea. One of my roommates had also read Marya Hornbacher’s Wasted and was inspired. “I was on vacation with my parents, so I couldn’t do anything, but I took notes,” she told me. Other inpatients talked about entering starvation pacts with like-minded friends, or actively competing to see who could eat the least. Like me, they had fallen in love with the symbolism of anorexia and then found themselves unable to easily reverse their destructive habits. I began to think that there might not be a big distinction between a “real” anorexic and a person like me who had willed herself to get it.

Obviously, once a girl decides to starve herself she will become malnourished. This will have a direct affect on her body, including her brain. It seems reasonable to assume that she will not be thinking clearly, will not be able to process the signals that her body might be sending and might come to believe that she looks and feels great. If she surrounds herself with her fellow anorexics she will be receiving moral support for her delusional beliefs.

It’s not so easy, at that point, to explain to her that she is starving herself to death. It is even more difficult to get her to start eating… especially when the anorexia has damaged her digestive system to the point where eating has become an unpleasant, even a painful experience.