"Anorexia nervosa exemplifies the arbitrariness inherent in labelling individuals mentally ill. Imposing the medical model upon the events comprising an episode of anorexia is only one of several ways to give meaning to these events"
Dresser, R (1984) "Feeding the Hunger Artists: Legal Issues in Treating Anorexia Nervosa", 1984 Wisconsin Law Review 297.

If someone has a cold she probably want to get better. Any aid she receives will be greeted with open arms, but what if she only appears to be ill and resists help? Does anyone have a responsibility to force her to get better? What if she claims that she enjoys sneezing and coughing—does anyone have the responsibility or the right to save her from herself?

In the case of mental disorders this problem is common. The DSM-IV definition of anorexia actually includes fierce resistance to treatment as a symptom.

As someone who has had anorexia and recovered I can’t help but find this a little, well, circular. In the end I found that my gender and age played a large role in my perceived ability to make choices that might impact my health. In this essay I will attempt to show how the definitions of eating disorders reflect sexist ideas in our culture.

I am not arguing that eating disorders are “good” –that they are a smart way to loosing weight or that anyone should “try” to have one. I am asking that we re-examine our ways of thinking about disorders and re-consider the possibility that a person may choose to live with an eating disorder. Since recovery is impossible untill the disordered person chooses to want help anyway it stands to reason that remaining disordered may very well be a kind of lifestyle. A smart one? Probably not... but one that can be chosen. (Quick note: there are people with eating disorders who want very badly to recover and can’t—this essay concerns those who resist treatment: repeatedly, vehemently and not in such a manner that the resistance is a veiled plea for help.)

When I was still in the grip of anorexia I would often get in arguments that went something like this:

“I don’t want help, I’m fine.”
“You don’t want help because you are sick.”
I’m not sick, this is how I live my life.”

“An eating disorder can not be a lifestyle choice.”

The matter of choice is at the heart of the debate over pro-anorexia websites. I think there are a number of things wrong with this statement. But, let’s dissect it a bit first: What is an eating disorder anyway? Oddly enough, the disorder, as defined by medical texts seems to encompass a wide range of potentially self-destructive behaviors that are not even remotely limited to food. Moreover, all of the behaviors are done with the hopes of losing or controlling ones weight or regulating ones moods.

Some of these behaviors are done by many non-disordered people under other circumstances. A fast (for example) is OK for religious reasons, but not for weight loss (it’s not incidentally the most effective means of weight loss) A restrictive diet (within reason) is fine for a person who is asked by their doctor to lose weight but for a person who is a normal weight or underweight it is not permitted, binge eating is accepted during thanksgiving as a way to celebrate, but to eat large amounts of food all on your own is not correct, the Romans (I read) were fond enough of purging to build rooms for it (don’t know of any modern examples)—but a young woman who dose this is out of line.

The difference between the disordered person and the normal person lies in two areas, motivation and degree. Anything taken too far can become a kind of madness. This all seems reasonable enough until you look at a similar kind of self destructive behavior and discover that, while the behavior is frowned upon it is not called a mental illness when taken to extremes. I’m talking about extreme bodybuilding. Many bodybuilders die from heart failure or compilations from steroids. Bodybuilding involves modification of the body to an extreme that goes beyond what nature really expects of us. Even when no steroids are used the restrictive diets and strenuous training pose a risk. So why are eating disorders mental illness, but bodybuilding is just made fun of now and then or ignored? While many young women have disordered eating patterns only a small number die from anorexia a year. It’s not an epidemic… neither are bodybuilding related deaths… what is the difference??? It’s sex people. It is far more disturbing to know that young women are going to extremes to reach dubious ideals-—young men on the other hand are permitted a certain license of recklessness by our culture. This places them in greater danger, but it also gives them a greater sense of responsibility and more room for growth in the area of self-respect.

For centuries women with deviant behavior have been called ill rather than be allowed to face the consequences of their choices. At one time a woman who committed adultery could have been diagnosed with hysteria. Certainly, women lack a certain amount of free will, any deviant choices must be the work of an infection of some kind. Yes, that’s why we took a bite of the goddamed apple. (or in my case failed to take a bite.) Temptation weighs heavy on the weak female will, and her soft heart my bend too far when allow too much freedom.

If women are deviant it’s not their fault, it’s madness. They can’t help it. GIVE ME A BREAK. I think there are two possibilities here: baby men in the same manner that women are babied OR stop calling the choice to go on a never-ending crash diet a “disorder” (by the way saying that “we can’t help it” makes it very easy for people to stay disordered and “fail” at recovery because “it won’t let me out” I think this is why most treatment centers for eating disorders have abysmal recovery rates… there is no “it” there’s just you.) The pro-anorexia movement is not just compatible with feminism—it is in and of itself feminist.

(please note: I know that there are men with eating disorders, and likewise female bodybuilders, I’m talking about large cultural trends here, and going out on a limb in more than one way. This isn’t a manifesto—and it’s not all-inclusive.)