Anorexia nervosa: views challenged by new book

Wednesday, 24 November 1999

Anorexia nervosa is an outdated term for the eating disorder which does not reflect contemporary ideas, according to a new book on the subject.

The Social Construction of Anorexia Nervosa takes a critical look at the historical, social, cultural and gender issues which brought about the naming of the eating disorder.

Written by a psychologist in Adelaide University's Department of General Practice, Dr Julie Hepworth, the book argues that the term is no longer relevant and in fact is an obstacle to developing prevention and treatment for sufferers.

The approach developed in the book is based on Dr Hepworth's long-standing interest in the philosophy of science, examining in greater detail how scientific discoveries are made.

Anorexia nervosa was first given its name in 1874 by William Withey Gull, a British physician at Guy's Hospital, London.

Dr Hepworth explains how the name given to the disorder is based on the medical definition of women who suffered from it in the late 19th century:

"A major part of the discovery of anorexia nervosa was that women were thought to be vulnerable to hysteria. Almost anything out of the 'normal' range of behaviour for women of that period was attributed to hysteria. Consequently, eating distress was seen as a form of psychopathology," Dr Hepworth says.

"So the explanation of women's behaviour - as a consequence of not finding any evidence of a gastric cause - was attributed to female psychology. It was a term based on popular, cultural ideas about women."

Dr Hepworth says that after more than a hundred years little headway has been made into anorexia nervosa, "but the language used to describe the condition over those years has had a major impact on the community and the sufferers themselves".

This impact includes negative stereotypes about sufferers of anorexia, as well as creating a psychological barrier for males who might otherwise be seeking medical help for their condition because it is seen as a female problem, Dr Hepworth says.

"I'd like to see a change, and hopefully this book raises some critical issues about women's mental health and makes visible the need for policy change."

Dr Hepworth's book also makes recommendations for the prevention and treatment of anorexia nervosa, such as the greater inclusion of sufferers in the decison-making processes regarding health care provision.

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