>> WELCOME. I'M JEFF REZNICK
SENIOR HISTORIAN NATIONAL
LIBRARY OF MEDICINE AT THE
NATIONAL INSTITUTES OF HEALTH.
THANK YOU FOR FOR JOINING US FOR
THE 50TH ANNUAL JAMES H. CASSEDY
MEMORIAL LECTURE HISTORY OF
MEDICINE PART OF THE NATIONAL
LIBRARY OF MEDICINE'S 2024
HISTORY TALKS SERIES. TALKS
PROMOTE AWARENESS AND USE OF NLM
AND RELATED HISTORICAL
COLLECTIONS OF RESEARCH
EDUCATION AND PUBLIC SERVICE IN
BIOMEDICINE AND SOCIAL SCIENCES
AND HUMANITIES. NLM HISTORY
TALKS SUPPORT COMMITMENT OF NLM
TO RECOGNIZE THE DIVERSITY
DIVERSITY OF COLLECTIONS
SPANNING 10 CENTURIES ENCOMPASS
RANGE OF FORMATS AND ORIGINATE
IN EVERY PART OF GLOBE. NLM
HISTORY OFFERS VOICES TO PEOPLE
OF COLOR, WOMEN AND CULTURES OF
DISCIPLINARY BACKGROUNDS WHO
VALUE AND USE THEM TO ADVANCE
RESEARCH AND TEACHING AN
LEARNING. FOR THOSE WHO WISH TO
SHARE QUESTIONS WITH OUR SPEAKER
PLEASE USE THE LIVE FEEDBACK
BUTTON YOU SEE UNDER YOUR VIDEO.
NOW FOR 15 YEARS THE NATIONAL
LIBRARY OF MEDICINE POSTED THIS
SPECIAL LECTURE IN MEMORY OF OUR
LATE COLLEAGUE JAMES H. CASSEDY,
RENOWN HISTORIAN OF MEDICINE 50
YEAR EMPLOYEE OF NLM EDITOR OF
THE BIBLIOGRAPHY OF HISTORY OF
MEDICINE AND SUPPORTER OF MANY
RESEARCH TOOLS VALUED BY
GENERATION OF SCHOLARS. DURING
THE COURSE OF HIS DISTINGUISHED
SCHOLAR CAREER HE RECEIVED EVERY
MAJOR HONOR THE AMERICAN
ASSOCIATION FOR HISTORY OF
MEDICINE BEST STOWSS. IN ADDITIN
O THE WELCH MEDAL RECEIVED BOOKS
AMERICAN MEDS SIN AND
STATISTICAL THINKING, 1800 TO
1860, PUBLISHED IN 1984 AND
MEDICINE AND AMERICAN GROWTH
1800 TO 1860 PUBLISHED IN 1986,
DR. CASSEDY WAS AWARDED THE
ASSOCIATION'S LIFETIME
ACHIEVEMENT AWARD AND DELIVERED
THE HONNARY GARY SON LECTURE. HE
ALSO SERVED AS PRESIDENT OF THE
ASSOCIATION FROM 1982 TO 1984
AND WORKED ON A NUMBER OF
COMMITTECOMMITTEES. SO IN EVERYT
OF FORMER COLLEAGUE IT IS MY
PRIVILEGE TO ANNOUNCE TO
INTRODUCE TODAY'S DISTINGUISHED
SPEAKER DR. ALICE WEINREB,
ASSOCIATE PROFESSOR HISTORY
LOYOLA UNIVERSITY IN CHICAGO
WHERE SHE TEACHES COURSES IN
20TH CENTURY EUROPE, FOOD IN THE
MODERN WORLD HOLOCAUST AND
HISTORY OF PSYCHIATRY. OVER THE
COURSE OF HER DISTINGUISHED DA
REPRODUCIBILITY CAREER SHE'S
RECIPIENT OF MANY FELLOWSHIPS
INCLUDING UNIVERSITY OF
MICHIGAN, 2008, 2009, A SOCIAL
SCIENCE RESEARCH COUNSEL
INTERNATIONAL DISSERTATION FIELD
RESEARCH FELLOWSHIP IN 2006 AND
7, THE BERLIN PROGRAM FOR
ADVANCE GERMAN EUROPEAN STUDIES
FELLOWSHIP IN 2006 AND 2007, THE
FOREIGN LANGUAGE AREA OF STUDIES
SCHOLARSHIP, 2004, 2005 AND
REGIONS FELLOWSHIP IN 2003,
2004. MOST RECENTLY SHE WAS
AWARD NATIONAL ENDOWMENT FOR THE
HUMANITIES FELLOWSHIP FOR THE
PERIOD 24, 25, TO PURSUE THE
PROJECT SHE HAD BEEN DISCUSSING
WITH US TODAY. DR. WEINREB'S
FIRST BOOK MODERN HUNGERS FOOD
AND POWER IN 20TH CENTURY
GERMANY WAS PUBLISHED WITH
OXFORD UNIVERSITY PRESS IN 2017
AND RECEIVED THE 2017 LIBRARY
FRANKEL BOOK PRIZE IN
CONTEMPORARY HISTORY AND
INAUGURAL 2017 WATERLOO CENTER
GERMAN STUDIES BOOK PROJECT.
THAT BRINGS ANALYSIS STATE
POLICY, EXPERIENCES OF FAMINE AN
MASS -- IN EVERY DAY FOOD
CONSUMPTION, TO TRACE HISTORY
AND LEGACY OF THE TWO WORLD WARS
AND THE COLD WAR. DR. WEINREB'S
ARTICLES APPEARED IN CENTRAL
EUROPEAN SENTENCERY, GERMAN
STUDIES REVIEW, BULLET OVIGER
MINUTE HISTORICAL INSTITUTE AND
(INAUDIBLE) OR POLITIC AS WELL
AS THEY HAVE BEEN INCLUDED IN --
HER SECOND BOOK TRACES THE RISE
OF EATING DISORDERS FOCUSING ON
ANOREXIA, BULIMIA AND BINGE
EATING WITH THE STATUS OF
EPIDEMIC DURING THE 1970s AND
1980s. SO TODAY DR. WEINREB
JOINS TO OFFER PERSPECTIVES ON
THIS PROJECT AS ITS SUBJECT
DRAWS UPON COLLECTIONS OF THE
NATIONAL LIBRARY OF MEDICINE AS
WELL AS MANY OTHER REPOSITORIES
ANOREXIA AND ARCHIVE,
DOCUMENTING THE LATE 20TH
CENTURY RISE IN EATING
DISORDERS. DR. WEINREB, WELCOME
AND THANK YOU SO MUCH FOR
JOINING US TODAY. LOOKING
FORWARD TO YOUR TALK.
>> THANK YOU SO MUCH, JEFF.
THANK YOU FOR THAT LOVELY
INTRODUCTIONS. IT IS AN HONOR
AND PRIVILEGE TO SPEAK WITH
Y'ALL AND TO TO SHARE MY WORK. I
WAS ESPECIALLY DELIGHTED TO
RECEIVE THIS INVITATION SINCE AS
YOU WILL SEE IN THIS TALK THE
COLLECTIONS OF THE NATIONAL
LIBRARY OF MEDICINE HAVE BEEN
CRUCIAL FOR THE DEVELOPMENT OF
THIS PROJECT. AND I WANT TO SAY
THE OUTSET, WHAT I'M PRESENTING
TODAY IS VERY MUCH A WORK IN
PROGRESS, HOPE TO TALK ADVANTAGE
OF THE REMARKABLY DIVERSE AND
MEDICALLY INFORMED AUDIENCE OF
THIS TALK TO INVITE QUESTIONS
CRITICISMS OR SUGGESTIONS DURING
THE Q&A OR INVITE PEOPLE TO
REACH TOUT ME AFTER THIS TALK IS
OVER. AS YOU HAVE HEARD AND CAN
SEE, THE TITLE OF MY TALK IS
ANOREXIA IN THE ARCHIVES
DOCUMENTING THE LATE 20TH
CENTURY RISE IN EITHER
DISORDERS. MY TITLE INVOKES TWO
DIFFERENT WAYS IN WHICH I
CONCEPTUALLY AND ARCHIVE. FIRST
OVER THE NEXT ROUGHLY 45 MINUTES
I MR. RECONSTRUCT WHAT I
CONCEPTUALIZE THE ARCHIVE OF A
DISEASE. WHERE DID I LOOK AND
WHAT SOURCES DID I FIND WHEN
TRYING TO DOCUMENT EATING KISS
ORDERS IN POST WAR AMERICA. I
WILL BE PRESENTING IN THIS SENSE
MY METHOD LOGICAL APPROACH FOR
WRITING THE HISTORY OF SPECIFIC
MEDICAL DIAGNOSES. TO BRIEFLY
CONTEXTUALIZE THIS TALK THE
LARGER PROJECT OF THIS TALK
COMES OUT OF IS HUGE, USING
MATERIAL FROM SEVERAL DOZEN
ARCHIVES LOCATED IN EIGHT
COUNTRIES. THESE ARCHIVES
INCLUDED MEDICAL LIBRARIES,
COLLEGE AND UNIVERSITY ARCHIVE,
FEMINIST ARCHIVES NATIONAL AND
CITY ARCHIVES AND HOSPITAL AND
CLINIC ARCHIVES. I DID WANT TO
BRIEFLY MENTION NOTHING I'M
GOING TO BE DISCUSSING OR
PRESENTING HERE TODAY INVOLVES
ANY CONFIDENTIAL OR PATIENT
MATERIALS. THUS THOUGH I WILL
BE PRESENTING TO AMERICAN
ARCHIVES IN MY TALK, MY
OVERARCHING INTEREST IS
MULTITUDE OF CO-EXISTING AND
INTERSECTING ARCHIVES THAT
EMERGED AROUND THE WORLD AT THIS
TIME AROUND EATING DISORDERS.
SECONDLY, I TRY TO THINK ABOUT
ARCHIVESARCHIVES METAPHORICALLY
AFFIRMING THE REALITY AND
SIGNIFICANCE OF A SUBJECT. I
ARGUE IN THIS TALK THAT DURING
THE LATE 20TH CENTURY SPECIFIC
ACTORS AN SECONDMENTS OF SOCIETY
COLLABORATED IN THE CONSTRUCTION
OF EATING DISORDER ARCHIVES, A
DELIBERATE PROJECT ROOTED IN A
SHARED SENSE OF THE SIGNIFICANCE
AND MEANING OF THESE PARTICULAR
AFFLICTIONS. THUS MY TALK TODAY
ANSWERS A HOW QUESTION, HOW DID
EATING DISORDERS BECOME SUCH A
CENTRAL CATEGORY OF MENTAL
ILLNESS IN THE UNITED STATES
DURING THE LATE 20TH CENTURY? TO
ANSWER THIS QUESTION, I WILL
TRACE TWO SPECIFIC MINI ARCHIVES
OR TWO SPECIFIC ARCHIVES. AND
HERE AS YOU WILL SEE, I'M
THINKING OF ARCHIVES NOT ONLY AS
A COLLECTION OF STATIC DOCUMENTS
AND OBJECTS BUT ALSO AS PLACES
OF MOVEMENT AND CIRCULATION.
ARCHIVE ECONOMIES OR KNOWLEDGE
INFRASTRUCTURE THAT DEVELOP
AROUND TWO SPECIFIC DIAGNOSES IN
TWO SPECIFIC CONTEXTS. FIRST FOR
THE BULK OF THE TALK I WILL BE
LOOKING AGENT THE ELEVATION OF
ANOREXIA FOR VOICE IS A TO THE
STATUS OF NATIONAL CRISIS
BETWEEN 1970s AND EARLY
1990s. DETAILING THE DIFFERENT
CONSTITUENCIES THAT PARTICIPATED
IN THE CONSTRUCTION OF THIS
EPIDEMIC. IN A SECOND PART OF MY
TALK I WILL BRIEFLY DESCRIBE A
RELATED BUT DISTINCT EATING
DISORDER ARCHIVE, BULIMIA
NERVOSA ON UNIVERSITY AND
COLLEGE CAMPUSES. I MENTION MY
INTEREST IS REALLY LARGELY DUE
TO THE WORK OF SEVERAL WONDERFUL
STUDENT INTERNS WHO I WORKED
WITH OVER THE PAST FEW YEARS AT
LOYOLA UNIVERSITY. BY TELLING
THESE SORRIES AND NARRATING
THESE ARCHIVES I HOPE TO
HIGHLIGHT THE CONSTRUCTIVENESS
AND HISTORICAL SPECIFICITY OF
MENTAL HEALTH EPIDEMICS AS WELL
AS TO DRAW ATTENTION O THE
VARIETY OF WAYS IN WHICH MEDICAL
KNOWLEDGE IS PRODUCED AND
CONSUMED AS IT MOVES BETWEEN
INDIVIDUALS AND COMMUNITIES. IN
1978 GERMAN JEWISH IMMIGRANT
PEDIATRICIAN AND PSYCHIATRIST
HILDA BROOK PUBLISHED THE FIRST
BOOK ON ANOREXIA INTEND FORD THE
LAY AUDIENCE. THE GOLDEN CAGE
THE ENIGMA WAS HAILED UPON THE
PUBLICATION OPENING A NEW
CHAPTER IN MEDICINE AND POPULAR
CULTURE INTRODUCING ANOREXIA TO
A GENERATION OF YOUNG PEOPLE AND
THEIR FAMILIES. THE BOOK
REISSUED IN TIMES TRANSLATED
INTO 12 LANGUAGES AND SOLD OVER
150,000 COPIES WORLDWIDE OPENS
WITH A DRAMATIC CALL TO ARMS.
NEW DISEASES ARE RARE. AND A
DISEASE THAT SELECTIVELY BEFALLS
THE YOUNG RICH AND BEAUTIFUL IS
PRACTICALLY UNHEARD OF. BUT SUCH
A DISEASE IS AFFECTING THE
DAUGHTERS OF WELL TO DO EDUCATED
AND SUCCESSFUL FAMILIES IN NOT
ONLY IN THE UNITED STATES BUT
ALSO IN MANY OTHER AFFLUENT
COUNTRIES. THE CHIEF SYMPTOM IS
SEVERE STARVATION LEADING TO A
DEVASTATING WEIGHT LOSS. SHE
LOOKS LIKE THE VICTIM OF A
CONCENTRATION CAMP IS NOT
UNHEARD OF DESCRIPTION. IN THE
YEARS PRECEDING THE PUBLICATION
OF THIS BOOK ANOREXIA HAD BEEN
OBSCURE DISEASE THAT DOCTORS
RARELY IF EVER ENCOUNTER. WITHIN
JUST A FEW YEARBOOKS PUBLICATION
MAINSTREAM MEDIA WAS REFERRING
TO THE ERA AS QUOTE THE AGE OF
ANOREXIA. WHILE BROOKS BOOK WAS
HAILED AS ONE OF THE MOST
THOUGHTFUL SENSITIVE AND
COMPREHENSIVE DISCUSSIONS OF THE
ILLNESS TITLE OF THE BOOK ALSO
PROVIDED A CENTRAL METAPHOR FOR
ANOREXIA NERVOSA THAT SHAPED
UNDERSTANDING OF THE ILLNESS IN
IMPORTANT WAYS THE ANOREXIC WAS
TRAPPED IN A GOLDEN CAGE
REFLECTING THE PRIVILEGE THAT
HER -- THAT MADE UP HER WORLD.
REWORKING THIS METAPHOR POP LAHR
PSYCHIATRIST RELEASED THE FIRST
YOUNG ADULT NOVEL ABOUT ANOREXIA
NERVOSA IN 1979, THE BEST LITTLE
GIRL IN THE WORLDED. HIS TITLE
PROJECTED ANOREXIA AS ILLNESS
THAT STRUCK THE BEST LITTLE
GIRLS IN THE WORLD. GIRLS WHO
WERE BOTH ORDINARY, LIKE ALL OF
US, AND EXTRAORDINARY, THE BEST
OF THE BEST. THE BOOKS DUST
JACKET EXPLAINED QUOTE TO ANYONE
TO WHO MEETS HER SHE IS LIKE ANY
OTHER ORDINARY TEENAGE GIRL IF
ANYTHING NEE IS PRETTIER,
SLIMMER AND MORE INTELLIGENT
THAN MOST GIRLS OF HER AGE. BUT
THAT'S NOT HOW FRANCESCA SEES
HERSELF. WHEN SHE LOOKS IN THE
MIRROR DURING BALLET CLASS SHE
SEES A FLABBY OBESE MONSTER. THE
WIDELY ACCLAIMED TV MOVIE
RELEASED TWO YEARS AFTER THE
BEST SELLING BOOK CHANGED THE
HOBBY OF PROTAGONIST FROM BALLET
TO CHEER LEADING BUT WAS
OTHERWISE QUITE FAITHFUL TO
LEVENKRON'S STORY. THE FILM
POSTER NARRATES I'M CASEY, 17,
GETTING ALL A AND MADE
CHEERLEADER. MY PARENTS I'M THE
BEST GIRL IN THE WORLDED.
SOMEBODY STOP ME FROM STARVING
MYSELF TO DEATH. DELIBERATELY
STOKING PARENTAL FEAR IT IS
MOVIE DESCRIBES A DRAMA OF
ANOREXIA A MOVIE THAT JUST MIGHT
SAVE YOUR CHILD'S LIFE. PUBLIC
INTEREST IN ANOREXIA PEAK WITH
THE 1983 DEATH OF POP STAR KAREN
CARPENTER OF THE POP GROUP THE
CARPENTERS. THIS WAS THE FIRST
CELEBRITY DEATH ATTRIBUTED TO
ANOREXIA AND IT WAS WIDELY
COVERED IN GLOBAL MEDIA.
IRONICALLY STEVEN THE AUTHOR OF
BEST LITTLE GIRL IN THE WORLDED
HAS BEEN HER THERAPIST PRIOR TO
HER DEATH. KAREN CARPENTER
EPITOMIZED THE GOLDEN CAGE
NARRATIVE OF ANOREXIA WHILE
CONSTRUCTED AND CONFIRMING THE
DANGER OF THIS DISEASE. ANOREXIA
WAS NOT ONLY FRIGHTENING IN AND
ENIGMATIC, IT WAS DEADLY. AND I
SHOULD NOTE HERE THAT AS STILL
TRUE TODAY ANOREXIA HAS THE
HIGHEST MORTALITY RATE OF ANY
MENTAL ILLNESS USUALLY CITED
AROUND 5%. THIS WAS CERTAINLY A
DRAMATIC NARRATIVE. AN ILLNESS
THAT STRUCK WHITE PRETTY
SUCCESSFUL TEENAGE GIRLS, AND
THAT KILLED. INDEED THESE
ASPECTS OF ANOREXIA REINFORCED
ONE ANOTHER. PRECISELY BECAUSE
THESE PATIENTS WERE SO HIGHLY
VALUED, EATING DISORDER WARDS
AND RESIDENTIAL TREATMENT
PROGRAMS BEGAN OPENING ACROSS
THE COUNTRY AT REMARKABLE SPEED
HERE ARE A FEW ADS FROM SUCH
PROGRAMS. THERE WERE HUNDREDS
THAT CIRCULA CIRCULATED IN THE D
'80s THAT RAN IN NATIONAL
NEWSPAPERS. THESE ADS EMPHASIZE
THE PARTICULARITY OF THE PATIENT
PROFILE, AND THE TERRIFYING AND
DEADLY THREAT REPRESENTED BY
ANOREXIA. SO I WILL WALK YOU
THROUGH THESE ADS. ON THE FAR
LEFT, SUSAN WAS DYING TO LOSE
WEIGHT. SHE STARVED HERSELF TO
DEATDEATH. MOST ANOREXIA VICTIMS
DON'T KNOW THEY ARE SICK. MOST
WON'T SEEK HEALTH. IF YOU KNOW
SOMEONE SUFFERING YOU MAYBE ABLE
TO SAVE HER LIFE. IN THE MIDDLE,
SHE'S PRETTY, POPULAR AND SHE IS
STARVING HERSELF TO DEATH. IT IS
ESTIMATED THAT AT LEAST ONE OUT
OF EVERY 20 WOMEN BETWEEN AGE 16
AND 21 NOW SUFFER FROM AN EATING
DISORDER ANOREXIA AND BULIMIA
HAVE NOW REACHED EPIDEMIC
PROPORTIONS IN THIS COUNTRY. AND
THIS AD INCLUDE A SMALL CHART OF
DISORDER SYMPTOMS SO THAT PEOPLE
CAN LEARN THE SPECIFIC SYMPTOMS
OF ANOREXIA AND BULIMIA AND
EVALUATE THEMSELVES OR THEIR
LOVED ONES TO SEE IF THEY MIGHT
BE DIAGNOSEABLE. ON THE FAR
RIGHT, PATRICIA K., HAS A
PERFECT 4.0 GPA, AN ACCOMPLISHED
MUSICIAN, MEMBER OF THE NATIONAL
HONOR SOCIETY, AND PRESIDENT OF
HER SCHOOL DRAMA CLUB. SHE'S
DEVOTED DAUGHTER AS WELL AS
FRIEND IN WHOM ALL OTHERS
CONFIDE. BUT IT IS NOT ENOUGH.
AT 5-FOOT 7 AND 85 POUNDS
PATRICIA K. THINKS SHE'S FAT.
AND NOW HER WORLD IS FALLING
APART. PATRICIA K OVERACHIEVE IS
STARVING HERSELF TO DEATH. THESE
CLINICS AND THE ECONOMY THAT
SURROUND THIRD DEGREE NEW
MEDICAL THREAT WAS NEVER JUST
FOR AN ANOREXIA BUT FOR EATING
DISORDERS. DEFINED AS USUALLY
ANOREXIA NERVOSA BULIMIA AND
BINGE EATING OR COMPULSIVE
OVEREATING. ALL THESE DISORDERS
WERE ON THE INCREASE, AND ALL OF
THEM WERE TREATED IN THESE
FACILITIES. BUT IT WAS ALMOST
ALWAYS ANOREXIA THAT WAS THE
PRIMARY FOCUS AND ULTIMATELY
BECAME THE SYMBOL OF EATING
DISORDERS AS A CATEGORY OF
MENTAL ILLNE ILLNE ILLNESS. NOWA
DIFFERENT REGISTER AWAY FROM
THIS MAINSTREAM FRAMING OF THE
ILLNESS AND TOWARD THINKING THE
WAYS IN WHICH MEDICAL
PROFESSIONALS DOCTORS
PSYCHOLOGISTS AND NURSES WERE
SIGH MULL MULL TRAINIOUSLY BEGIN
TAUGHT ABOUT ANOREXIA AS WELL.
-- SIMULTANEOUSLY BEING TAUGHT
ABOUT ANOREXIA AS WELL. THIS
PART OF MY PRESENTATION IS
RELIANT UPON COLLECTIONS OF NLM,
WHICH NOT ONLY HOLDS MEDICAL
PUBLICATIONS BUT MATERIAL
RELATED TO MEDICAL EDUCATION,
MATERIAL DOCUMENTING HOW DOCTORS
AND NURSES LEARNED ABOUT
SPECIFIC DISEASES. THIS OF
COURSE IS ESPECIALLY INTERESTED
IN THE CASE OF NEW OR EXOTIC
ILLNESSES. THE ABILITY TO
DIAGNOSE AND TREAT A SICKNESS
DEPENDS ENTIRELY UPON HOW A
PRACTITIONER HAS LEARNED THAT
THE DISEASE PRESENTS ITSELF. HOW
HE OR SHE LEARNS WHAT TO EXPECT
AND HOW TO REACT TO PARTICULAR
SYMPTOMS IN PARTICULAR BODIES.
TODAY I WANT TO BRIEFLY SUGGEST
A FEW WAYS OF THINKING ABOUT
THIS ASPECT OF THE POST WAR
HISTORY OF EATING DISORDER TO
GIVE YOU A SENSE OF THE KINDS OF
SOURCES I'M WORKING WITH AND THE
KINDS OF QUESTIONS THAT I'M
ASKING OF MY SOURCES. SO I WANT
TO START QUICKLY WITH SOME
MATERIAL FROM MEDICAL SCHOOL,
THIS IS A UNIVERSITY BOOKLET
CLARIFYING GRADUATION
REQUIREMENTS FOR DEGREE IN
PSYCHIATRY. THE PAGE SHOWN HERE
LISTING CATEGORIES OF MENTAL
ILLNESS, THIS IS A CHECKLIST
LISTING ALL THE CATEGORIES OF
MENTAL ILLNESS THAT ALL STUDENTS
MUST PERSONALLY DIAGNOSE IN
ORDER TO COMPLETE THEIR TRAINING
AND RECEIVE A PSYCHIATRY DEGREE.
IT DOCUMENTS THE INTEGRATION OF
ANOREXIA INTO THESE CATEGORIES
OF STANDARD OR KEY MENTAL
ILLNESS. THOSE ARE GENERALLY
ASSUMED TO BE THE ONES STUDENTS
ARE MOST LIKELY TO ENCOUNTER. SO
THESE ARE ILLNESSES LIKE
AFFLICTIONS LIKE ANXIETY,
HYSTERIA, ALCOHOLISM, SEXUAL
PROBLEMS AND ANOREXIA NERVOSA. A
FEW YEARS EARLIER ANOREXIA WOULD
NOT HAVE BEEN ON THIS STANDARD
LIST OF MANDATORY KNOWLEDGE FOR
TRAINING IN PSYCHIATRY. NOT JUST
STUDENTS BUT PRACTICING DOCTORS
ALSO REGULARLY UNDERGO MEDICAL
EDUCATION. THE MEDICAL
ESTABLISHMENT PRODUCES A WIDE
ARRAY OF CONTINUING EDUCATION
OPPORTUNITIES TO KEEP
PRACTITIONERS ABREAST OF MEDICAL
KNOWLEDGE. THE NLM HOLD AS GREAT
DEAL OF THIS MATERIAL INCLUDING
PRE-RECORDED LECTURE, SLIDES AND
FILMS WHICH WERE SHIPPED ACROSS
THE COUNTRY AND OFF TO OTHER
COUNTRIES AS WELL TO INDIVIDUALS
AND INSTITUTIONS SEEKING NEW
INFORMATION. ONE OF THE MAIN
GOALS OF THIS TRAINING IS TO
GIVE DOCTORS WAY OF
CONCEPTUALIZING AND CATEGORIZING
NEW ILLNESSES. THIS IS A SLIDE
FROM ONE SUCH CONTINUING
EDUCATION LECTURE COURSE ON
ANOREXIA NERVOSA. THIS SLIDE
OFFERS DOCTORS A DIAGRAM,
PICTORIAL REPRESENTATION OF THE
DISEASE ITSELF. AS YOU CAN SEE
THE LECTURER, A WELL KNOWN
BRITISH PSYCHIATRIST, DR. ROSS
MITCHELL, SUGGESTS THAT DOCTORS
CONCEPTUALIZE ANOREXIA AS A
CYCLE. IN WHICH STARVATION IS
BOTH CAUSE AND AFFECT OF
ANOREXIA. AND JUST TO WALK YOU
THROUGH THE SLIDE. AT THE TOP OF
THE CIRCLE IS STARVATION, WHICH
LEADS TO PHYSICAL REGRESSION,
WHICH LEADS TO SENSE OF CONTROL,
WHICH LEADS TO AUTONOMY AND
SECURITY, WHICH LEADS TO
RESISTANCE TO CHANGE, WHICH THEN
IN TURN LEADS BACK TO FURTHER
STARVATION. THE DRIVE ON THE
PART OF MEDICAL EDUCATION TO
ENABLE DOCTORS TO VISUALIZE
DISEASE IS ESPECIALLY COMPLEX
MANY THE CASE OF MENTAL ILLNESS
AND PARTICULARLY FRAUGHT I ARGUE
IN THE CASE OF EATING DISORDERS
WHICH TEND TO BE OVERLY FIXATED
ON THE APPEARANCE OF THE BODY.
SO I'M PARTICULARLY INTERESTED
IN THE WAYS IN WHICH DISCOURSES
OF VISUALITY SHAPED THE EATING
DISORDER EPIDEMIC AT THIS TIME.
AS WELL AS PROVIDING
PRACTITIONERS WITH WAYS OF
CATEGORIZING AND CONCEPTUALIZING
ANOREXIA, MEDICAL EDUCATION ALSO
TOLD DOCTORS WHAT TO EXPECT WHEN
DEALING WITH THIS NEW ENANYTHING
MATTIC AFFLICTION. ENIGMATIC
AFFLICTION. LIKE THE FILMS AND
ADVERTISEMENTS, MEDICAL
EDUCATION MATERIAL RELIES ON
STANDARDIZED DESCRIPTIONS OF TIP
ANOREXIA PATIENT. BY THOSE
EXPLICITLY AND IMPLICITLY TEACH
DONGS TOKER WHAT KINDS OF PEOPLE
ARE LIKELY TO DEVELOP A DISEASE,
MEDICAL EDUCATION INFLUENCES
DIAGNOSIS AND TREATMENT. ONE
EXAMPLE HOW DOCTORS WERE TAUGHT
TO SEE ANOREXIA, I WANT TO SHOW
A FEW SLIDES FROM A DIFFERENT
SERIES OF LECTURES ON ANOREXIA
NERVOSA. ONE LECTURER OPENS WITH
THIS SLIDE. THE NARRATING
PSYCHIATRIST BEGINS HIS LECTURE
BY DESCRIBING QUOTE A YOUNG GIRL
WHOM WE WILL CALL ALICE. ALICE
CAME TO US ON EASTER SUNDAY.
SHE WAILINGED 40 POUNDS AND WAS
SEVERELY MAL NOURISHED, BARELY
WALK AND WAS SO WEAK SHE COULD
NOT SWALLOW. AFTER 45 MINUTE
DISCUSSION OF SYMPTOMS AND SOME
THEORIES OF ETIOLOGY THE LECTURE
ENDS WITH SLIDE 15. THIS IMAGE
OF BLONDE AND BLUE EYED ALICE
BEAUTIFULLY DRESSED IN ELABORATE
BLUE GOWN SITTING UP AND LOOKING
STRAIGHT INTO THE AUDIENCE'S
EYES WITH A SMALL SMILE ON HER
FACE, IS DISPLAYED WITH THE
TRIUMPHANT NARRATION, YOU SEE,
IT IS ALL WORTH IT. HERE SHE
WEIGHS 80 POUNDS, HAPPY CHEERFUL
AND DOOING WELL. -- DOING WELL.
THIS STORY OF MEDICAL
RESURRECTION THE PATIENT ENTERED
THE HOSPITAL ON EASTER SUNDAY,
ALIGNING THE SUFFERING OF ALICE
WITH THE SUFFERING OF JESUS
CHIAS UNDERSCORES THE INNOCENCE
AND ETHICAL VALUE OF THE
ANOREXIC. THESE IMAGES ALSO OF
COURSE DEPICT THE ANOREXIC AS
WHITE FEMALE CHRISTIAN AND
MIDDLE CLASS. THE MEDICAL
CONSTRUCTION OF THE AVERAGE OR
TYPICAL ANOREXIC PATIENT ON THE
ONE HAND INSISTED THAT SHE WAS
WHITE, WELL EDUCATE AND
PROSPEROUS. PRACTITIONERS WERE
ALWAYS HOWEVER WARNED OF THE
UNIQUE AND PROFOUND DIFFICULTIES
THAT ACCOMPANY TREATING THIS
PARTICULAR ILLNESS. DESPITE OR
PERHAPS BECAUSE OF THE FACT THAT
THESE PATIENTS WERE SO PERFECT
ANOREXIA WAS DESCRIBED AS THE
MOST DIFFICULT UNPLEASANT AND
FRUSTRATING MENTAL ILLNESS TO
TREAT. THE ANOREXIC IF I RECALL
WAS PRESENTED AS A COMPLEX
DUALITY, SIMULTANEOUSLY THE BEST
LITTLE GIRL IN THE WORLDED AND A
DECEPTIVE VIOLENT UNRESPONSIVE
MANIPULATIVE OFTEN DISGUSTING
AND HOSTILE PATIENT. DR.
MITCHELL'S LECTURE TAUGHT
MEDICAL PERSONNEL TO ANTICIPATE
WHAT HE TERMED QUOTE, THE
ANOREXIC BATTLE. A CONSTANT
EXCHANGING BETWEEN DOCTOR, NURSE
AND PATIENT THAT ALWAYS FOLLOWS
THE SAME PATTERN. AND I'M JUST
GOING TO NARRATE WHAT THE SLIDE
TEACHES. SO THIS IS A DIALOGUE
BETWEEN DOCTOR AND PATIENT. I
DON'T WANT TO PUT ON WEIGHT. YOU
ARE NOT AT ALL OVERWEIGHT. I
WANT TO LOSE WEIGHT. YOU ARE
LOSING TOO MUCH AND YOU ARE ILL.
I DON'T WANT TO EAT. YOU MUSTS
EAT NOW. I WON'T LET YOU FORCE
ME. HOW CAN WE MAKE HER EAT? IN
PARTICULAR THIS LAST EXCHANGING
HIGHLIGHTS THE PROFOUND POWER
STRUGGLE THAT WAS BEING TAUGHT
AS CENTRAL TO THE ANOREXIC
BATTLE. OF COURSE THE PROFOUND
POWER IMBALANCE. IN ADDITION TO
FORMAL TRAINING LECTURES,
MAGAZINES FROM MEDICAL WORKERS
WERE IMPORTANT WAYS TO INTRODUCE
NEW OR CUTTING EDGE DEVELOPMENTS
IN THE FIELD. IN 1978 ARTICLE
FROM THE PROFESSIONAL MAGAZINE
MD WHICH OBVIOUSLY IS TARGETING
DOCTORS, EXPLAINED THAT QUOTE,
INDIVIDUALS WITH ANOREXIA
NERVOSA ARE AMONG THE MOST
FRUSTRATING PATIENTS PHYSICIANS
WILL EVER HAVE TO DEAL.
EXCEEDINGLY DIFFICULT FOR
PHYSICIANS TO GAIN COOPERATION
FROM ANOREXIC PATIENTS SINCE
THEY TEND TO DENY THE PRESENCE
OF ANY ILLNESS AND REJECT THE
PHYSICIAN'S HELPING EFFORTS. NOW
I WANT TO MOVE AWAY FROM THE
FORMAL MEDICAL ESTABLISHMENT AND
TALK ABOUT ANOTHER MAJOR PLAYER
IN THE CONSTRUCTION OF
UNARCHIVED ANOREXIA. SECOND WAVE
FEMINIST. THE FACT A NEW DEADLY
WOMAN'S DISEASE WAS EMERGING AT
A MOMENT WHEN WOMEN'S RIGHTS AND
LIVES WERE UNDERGOING RADICAL
CHANGE STRUCK EVERYONE AS
SIGNIFICANT. IT SEEMED OBVIOUS
TO BOTH MEDICAL EXPERTS AND LAY
PEOPLE THAT ANOREXIA MUST IN
SOME WAY BE CONNECTED TO SECOND
WAVE FEMINISM. DR. HILDA BROOK
THE AUTHOR OF THE GOLDEN CAGE,
HAD POSIT AD RELATIONSHIP
BETWEEN ANOREXIA AND POST WAR
FEMINISM WITH A WIDELY CITED
HYPOTHESIS THAT FEMINISM BY
INCREASING THE AMBITIONS OF
YOUNG WOMEN TO IMPOSSIBLE LEVEL,
WAS RESPONSIBLE FOR THE GROWTH
OF ANOREXIA. IN AN INTERVIEW
WITH THE NIMH, BROOK CLAIMED
THAT QUOTE, WOMEN EASILY HAD LET
TO AN EMPHASIS ON ACHIEVEMENT OF
WOMEN WHICH PRESENTS AN
UNBEARABLE CHALLENGE TO THESE
UNOVERCONFORMING YOUNGSTERS.
SECOND WAVE FEMINISTS THEMSELVES
FRAMED ANOREXIA AS A POTENT
SYMBOL OF THE STATE OF MODERN
WOMAN HOOD AND FEMALE
OPPRESSION. FOCUSING ON GENDER
FORMS OF OPPRESSION CAUSED BY
POST WAR CONSUMER CAPITALISM
PARTICULARLY THE PRESSURES OF
UNATTAINABLE BEAUTY NORMS AND
SOCIETAL AMBIVALENCE AROUND
FEMALE CONSUMPTION. TITLES LIKE
PHILOSOPHER SUSAN'S PATH
BREAKING ESSAY, ANOREXIA NERVOSA
PSYCHOPATHOLOGY AS
CRYSTALLIZATION OF CULTURE, OR
SHOWN HERE ON YOUR SCREEN,
PSYCHOANALYST SUSIE BEST SELLING
HUNGER STRIKE THE ANOREXIC'S
STRUGGLE METS FOR FOR OUR AGE,
RELIED UPON ANOREXIA FOR
UNDERSTANDING THE RELATIONSHIP
BETWEEN WOMEN AN POST WAR
MODERNITY. ULTIMATELY THESE
CONTRADICTORY NARRATIVES THAT
FEMINISM BY INCREASING PRESSURE
AND ENCOURAGING AMBITION WAS A
CAUSE OF EATING DISORDERS AND
THE FEMINIST REPRESENTED A
COUNTER WEIGHT EVEN A POSSIBLE
SOLUTION TO THE SOCIAL CRISIS
REPRESENTED BY ANOREXIA OR BOTH
ACCEPTED INTO MEDICAL AND
POPULAR UNDERSTANDINGS OF THE
ILLNESS AND OFTEN SIMULTANEOUSLY
IN THE SAME LITERATURE. FEMINIST
WRITING DIDN'T JUST PROVIDE
THEORETICAL PARADIGMS FOR
EXPLAINING ANOREXIA AND OTHER
DISORDERS. THE VAST
INFRASTRUCTURE OF EATING
DISORDER SUPPORT GROUPS THAT
BEGAN EMERGING DURING THE LATE
1970s WERE DIRECTLY RELATED TO
GRASSROOTS WOMEN'S HEALTH AND
EDUCATION MOVEMENTS OF SECOND
WAVE FEMINISM. WOMAN LED SUPPORT
GROUPS WERE IMPORTANT FOR EATING
DISORDERS BECAUSE OF THE SUDDEN
AND EXTREME GROWTH IN BOTH
DIAGNOSES AND AWARENESS CREATING
LARGE NUMBERS OF PATIENTS FAMILY
AND FRIENDS WITHOUT ANY
INFRASTRUCTURE FOR SUPPORT.
EARLY ON THESE GROUPS WERE
INFORMAL AND POORLY FUNDED. THIS
IN THE MIDDLE OF THE SCREEN IS
EARLY STAPLED NEWS LETTER FROM A
REGIONAL SUPPORT GROUP WHICH
INCLUDED CAREFULLY CURE ATED
TYPED LISTS OF DOCTORS ACROSS
THE COUNTRY. SO AT THIS POINT
THERE WERE SO FEW SPECIALISTS IN
EATING DISORDERS THEY WERE ONE
BY ONE GATHERED AND TYPED UP ON
CIRCULATING LISTS SO IF SOMEBODY
NEEDED -- WITH PHONE NUMBERS SO
YOU CAN IS HAVE AN EXPERT TO
CALL IN CALIFORNIA OR ARIZONA
OREGON, PENNSYLVANIA, ET CETERA
BY THE MID 1980s HOWEVER MANY
OF THESE GROUPS HAD BECOME
NATIONAL IN SCOPE, SOME BOASTING
DOZENS OF LOCAL BRANCHES. ONE
OF THE MOSTEN INFLUENTIAL WAS
THE ANOREXIA AID SOCIETY. THEY
EXPLAINED THEIR PURPOSE IN THEIR
OWN PROGRAM LETS. YOU ARE NOT A
RESEARCH CENTER OR HOSPITAL
CLINIC, WHAT ARE YOU?
UNTIL THE LEVERAGE RESEARCH IS
TALLIED, ANAS AND SIMILAR
SELF-HELP ORGANIZATIONS ACROSS
THE COUNTRY WILL SPEND TIME ON
THE CONNECTIONS GETTING TOGETHER
THOSE WHO ARE SEEKING SUPPORT
WITH THOSE WHO ARE ABLE TO GIVE
IT. THESE GROUP -- THESE SUCH
GROUPS TOOK ON A WIDE ARRAY OF
TASKS.S. MOST AUTHORED REFERRAS
TO CLINICS AND PHYSICIANS,
SUPPORT GROUPS FOR ANOREXIA AND
BULIMIA AND THEIR FAMILIES AN
REFERENCE LISTS OF BOOKS AND
ARTICLES. SOME EXPERIMENTED ARE
IDEAS RANGING FROM INTERACTIVE
PREVENTION PROGRAM WITH LIFE
SIZE PUPPETS TO LECTURES ON
INAPPROPRIATE ADVERTISING.
INITIATING SPEAK OUTS OR LETTER
WRITING CAMPAIGNS. SUCH FORMS OF
CONSCIOUSNESS RAISING IN WOMEN'S
SELF-HELP WERE INDEBTED TO
SECOND WAVE FEMINIST TECHNIQUES
OF EDUCATION AS WELL AS FEMINIST
INTERPRETATIONS OF EATING
DISORDERS EVEN IF MANY LARGEST
AND SUCCESSFUL OF THE
ORGANIZATIONS DID NOT EXPLICITLY
FRAME THE THEMSELVES IN FEMINIST
TERMS. WHAT I HAVE DONE UP TO
NOW IS HIGHLIGHT CENTRAL VOICES
OR CONSTITUENT SAYS
PARTICIPATING IN THE
CONSTRUCTION OF THIS ANOREXIA
EPIDEMIC. BUT I WANTED TO
UNDERSCORE THE FACT THAT
KNOWLEDGE ABOUT EATING DISORDERS
CIRCULATED IN A REMARKABLE
VARIETY OF WAYS AND WHAT I WANT
TO DO IS EMPHASIZE THE DIVERSITY
OF GENRES AN AUDIENCES THAT ARE
BEING TARGETED AND AT THE SAME
TIME JUNE FORMTY OF THE
INFORMATION THAT IS BEING
COMMUNE -- UNIFORMITY OF THE
INFORMATION COMMUNICATED SO BOTH
DIVERSITY AND UNIFORMITY I FINDS
COMPELLING. TO WALK YOU LIEU THE
SOURCE, ON THE LEFT IS A FLYER
FOR A MEDICAL WORKSHOP HOSTED AT
HARVARD, MEDICAL PRACTITIONERS
PRIMARILY DOCTORS PSYCHIATRISTS
PSYCHOLOGISTS, AND NURSES, CAN
GATHER FOR A WEEKEND TO LEARN
ABOUT ANOREXIA AND BULIMIA. NEXT
TO THAT IS A BOOK TARGETING
PARENTS A GUIDE THE EATING
DISORDERS FOR PARENTS. THERE
WERE MANY SUCH BOOKS FOR
SPECIFIC CATEGORIES OF PEOPLE,
PATIENTS, PARENTS, FRIENDS,
BOYFRIENDS, GIRLFRIENDS, ET
CETERA, ET CETERA. THEN THIS IS
A FLYER FOR A TELECONFERENCE FOR
NON-MEDICAL PROFESSIONALS SO
THIS IS PARTICULARLY TARGETING
SCHOOLTEACHERS, COUNSELORS,
ADMINISTRATION, PEOPLE WHO ARE
INTERESTED IN LEARNING ABOUT
EATING DISORDERS BUT ARE NOT
TREATING PEOPLE DIRECTLY AND
FINALLY ON THE RIGHT IS A FREE
COMMUNITY TALK FOR ANYONE IN THE
COMMUNITY INTERESTED IN
LEARNING. OF COURSE THE PRESS
PLAYED AN IMPORTANT ROLE IN
SUPPORTING THIS CIRCULATION OF
KNOWLEDGE. AS NEWSPAPERS ACROSS
THE COUNTRY REPORTED REGULARLY
ON HE IS ILLNESSES, ECHOING AND
REINFORCING MEDICAL AND LAY
PERSPECTIVES. AMERICAN MEDIA
NOT ONLY CONFIRMED WHAT PATIENTS
AN DISEASES LOOKED LIKE, BUT
CREATED THE SENSE OF AN
IMMEDIATE AND PRESSING CRISIS IN
WHICH EATING DISORDERS WERE ONE
OF THE LARGEST THREATS FACING
AMERICAN YOUTH AND THUS AMERICAN
PARENTS. THIS 1986 ANNOUNCEMENT
IN THE NEW YORK TIMES DESCRIBES
THE THREE MAJOR THREATS FACING
TEENAGERS AS DRUGS, SUICIDE AND
EATING DISORDERS. AND WHAT
LINKSES THEM ALL IS BOTH THE
FACT THEY ARE INVISIBLE TO
PARENTS, THAT PARENTS WON'T KNOW
THEY EXIST, AND THAT THEY ARE
DEADLY. THIS IS OF COURSE A
REMARKABLE PERSPECTIVE
CONSIDERING THE FACT THAT A
DECADE AGO THE VAST MAJORITY OF
AMERICANS HAD NEVER EVEN HEARD
OF EATING DISORDERS. I TRIED TO
LAY OUT THE MULTIPLE DISCOURSES
AROUND ANOREXIA THAT CO-EXISTED
AND INTERSECTED AT THIS TIME.
THE MEDICAL, THE POPULAR AND
FEMINIST. ABOVE ALL WHAT I WANT
TO HIGHLIGHT IS NOT THE FACT
THAT THESE MULTIPLE DISCURSIVE
LEVELS EXIST, ALL MAJOR SOCIAL
CONVERSATIONS TAKE PART IN
MULTIPLE REGISTERS. BUT THAT
THEY WERE ALL MUTUALLY
REINFORCING ENSURING REMARKABLY
SMOOTH AND UNCONTESTED PATH
FORWARD CONSENSUS. MANY DISEASES
OF COURSE UNDERDISCUSSED OR
IGNORED. STILL OTHERS ARE
HEAVILY CONTESTED WITH RADICALLY
DISPARATE OR OPPOSING CLAIMS
ABOUT CAUSE, SYMPTOMOLOGY OR
TREATMENT. TO GIVE ONE DRAMATIC
EXAMPLE, THE AIDS EPIDEMIC THAT
EMERGED PUBLIC HEALTH THREAT AT
THE SAME TIME EATING DISORDERS
WERE CLAIMING A LARGE PART OF
AMERICAN CONSCIOUSNESS WAS THE
SUBJECT OF INCREDIBLE CONTENTION
AND HOSTILITY AT ALL LEVELS OF
AMERICAN SOCIETIES. IN CONTRAST
BY THE LATE 1980s, EATING
DISORDER SUPPORT GROUPS BEGAN
LOBBYING CONGRESS TO INCREASE
AWARENESS OF EATK DISORDERS BY
DESIGNATED A NATIONAL EATING
DISORDERS AWARENESS WEEK. THERE
WAS NO OPPOSITION. THE BILL
SPONSORED BY NEW YORK
CONGRESSMAN HAMILTON FISH JR.
WAS APPROVED BY CONGRESS IN
1991. IT STATED QUOTE, WHEREAS
ANOREXIA NERVOSA ALSO KNOWN AS
STARVATION SICKNESS, AND
BULIMIA, ALSO KNOWN AS BINGE
PURGE SYNDROME, COLLECTIVELY
KNOWN AS EALING DISORDERS ARE
EMOTIONAL DISORDERS THAT CAN
LEAD TO SERIOUS PHYSICAL ILLNESS
AND EVEN DEATH, WHEREAS EXPERTS
ESTIMATE ONE OUT OF EVERY 100
WOMEN BETWEEN AGE OF 12 AND 25
SUFFERS FROM ANOREXIA NERVOSA
AND ONE OUT OF EVERY 7 WOMEN IN
THAT AGE GROUP DEVELOPS BULIMIA,
AND WHEREAS PUBLIC AWARENESS
ABOUT THE PERSONAL AND FAMILIAL
TRAGEDIES CAUSED BY ANOREXIA AND
BULIMIA MUST BE RAISED IN ORDER
TO PROMOTE CONTINUED RESEARCH
INTO THE CAUSES AND TREATMENTS
OF THESE AND OTHER EATING
DISORDERS, NOW, THEREFORE BE IT
RESOLVED BY THE SENATE AND HOUSE
OF REPRESENTATIVES OF THE UNITED
STATES OF AMERICA IN CONGRESS
ASSEMBLED THAT THE WEEK OF
FEBRUARY 2ND THROUGH FEBRUARY 8
BE DESIGNATED EATING DISORDERS
AWARENESS WEEK. THIS WEEK IS
STILL FEDERALLY OBSERVED THOUGH
IT IS MOVED SLIGHTLY LATER INC
CALENDAR AND NOW BEING
CELEBRATED DURING THE LAST WEEK
OF FEBRUARY. THE SAME YEAR THIS
BILL WAS PASSED PRESIDENT GEORGE
BUSH DESIGNATED THE BOSTON BASED
EITHER DISORDER SUPPORT GROUP A
B C OR ANOREXIA BULIMIA CARE, AS
ONE OF THE COUNTRY'S 1,000
POINTS OF LIGHT. A PROGRAM THAT
HE INITIATED TO PROMOTE PRIVATE
NON-GOVERNMENTAL SOLUTIONS TO
PRESSING SOCIAL ISSUES. THE
OFFICIAL ANNOUNCEMENT STATED
QUOTE, THE MUTUAL SUPPORT AND
CARE PROVIDED BY THE VOLUNTEERS
OF ABC HAVE SPAWNED NEW HOPE FOR
THE ESTIMATED 1 OUT OF 5 COLLEGE
AGE WOMEN WHO SUFFER FROM THESE
DREADFUL DISORDERS. BECAUSE OF
ABC'S OUTREACH TO THE COMMUNITY,
MORE INDIVIDUALS NOW UNDERSTAND
THE GREAT IMPLICATIONS OF EATING
DISORDERS AND THE NEED TO
ADDRESS THIS PROBLEM. I WANT TO
END THIS DISCUSSION OF ANOREXIA
WITH A SHORT VIDEO CLIP, THIS IS
FROM ONE OF MY FAVORITE SOURCES
FROM THE NATIONAL LIBRARY OF
MEDICINE. AN EDUCATIONAL FILM ON
ANOREXIA FOR NURSES, TITLED
DYING TO BE THIN. THE MOVIE
ITSELF IS CONVENTIONAL FOR ITS
GENRE, MADE OF PRIMARILY SHORT
INFORMATIVE INTERVIEWS WITH
PATIENTS, HAIR PARENTS AND
DOCTORS. IT MAKES A POINT OF
BEING ALMOST BRUTALLY REALISTIC
EMPHASIZING HOW DIFFICULT AND
OFTEN UNSUCCESSFUL TREATMENT IS.
THE MOVIE INCLUDES PATIENTS WHO
DID NOT RESPOND SUCCESSFULLY TO
TREATMENT AND ONE PATIENT WHO
DIES OF ANOREXIA. AND
UNDERSCORES THE TRAUMA CAUSED BY
THE DISEASE FOR PATIENTS THEIR
FAMILIES AND MEDICAL PERSONNEL
WHO CARE FOR THEM. YET THE FILM
TAKES A BREAK FROM A SERIES OF
SOMBER TALKING HEADS AND YOU CAN
SEE HERE SOME SLIDES I HAVE MADE
FROM THE FILM, FOR A MUSIC VIDEO
ABOUT ANOREXIA WHICH IS WHAT I
WANT TO SHOW NOW. THIS VIDEO I
THINK REALLY ILLUSTRATES THE
WAYS IN WHICH FEMINISM POP
CULTURE AND MEDICAL PROFESSION
CAME TOGETHER IN THE
CONSTRUCTION OF A PARTICULAR
ITERATION OF ANOREXIA NERVOSA.
♪ DYING TO BE THIN, DYING TO BE
THIN, EVERYBODY IS GOING TO LOVE
ME WHEN I'M NOTHING BY SKIN. FAT
FAT FAT, GOODBYE FAT, I'M GOING
TO LOOK HEALTHY WHEN MY TUMMY IS
FLAT ♪ I WANT TO BE LOOK LIKE
THE LADY IN THE AD WHERE THE
LITTLE TINY GOING TO BE SO BAD.
EVERYBODY IS SKINNY THIGHS AND
MY BIG SEXY SONG AND I ♪
♪ TOUGH TOUGH TOUGH, GOT TO GET
TOUGH SO I PUNISH MY BODY BUT
NEVER ENOUGH, DYING TO BE THIN,
DYING TO BE THIN, EVERYBODY IS
GOING TO LOVE ME WHEN I'M
NOTHING BUT SKIN. MANIAC.
MANIAC. I WANT TO BE YOUNG AND I
WANT TO BE SWEET, I WANT TO BE
SPECIAL SO I DON'T WANT TO EAT.
I'M GOING ON A FAST, I'M GOING
ON DIET AND YOU CAN'T STOP ME SO
YOU BETTER NOT TRY IT. ♪ YOU
LOOK SIMPLY MARVELOUS, ENTETE
SWEAT SWEAT, GOT LOST A COUPLE
POUNDS BUT NOT THERE YET. WEIGHT
WEIGHT WEIGHT, GOT TO LOSE
WEIGHT. I STARVE MYSELF AND THEN
I CELEBRATE. IT LOOKS SO GOOD ♪
DRINKING DIET ROOT BEER, LICKING
DIET ICE CREAM COOL AND SWEET,
SUCKING DIET CANDY BUT I GOT TO
STAY THIN SO I THROW IT ALL OUT
AND START MY DIET AGAIN ♪ SICK
SICK SICK, I'M A WILL I WILL BIT
SICK BUT WHEN I'M GOING TO LOOK
SLICK. DYING TO BE THIN, DYING
TO BE THIN, EVERYBODY IS GOING
TO LOVE ME WHEN I'M NOTHING BUT
SKIN ♪ I WANT TO BE BEAUTIFUL
AND HAPPY AND SUCCESSFUL ♪ IF
IT'S THE LAST THING I DO. DYING
TO BE THIN, DYING ♪
>> ALL RIGHT. VERY INTERESTING
MOVIE. I NOW WANT TO SHIFT GEARS
AND BRIEFRY DESCRIBE A DIFFERENT
ECONOMY OR ARCHIVE OF EATING
DISORDERS. ONE THAT EMERGED ON
AMERICAN CAMPUSES AND THAT WAS
FOCUSED NOT ON ANOREXIA BUT ON
BULIMIA NERVOSA. I WILL DISCUSS
THE WAYS SOCIAL SCIENTISTS,
STUDENTS AND COLLEGE
ADMINISTRATORS CAME TOGETHER TO
IDENTIFY, DOCUMENT AND TREAT A
NEW AND PRESSING THREAT. AGAIN,
MY EMPHASIS IS ON SIMULTANEOUS
AND CONSENSUS. THIS PARTICULAR
STORY IS PART OF A LARGER SHIFT
IN HISTORY OF HIGHER EDUCATION.
1980 MARKED THE BEGINNING OF THE
FEMMIZATION OF COLLEGE CAMPUSES
AND FEMALE UNDERGRADUATES FIRST
OUTNUMBERED MEN. YOUNG WOMEN'S
RECORD RATES OF ENROLLMENT WAS
SEEN AS CAUSE AND PROOF OF
GENDER EQUALITY. YET AS
CONVERSATIONS AROUND EATING
DISORDERS REVEAL, THIS FEMINISM
OF HIGHER EDUCATION CAUSED A
GREAT DEAL OF CONCERN AS WELL.
THIS CARTOON FROM THE DARTMOUTH
STUDENT NEWSPAPER CAPTURES THESE
TENSIONS WELL. SHOW AS MEET
INCOME A SORORITY HOUSE WHERE
SISTER NOTES HOW UNUSUALLY
SKINNY ALL HER SISTERS ARE. SHE
SAYS I'M HEALTHY BUT NEXT TO A
LOT OF YOU I FEEL FAT. WHAT THE
HELL IS GOING ON? THEN BUN
SISTER STAND UP AND SAYS WE ARE
HAVING IT ALL, BEAUTY,
INTELLIGENCE, WEALTH AND ABOVE
ALL, THINNESS. WE ARE WOMEN OF
THE '80s. THEN ALL OF THE
OTHER SISTERS SAY SURE, I WEIGH
85. I'M 84. 82. SO ON.
>> GIVEN THE FACT INTELLIGENT
AMBITIOUS AND HIGHLY EDUCATED
WOMEN WERE THE ONES WHO WERE
SUPPOSED TO DEVELOP EATING
DISORDERS IT SEEMS LOGICAL
COLLEGES AN UNIVERSITIES MIGHT
HAVE A DISPROPORTIONATE NUMBER
OF ANOREXICS. HOWEVER IT WAS
NOT ANOREXIA BUT BULIMIA THAT
EMERGED AS THE FOCUS OF EATING
DISORDERS DISCOURSE ON AMERICAN
CAMPUSES. BEFORE I GO ON I WANT
TO BRIEFLY DISCUSS THE HISTORY
OF BULIMIA NERVOSA UNLIKE
ANOREXIA WHICH WAS CLINICALLY
DESCRIBED IN 19TH CENTURY
BULIMIA A PATTERN OF ALTERNATE
BINGING AND PURGING BY VOMIT
PREGNANT OR LACKSTIVE USE WAS
NOT FORMULATED AS A DISTINCT
MEDICAL DIAGNOSIS UNTIL 1978.
THOUGH IT WAS INITIALLY
CONCEPTUALIZED AS A VARIANT OF
ANOREXIA, AN OFTEN CALLED
BULIMIAREXIA IT BECAME A
SIGNIFICANT DIAGNOSIS IN ITS OWN
RIGHT. AND ALSO BECAME
ASSOCIATED WITH ITS OWN DISTINCT
DEMOGRAPHIC WHICH IS THE STORY I
WILL BE DISCUSSING FOR THE REST
OF MY TALK. THE ASSOCIATION OF
AMERICAN COLLEGES AND
UNIVERSITIES WITH EATING
DISORDERS CAN BE TRACED TO THE
BULIMIA STUDY OF 1982, A WIDELY
CITED STUDY INITIATED BY
RADCLIFFE'S ASSOCIATE DEAN NORMA
WARE PICTURED HERE, A MEDICAL
ANTHROPOLOGIST WITH A PARTICULAR
INTEREST IN QUANTIFYING THE
EXPERIENCES OF HARVARD'SER
FEMALE STUDENTS. THAT IN FACT
WAS HER JOB TO QUANTIFY THESE
NEW FEMALE STUDENTS OF HARVARD.
IN 1981 DEAN WARE WAS AWARDED A
LARGE NSF GRANT TO RUN WHAT WAS
TO BECOME THE RADCLIFFE BULIMIA
STUDY. AN ELABORATE MULTI-STAGE
PROJECT. THE FIRST STEP ALONE
INVOLVED SENDING QUESTIONNAIRES
TO 400 WOMEN AND 200 MEN FROM
BOTH THE SENIOR AND FRESHMAN
CLASSES. THIS INITIAL DATA
REVEALED QUOTE, THAT A SEVERE
PREOCCUPATION WITH WEIGHT AND
EATING HABITS IS WIDESPREAD
AMONG COLLEGE WOMEN. FOLLOW-UP
INTERVIEWS MEDICAL EXAMINATIONS,
DOUBLE BLIND STUDIES AND
ELABORATE DATA CRUNCHING AND
THIS STUDY I SHOULD SAY HAS
UNBELIEVABLE INTERNAL ARCHIVE,
VAST AMOUNTS, VAST NUMBERS OF
FILES WENT OVER MANY YEARS UNTIL
THE RESULTS WERE OFFICIALLY
FIRST PUBLISHED. THIS IS THE
QUOTE, USING RIGOROUS DSM 3
CRITERIA, 8% OF COLLEGE WOMEN
AND .7 OF COLLEGE MEN ARE
CLASSIFIED AS BULIMIC. THESE
DRAMATIC NUMBERS WERE
IMMEDIATELY AND WIDELY
CIRCULATED. AND HERE ARE THE
DATA IS BEING ISSUED A AS PUBLIC
HEALTH BRIEF AND CIRCULATED ALL
KINDS OF VENUES I. TRIGGERED A
REMARKABLE DOMINO AFFECT AS
OTHER SCHOOLS RAN ANALOGOUS
STUDIES. THIS HAPPENED FIRST IN
OTHER ELITE SCHOOLS. UNIVERSITY
OF PENNSYLVANIA REPORTED THAT
QUOTE, MORE THAN 21% OF ITS
FEMALE UNDERGRADUATES HAD
BULIMIA. A DISEASE WHICH THE
REPORT CLAIMED OFTEN STRIKES
WOMEN WHO ARE INTELLIGENT,
ACHIEVEMENT ORIENTED, AND FROM
UPPER MIDDLE CLASS SEEMINGLY
PERFECT FAMILIES. THE IVY LEAGUE
IN GENERAL PROBABLY HAS MORE
THAN A NORMAL SHARE OF BULIMICS.
IN A STANDING ROOM ONLY TALK AT
DARTMOUTH, THE FAMED HISTORIAN
OF ANOREXIA, JOAN BRUMEBURG
NOTED THAT QUOTE, THE ONES MOST
AT RISK ARE THE ONES IN THIS
AUDIENCE. THE HIGHER THE
TUITION, THE MORE THE EATING
DISORDERS. CLOSE QUOTE. IN FACT,
SURVEYS OF COLLEGE AGE STUDENTS
ACROSS THE COUNTRY REFLECTED
SIMILAR RATES OF EATING
DISORDERS AND ET CETERA
SPECIALLY BULIMIA. ELITE AND I
VIE LEAGUE UNIVERSITIES DID NOT
HAVE MEANINGLY HIGHER RATES THAN
SMALLER CHRISTIAN OR RURAL OR
STATE SCHOOLS EVEN HBCUs HAD
HIGH RATES OF DISTURBED EATING
DESPITE THE UNIVERSAL CLAIMS
THAT THIS WAS A WHITE PROBLEM,
SPECIFICALLY AFRICAN AMERICAN
COLLEGES DISPLAYED MUCH LOWER
RATES OF ANOREXIA BUT SIMILAR
RATES OF BULIMIA AND OTHER FORMS
OF DISORDERED EATING. THIS
CONVERSATION ALMOST IMMEDIATELY
REACHED BEYOND THE WORLD OF
HIGHER EDUCATION. NOT ONLY
NATIONAL AND LOCAL NEWSPAPERS
BUT POPULAR TEEN AND WOMEN'S
MAGAZINES INCLUDING COSMOPOLITAN
AND MOD MAY SEVERAL REACHED OUT
TO DEAN WARE TO WRITE ARTICLES
ABOUT THE RESULTS OF THE STUDY
TEACHING MOTHERS AND DAUGHTERS
ABOUT THE CONNECTION BETWEEN
BULIMIA AND COLLEGE CAMPUSES.
THIS CAREFUL DOCUMENTATION OF
THE UBIQUITY OF EATING DISORDERS
ON COLLEGE CAMPUSES TOOK PLACE
ALONGSIDE INTENSIVE PROGRAM OF
EDUCATION AIMED AT STUDENTS
THEMSELVES, ABOUT THESE
ILLNESSES. MOST AIMED TO TEACH
STUDENTS QUOTE, THE SYMPTOMS OF
BULIMIA. AN EATING DISORDER
GATHERING INCREASING ATTENTION
PARTICULARLY ON COLLEGE
CAMPUSES, CLOSE QUOTE. SO I'M
GOING TO BE READING QUOTE FROM
ASSORTMENT OF THESE STUDENT MADE
EDUCATIONAL PAMPHLETS TO GIVE A
SENSE OF THE DISCOURSE OF THEM.
ECHOING THE FEMINIST LOGIC THAT
FRAMED THE RISE OF ANOREXIA
SELF-HELP GROUPS MANY STUDENTS
SUPPORT GROUPS AND PUBLICATIONS
EMPHASIZEDDED SAMENESS AND
SOLIDARITY, QUOTE, A PERSON
SUFFERING FROM BULIMIA THINKS
SHE IS A FREAK. . THIS IS WHY A
GROUP OF US CAME TOGETHER TO
WRITE THIS BOOKLET, WE KNOW HOW
A PERSON WITH BULIMIA FEELS
BECAUSE WE OURSES ARE BULIMIC.
WHILE AT THE SAME TIME THIS
LITERATURE REITERATES DISCOURSES
OF ELITISM AND SUPERIORITY THAT
SOCIAL SCIENTISTS STUDY THE
BULIMIA EPIDEMIC BORROWED FROM
ANOREXIA AT THIS COURSE. QUOTE,
WHO ARE WE? WE OFTEN COME FROM
FAMILIES WHO PRIZE PERFECTION
ACHIEVEMENT AND SUCCESS. WE ARE
GO GETTERS. WE SET UNDULY HIGH
STANDARDS FOR THE WAY WE LOOK
AND FEEL. WE FEEL A LOT OF
PRESSURE TO MEASURE P TO
SOCIETY'S STANDARDS FOR THE
IDEAL WOMAN. SUCCESSFUL,
POPULAR, TALENTED ATTRACTIVE AND
ABOVE ALL, SHE IS THIN. VARIOUS
CAMPUS ORGANIZATIONS ENCOURAGE
SELF-DIAGNOSIS IN OTHER WAYS.
STUDENTS WERE ASKED TO COMPLETE
SELF-ASSESSMENT SURVEYS. TO
MONITOR THEIR FEELINGS ABOUT
FOOD AND TO TRACK ANY
POTENTIALLY PROBLEMATIC
BEHAVIORS AROUND THEIR EATING.
THIS IS ONE SUCH SURVEY. EATING
DISORDERS SELF ASSESSMENT.
COLLEGES AND UNIVERSITIES WORKED
IMMEDIATELY RECOGNIZED AS A
MARKET FOR EATING DISORDER
MATERIALS SPECIFICALLY. AND THIS
IS A FLYER FOR A SMALL PRESS
THAT WAS DEDICATED EXCLUSIVELY
TO PRODUCING EDUCATIONAL EATING
DISORDER EDUCATIONAL MATERIALS
FOR COLLEGE STUDENTS. OF COURSE
THERE WERE DOZENS OF FILMS,
PROFESSIONAL AND INSPIRATIONAL
SPEAKERS FEMINIST SPEAKERS
CABARET GROUPS AND SO ON TO
EMERGE TO MEET THE NEEDS OF THE
NEW MARKET. AS STUDENTS
ESPECIALLY FEMALE STUDENTS, WERE
BEING INUNDATED WITH INFORMATION
ABOUT EATING DISORDERS, COLLEGE
ADMINISTRATORS WERE DEVELOPING A
FORMAL INFRASTRUCTURE FOR
TREATING THESE SUBSTANTIAL
NUMBERS OF SICK STUDENTS. NOW I
WANT TO SHOW A FEW IMAGES I
FOUND IN UNIVERSITY ARCHIVES
DEPICTING THE DIFFERENT
STRUCTURE DEVELOPED FOR EATING
DISORDER SUPPORT DURING THE
1980s. BOTH THE CHECKTY AND
VARIETY OF -- COLLECTTY AND
VARIETY OF WAYS SCHOOLS
ATTEMPTED TO DEAL WITH THIS NEW
CRISIS ARE REMARKABLE. AND I
WANT TO BRIEFLY HIGHLIGHTED THE
IMPORTANCE OF DARTMOUTH, JUST AS
IT HAD BEEN RADCLIFFE DEAN NORMA
WARE WHO INITIATED THE PROJECT
OF QUANTIFYING AND CIRCULATING
DATA ON COLLEGE EATING
DISORDERS, IT WAS THE DARTMOUTH
DEAN OF STUDENTS ED WAR SHAN
HAHN, ONE OF THE FIRST TO
DEDICATE HIS ADMINISTRATION TO
TACKLING THIS UNPRECEDENTED
PROBLEM. SHAN HAHN CAME TO
DARTMOUTH IN 1982, THE SAME YEAR
AS THE BULIMIA STUDY AND AS HE
NOTED IF THE 1989 LETTER TO A
COLLEAGUE, QUOTE, I HAVE BEEN
EXTREMELY VIGILANT AND CONCERNED
ABOUT THE ISSUE OF EATING
DISORDERS AT DARTMOUTH SINCE MY
ARRIVE. MANY IDEAS THAT I CAME
ACROSS IN COLLEGE AND UNIVERSITY
ARCHIVES FROM AROUND THE COUNTRY
I RECOGNIZED HAVING FIRST BEEN
DEVELOPED AT DARTMOUTH AND ONE
EXAMPLE IS ONE OF DARTMOUTH'S
PROGRAMS FOR WHAT THEY CALLED
EDPA, AN EATING DISORDER PEER
ADVISOR. AND THERE WERE REALLY
DOZENS OF DIFFERENT
INTERVENTIONS DEVELOPED AT
DARTMOUTH. DURING THESE YEARS.
CAMPUSES BEGAN TO REGULARLY
SURVEY INCOMING STUDENTS ABOUT
THEIR MENTAL HEALTH. ASKING IF
THEY HAD EVER SUSPECTED OR BEEN
TOLD YOU MIGHT HAVE AN EATING
DISORDER AND THEY WOULD
FOLLOW-UP ON THE RESULTS
ASSIGNING STUDENTS THERAPISTS OR
ENCOURAGING INTERVENTIONS.
COLLEGE HEALTH SERVICES BEGAN
DEVELOPING GUIDELINES NOT JUST
FOR DIAGNOSING ANOREXIA AND
BULIMIA BUT ESTABLISHING THE
POINT WHICH THEY WOULD REQUIRE
STUDENTS TO LEAVE CAMPUS AND
SEEK TREATMENT ELSEWHERE. SO
JUST ONE EXAMPLE, MIDDLE BURY
COLLEGE GUIDELINES REGARDING
PATIENT DIAGNOSED AS HAVING
SIGNIFICANT ANOREXIA NERVOSA
SPECIFIES IF THE STUDENTS DOES
NOT RESPOND TO PHONE CALLS,
LETTERS OF CORRESPONDENCE OR
MISS A MEDICAL APPOINTMENT WHEN
THEIR WEIGHT IS 80% OF THE
PRE-DETERMINED NORMAL WEIGHT,
STAFF WILL PROCEED AND
CONTACTING A PARENT WHICH
USUALLY INITIATES THE PROCESS OF
REMOVING THE STUDENT FROM
SCHOOL. SO WHAT I WANT TO
HIGHLIGHT IS NOT THE PROCESS
ITSELF BUT THE FACT THAT THESE
POLICIES WERE FOR THE FIRST TIME
BUREAUCRATICALLY BEING
CONSTRUCTED BY UNIVERSITIES AS A
RESPONSE TO THIS CRISIS. THERE
WERE CONFERENCES AND TRAINING
SESSIONS DEDICATED TO TEACHING
SCHOOL ADMINISTRATORS HOW TO
RESPOND TO CRISIS OF EATING
DISORDERS. ONE CONFERENCE HOSTED
BY (INAUDIBLE) ON 1987 ASSISTING
THE STUDENT INCLUDED PANELS LIKE
ESTABLISHING AN
INTERDISCIPLINARY EATING
DISORDERS TASK FORCE ON CAMPUS
AND AVOIDING CAFETERIA CHAOS,
MAKING HEALTHY CHOICES AWAY FROM
HOME. EVEN POP PSYCHOLOGIST
STEVEN BEGAN TO OFFER COLLEGE
VISITS. FOR A FEE, HE SENT OUT
LETTERS TO COLLEGE CAMPUSES
OFFERING TO DISCUSS THE ROLE OF
THE COUNSELING OFFICE STAFF AND
RESIDENT ADVISORS IN RESPONDING
TO STUDENTS IN NEED OF
APPROPRIATE SUPPORT AND
GUIDANCE. MR. LEVINKROEN
ASSISTED COLLEGE COUNSELORS AND
-- AND RESIDENT ADVISORS
LEARNING HOW TO IDENTIFY
ANOREXIA AND BULIMIA, OFFERED A
VICE TO STUDENTS WHO MAY BE
SUFFERING FROM THESE DISORDERS
AND SUGGESTS WAYS OF FINDING
PROFESSIONAL HELP. THIS FOCUS ON
EATING DISORDERS ON THE PART OF
RESEARCHERS ADMINISTRATION AND
STUDENTS ENCOURAGE A NEW
PERCEPTION OF COLLEGE CAMPUS AS
SITES OF GENDERED MENTAL HEALTH
CRISIS. THE HARVARD CRIMSON
BLOUNTLY CLAIMED QUOTE EXPERTS
BELIEVE CO-EDUCATION EXACERBATES
A WOMAN'S VULNERABILITY TO
EATING DISORDERS. A CONSENSUS
EMERGED BOTH THAT COLLEGE
STUDENTS WERE PRONE TO EATING
DISORDERS AND THAT EATING
DISORDERS WERE ONE OF THE MOST
PRESSING THREATS FACING FEMALE
STUDENTS. THESE IDEAS HAD WIDE
REACHING CONSEQUENCES. AS
INSTITUTIONS CAREFULLY
DOCUMENTED SPREAD OF CLINICALLY
DIAGNOSEABLE EATING DISORDERS
AMONG THEIR STUDENT BODY, THEY
BECAME CONCERNED THAT GENERAL
PATHOLOGICAL SYMPTOMOLOGY AROUND
ISSUES OF FOOD AND BODY. SURVEYS
REVEALED, QUOTE, A SIGNIFICANT
NUMBER OF OUR FEMALE STUDENTS
DEMONSTRATE BODY IMAGE CONCERNS
AND A DISTRESSED RELATIONSHIP
WITH FOOD. THE LEVEL OF DISTRESS
EXPERIENCED BY A SIGNIFICANT
NUMBER OF OUR FEMALE STUDENTS
HAS BEEN DESCRIBED AS AT TIMES
OVERWHELMING. IN RESPONSE
CAMPUSES BECAME INVESTED IN
MONITORING AND IMPROVING STUDENT
HEALTH, SOMETHING BOTH STUDENTS
AND THEIR PARENTS BEGAN TO
REQUEST AND THEN DEMAND. THUS IN
ADDITION TO SUPPORT GROUPS FOR
STUDENTS WITH FORMAL EATING
DISORDERS, CAMPUSES BEGAN TO
OFFER WORKSHOPS AN DISCUSSION
GROUPS ON BODY LOVE, GOOD AND
BAD, WEIGHT LOSS STRATEGIES AND
HEALTHY EATING. ISSUES THAT WORK
FOR THE FIRST TIME RECEIVED AS
NECESSARY FOR STUDENT MENTAL
HEALTH. STUDENT HEALTH SERVICES
FOCUSED PRIMARILY AND OFTEN
EXCLUSIVELY ON LEE ISSUES, DRUGS
AND ALCOHOL, SEXUAL HEALTH, AND
EATING DISORDERS. ALL OF WHICH
EMPHASIZE FEMALE STUDENTS AS
THEIR PRIMARY VICTIMS. ALL THIS
OF COURSE SOUNDS VERY FAMILIAR
TO US TODAY. WHILE THE ARCHIVES
I TRACED HERE WERE HISTORICALLY
SPECIFIC AND HAD BEEN REPLACED
BY NEW DISCURSIVE CONSTRUCTIONS
AND CONSENSUS, GENERALLY
CONVERSATIONS AROUND EATING
DISORDERS IN TERMS OF DIAGNOSIS,
ETIOLOGY AND TREATMENT HAVE
CHANGED SURPRISINGLY LITTLE OVER
THE PAST FOUR DECADES. AND OF
COURSE AS WE ALL KNOW, RATES OF
DIAGNOSIS HAVE IN FACT ONLY BE
GROWING WITH AN ALARMING SPIKE
LINKED TO THE COVID PANDEMIC AND
THE PRESSURES OF LOCK DOWN. WHAT
I HOPE TODAY AND DO MORE
GENERALLY IN MY RESEARCH, AND
TOP OF THE SCREEN SEE THE TITLE
OF MY LARGER PROJECT ANOREXIA
NERVOSA AND THE RISE OF
DISORDERED EATING THE THE LATE
20TH CENTURY WORLD IS UNPACK AN
ORIGIN STORY OF A GLOBAL
EPIDEMIC OPHITE EATING DISORDERS
WHICH HAVE BECOME A NORMALIZED
PART OF MODERN LIFE. THANK YOU
SO MUCH FOR YOUR ATTENTION AND
I'M VERY MUCH LOOKING FORWARD TO
YOUR QUESTIONS. AGAIN, I AM
STILL RESEARCHING, IDENTIFYING
SOURCES, I'M CONDUCTING
INTERVIEWS WITH PRACTITIONERS, I
HAVE INCLUDED MY EMAIL ADDRESS
HERE SO ENCOURAGE ANYBODY PLEASE
REACH OUT CORRECT DIRECTLY WITH
ANY IDEAS QUESTIONS OR
SUGGESTIONS. THANK YOU SO MUCH,
I LOOK FORWARD TO HEARING FROM
YOU.
>> THANK YOU VERY MUCH. IT WAS
AN EXCELLENT, EXCELLENT TALK. SO
RICH WITH PERSPECTIVES FROM A
VARIETY OF SOURCES. WE DO HAVE
TIME FOR A FEW QUESTIONS. I
WOULD LIKE TO REMIND THOSE WHO
ARE WATCHING UNDER THE VIDEO
SCREEN, THE NIH VIDEOCAST IS A
LIVE FEEDBACK BUTTON. PLEASE USE
THAT BUTTON TO SEND QUESTIONS TO
DR. WEINREB, THEY WILL COME TO
ME AND I WILL TRIAGE THEM
ACCORDINGLY TO SHARE WITH HER.
PLEASE SEND YOUR QUESTIONS IN.
WE DO HAVE A FEW ALREADY. ALL OF
THEM, THANK YOU, FOR THIS
WONDERFUL ENLIGHTENED TALK,
THOSE WORDS USED REPEATEDLY.
FIRST QUESTION, YOU NOTED THAT
MEDIA IN 1986 IDENTIFIED DRUGS,
SUICIDE AND EATING DISORDER AS
THE BIGGEST THREATS TO AMERICAN
YOUTH. THESE ARE ALL SELF
IMPOSED AFFLICTIONS, THIS PERSON
WRITES IN. ARE WILL THEORIES
ABOUT OVERARCHING STRESSORS ON
AMERICA'S YOUTH THAT CAUSED
SELF-HARM SYNDROMES TO BECOME SO
COMMON? THOUGHTS ON THAT? >>
THAT IS A REALLY INTERESTING
QUESTION.
>> VERY BIG QUESTION.
>> IT IS A BIG QUESTION. WHAT I
WAS INTERESTED IN, I BRIEFLY
MENTIONED WHAT I -- THE WAY THEY
WERE FRAMED WAS IN TERMS OF
INVISIBILITY. THERE IS
DEFINITELY -- DEFINITELY A SENSE
IN THE 1980s, VERY INTEREST
MISDEMEANOR THE POLITICAL SOCIAL
CONTEXT OF THE 1980s. THIS
WAS A SENSE -- THIS WAS AN AGE
OF AUSTERITY, AGE IN THE
REJECTION OF STATE INTERVENTIONS
OF PRIVATIZATION, OF
NEOLIBERALISM, AND THIS LED TO
AN IDEA OF FRAGMENTATION OF
SOCIETY OR REAL CONCERNS OF
SOCIAL FABRIC COLLAPSING. . MY
SENSE IS THIS SENSE OF
FRAGMENTATION, INDIVIDUALIZATION
WAS -- THERE WAS A DISCOURSE
PARTICULARLY DEVASTATING TO
YOUNG PEOPLE ISOLATED AND ALONE
AND LOST. THAT WOULD THEN IN
TURN LEAD TO THESE
SELF-DESTRUCTIVE BEHAVIORS. THAT
IS A CONVERSATION ABOUT
ADOLESCENCE THAT WAS GOING ON AT
THE TIME. THOUGH AT THE TIME IT
DOES NOT EXPLICITLY LINK WITH
LARGER POLITICAL ECONOMIC
TRENDS. SO THAT IS ALL I CAN SAY
ABOUT THAT AT THE MOMENT. THERE
ARE SOME INTERESTING SCHOLARSHIP
BEING DONE IN BRITAIN ABOUT SELF
HARM AS A CATEGORY, BY A SCHOLAR
NAMED CHRIS (INDISCERNIBLE) WHO
ARGUES, POINTS OUT THAT
SELF-HARM -- THAT CUTTING WHICH
IS NOW BECOME SYNONYMOUS WITH
THE CATEGORY OF SELF-HARM THAT
IDEA OF SELF-HARM WAS LINKED
WITH DRUG OVERDOSES AND THOUGHT
ABOUT AS BEING A SORT OF SOCIAL
PROBLEM, THEN IN THE 70 ET
CETERA AND 80s IT BECOMES
ABOUT AN INDIVIDUAL CRY FOR
HELP. AND I THIS I THERE IS
SOMETHING SIMILAR HERE IN THE
U.S., THESE ARE DEEPLY
INDIVIDUALIZED AND ISOLATED
AFFLICTIONS THAT REFLECT THE
LARGER COLLAPSE OF SOCIAL
NETWORKS. BUT I SHOULD SAY THIS
IS REALLY A GREAT QUESTION I
HAVE NOT REALLY EXPLORED
DIRECTLY. THANK YOU FOR THAT.
>> CERTAINLY, TOTALLY RESPECT
AND HANKS TO THE INDIVIDUAL WHO
WROTE IN WITH THAT QUESTION.
ANOTHER QUESTION THAT'S COME IN.
THANKING YOU AGAIN FOR YOUR
ENLIGHTENING TALK, CAN YOU TALK
ABOUT THE CHALLENGES OF USING
RECORDS COVERED BY HIPAA AS
HISTORICAL SOURCES?
>> ABSOLUTELY. ONE -- VERY
GENERALLY MY PROJECT I'M WORKING
IN PRIMARY SOURCES FROM SEVERAL
-- MANY COUNTRIES ONE GENERAL
THING THAT I HAVE BEEN STRUCK BY
AND DIDN'T EXPECT THOUGH I
SHOULD HAVE IS HOW DIFFERENT
PRIVACY REGULATIONS ARE IN
DIFFERENT COUNTRIES AND EVEN IN
DIFFERENT SORTS OF ARCHIVES. SO
I HAVE NOT WORKED WITH ANY
OFFICIALLY HIPAA REGULATED
SOURCES YET. I HAVE APPLIED FOR
SOME ACCESS TO PATIENT MATERIALS
THOUGH LOCATING THEM HAS BEEN
DIFFICULT. I HAVE NOT BEEN
PURSUING THEM BECAUSE I FEEL
LIKE CENTRAL TO MY STORY, VERY
INTERESTING BUT NOT WHAT I'M
PURSUING PER SE. IN SOME SENSE
I'M NOT GRAPPLING WITH HIPAA
RIGHT NOW IN THIS PROJECTED BUT
WHAT IS INTERESTING IS I HAVE
COME ACROSS ENORMOUS PRIVATE
MATERIALS SO ARCHIVES ARE FULL
OF PRIVATE AND PERSONAL LETTERS,
DIARIES, DEEPLY INTIMATE
NARRATIVE RECORDS OF PEOPLE'S
EXPERIENCES DEALING WITH EATING
DATES ORDERS AND I HAD TO THINK
A LOT ABOUT WHAT PRIVACY MEANS
IN THOSE CONTEXTS. I WAS
SURPRISED BY HOW MANY LETTER
COLLECTIONS I FOUND IN DOCTORS'
ARCHIVES ACTIVIST ARCHIVES WHICH
PEOPLE USUALLY WOMEN WOULD SEND
IN PHOTOGRAPHS OF THEMSELVES
DURING AND AFTER EATING
DISORDERS OR DURING EALING
DISORDERS DEPICTING THEIR BODY
AND WANTING TO SHARE THAT WITH
THEIR PRACTITIONERS. SO MY
GENERAL SENSE I'M NOT
REPRODUCING THOSE KINDS OF
INFORMATION BUT LOOKING AT THEM
AS SOURCES FOR THINKING ABOUT
HOW PEOPLE WERE GRAPPLING WITH
THESE ISSUES. IN SOME SENSE
THAT IS HOW I'M DEALING WITH
THOSE QUESTIONS OF PRIVACY. AT
THIS POINT HIPAA ITSELF IN A
LITERAL SENSE IS NOT SOMETHING
I'M CONFRONTED WITH.
>> THANK YOU. CAN YOU SEEK MORE
ABOUT -- SPEAK MORE ABOUT THE
HISTORY OF POLICIES TO REMOVE
STUDENTS WITH EATING DISORDERS
FROM COLLEGE CAMPUSES?
>> I GUESS IN SOME SENSE NO, I
CAN'T. THIS WHOLE INTEREST IN
THE ADMINISTERED ASPECT OF HOW
UNIVERSITIES DEALT WE'LLING
DISORDERS I -- EATING DISORDERS
WAS FASCINATING AND UNEXPECTED
AVENUE OF RESEARCH FOR ME. THIS
WAS DUE TO WORK WITH STUDENTS
INTERNS AND I JUST SORT OF
RANDOMLY THOUGHT I WOULD WRITE
TO COLLEGES AND ASK FOR
MATERIAL. WHAT I WAS
ANTICIPATING WAS SORT OF
EDUCATIONAL MATERIALS BUT WHAT I
DIDN'T EXPECT WAS ALL THE
ADMINISTRATIVE MATERIALS THERE.
THE BUREAUCRATIC RECORDS HOW
CAMPUSES DEALT WITH THIS NEW
CRISIS. AND I FOUND THAT
FASCINATING. ALL I CAN -- SO I
AM NOT -- THIS IS NOT A
SYSTEMATIC SURVEY OF EVERY
SCHOOL IN THE U.S. OBVIOUSLY. I
REACHED OUT QUITE A FEW, I THINK
MY LIST IS MAYBE 150 COLLEGES
UNIVERSITIES BUT REALLY JUST A
DROP IN THE BUCKET. ANOTHER
THING THAT IS INTERESTING TO ME
IS IT WAS NOT PREDICTABLE WHICH
SCHOOLS WOULD HAVE MATERIAL FOR
ME. SO IT IS NOT LIKE WEST COAST
SCHOOLS DID OR EAST COAST
SCHOOLS DID, THERE IS NO
PATTERN. MY SENSE IS IT IS
REALLY DUE TO INDIVIDUAL
INSTITUTIONS, INDIVIDUAL
INSTITUTIONS SO IF THERE IS
SOMEBODY THERE WHO WANTS TO DO
SOMETHING THEY WILL. OTHER TIMES
JUST NOT ARCHIVED. IT IS A VERY
PATCH WORK BUT EXTENSIVE QUILT
OF WHAT YOU CAN FIND ABOUT
ADMINISTRATIVE RECORDS AND WHAT
THEY DID. WHAT YOU CAN CERTAINLY
SEE IS THAT THERE ARE
CONVERSATIONS GOING ON AT THIS
TIME, WHEN ALL OF A SUDDEN
ADMINISTRATION SAYS WE NEED TO
DEVELOP POLICIES FOR THESE
ILLNESSES. SO IT IS LIKE THERE
ISN'T -- AND AGAIN, ONE MY SENSE
IS EATING DISORDERS PLAY AD
CENTRAL ROLE IN UNIVERSE OR
COLLEGE MENTAL HEALTH SERVICES
AT LARGE SO THERE WERE NOT
MENTAL HEALTH POLICIES IN
GENERAL, RIGHT, ANOREXIA AND
BULIMIA THAT MADE THE NEED SEEM
PRESSING TO DEVELOP A WAY TO
EXPEL A STUDENT DUE TO A MENTAL
ILLNESS ISSUE. SO THAT I FEEL I
SUSPECT BUT HOW THE POLICIES
EVOLVED OR CHANGED OVER TIME I
CAN'T SAY ANYTHING TO THAT AT
THIS POINT.
>> UNDERSTOOD. SO FROM THAT
QUESTION AND YOUR ANSWER TO THAT
QUESTION TO ANOTHER WHICH IS
SOURCES. I'M GOING TO READ THIS
CAREFULLY, IT IS A GREAT
QUESTION. THIS PERSON WRITES
THANK YOU FOR THIS GREAT TALK.
ET CETERA SPECIALLY APPRECIATE
SEEING THE BROAD RANGE --
ESPECIALLY APPRECIATE THE BROAD
RANGE OF RESOURCES AND
DOCUMENTATION USED IN YOUR
RESEARCH SO FAR. ONE CAN IMAGINE
THESE TYPES OF RESOURCES WOULD
NOW BE DIGITAL AND SHARED
ONLINE. AS WE GET CLOSER TO THE
PRESENT, BEYOND THE 20TH
CENTURY, HAVE YOU CONSIDERED
WEBSITES OR BLOGS OR SOCIAL
MEDIA AS HISTORICAL RESOURCES
FOR UNDERSTANDING HOW PEOPLE AND
ORGANIZATIONS REPRESENT
COMMUNICATE AND SHARE
EXPERIENCES AS WELL AS PROVIDE
SUPPORT AND BUILD AWARENESS OF
EATING DISORDERS? THIS PERSON
POINTS OUT THAT NATIONAL LIBRARY
OF MEDICINE ITSELF AS ARCHIVE OF
HEALTH AND MEDICINE BLOGS AS
PART OF ITS OVERARCHING ARCHIVE
INITIATIVE. UNDERSTANDING THE
TIME FRAME OF YOUR WORK, COULD
YOU SPEAK TO THIS QUESTION?
>> ABSOLUTELY, IT IS A GREAT
QUESTION AND SOMETHING I THINK
ABOUT A LOT. I ALSO THINK ABOUT
AS A TEACHER BECAUSE OF COURSE
WHEN I TALK ABOUT EATING
DISORDERS YOUNG PEOPLE TODAY
THERE IS AN AUTOMATIC
ASSOCIATION WITH THE DIGITAL
WORLD WITH SOCIAL MEDIA. THOSE
THINGS ARE SO INTIMATELY
INTERTWINED THAT ASSUMED TO BE
SO INTERTWINED THAT TODAY WE
THINK ABOUT EATING DISORDERS TO
INTERNET AND SOCIAL MEDIA. BUT
WHAT IS INTERESTING TO ME IS
THAT IN 70s AND '80s THESE
WERE AUTOMATICALLY LINKED TO
MEDIA OF A DIFFERENT KIND. THEY
RELATED TO MASS POP CULTURE. IN
SOME SENSE WHAT IS INTERESTING
IS SEEMS NEW TODAY, THIS NEWNESS
OF INTERNET AT THIS COURSE, THE
NEWNESS THAT SOCIAL MEDIA
DISCOURSE IN FACT EXISTED IN THE
80s AND '90s BEFORE THE
DIGITIZATION AGE. SO THAT IS
THAT. I'M PARTICULARLY -- I SORT
OF CUT MY PROJECT OFF AROUND
2000 PARTIALLY TO AVOID THAT
ISSUE. THAT IS A KEY CHANGE IN
SORE SPACE AND I WANTED TO LIVE
MY OWN SOURCE BASES TO GENRE. SO
MATERIAL OBJECTS IN SOME WAY.
WHAT IS IMPORTANT ABOUT THIS
TRANSITIONAL POINT OF 2000 IS
RISE OF INTERNET WAS KEY TO A
NEW CONVERSATION ABOUT WHAT IS
USUALLY CALLED THE PROANNA
MOVEMENT WHICH WAS SPECIFIC TO
THE INTERNET AND STILL IS AN
ISSUE TODAY, AND THESE ARE
INTERNET SITES AND SUPPORT
GROUPS THAT PRESENT ANOREXIA IN
A POSITIVE LIGHT AND THAT ARE
SEEN AS SUPPORTING OR
ENCOURAGING GIRLS -- PEOPLE TO
DEVELOP ANOREXIA. AGAIN, THE
CONVERSATION AROUND THAT WAS
VERY MUCH ABOUT THIS FEAR OF CON
DAY GENERAL. MEDIA CONSUMPTION
ESPECIALLY YOUNG WOMEN, GIRLS
ARE VULNERABLE TO CONTAGION TO
GIRLSES BECAUSE OF THESE MEDIA,
IT WAS A POWERFUL CONVERSATION
BUT DOES LINK TO CONVERSATIONS
THAT HILDA BROOK WAS HAVING, SHE
WAS CONCERN ABOUT THE ARTICLES
AND MAGAZINES THAT GIRLS WERE
READING IN TEEN AND 17, AND
WORRIED THAT GIRLS WOULD LEARN
ABOUT ANOREXIA FROM READING
THESE ARTICLES, ONE THING I
DIDN'T MENTION ABOUT THE BULIMIA
CONFERENCE THAT WAS REFERENCED
CONSTANTLY IN THE MEDIA WAS THE
IDEA THAT THE PROBLEM WAS
DORMITORIES AND SORORITY HOUSES
WHERE ALL THESE GIRLS WERE
TOGETHER AND THEY WOULD TALK THE
EACH OTHER AND LITERALLY TEACH
ONE ANOTHER HOW TO PURGE. SO
THIS IDEA OF FEMALE SOCIOIBILITY
AND CONTAGION YOU CAN FIND
ACROSS ALL THESE MEDIA IN SOME
SENSE SO THAT DOESN'T DIRECTLY
ANSWER YOUR QUESTION. I'M NOT
LOOKING INTO THAT BUT I READ AND
THINK ABOUT IT A LOT. AND I'M
NOT ENTIRELY CONVINCED A LOT OF
STUFF GOING ON NOW IS SO
DIFFERENT THAN WHAT WAS IN THE
70s AND 80s.
>> VERY GOOD, THANK YOU VERY
MUCH. PERHAPS AFTER YOU PUBLISH
YOUR FIRST BOOK, THOSE TOPICS,
THIS COULD BE A VOLUME 2, NOT TO
GET AHEAD OF OURSELVES BUT WITH
ALL RESPECT BECAUSE OF RICHN 'T
OF TOPIC AND EVERYTHING THAT YOU
SHARED AND WHAT YOU ARE FURTHER
UNPACKING. ANOTHER QUESTION WE
RECEIVED THE SORRIES YOU TOLD
TODAY WERE ABOUT UNITED STATES.
-- STORIES WERE ABOUT UNITED
STATES BUT YOU MENTIONED YOUR
PROJECT IS GLOBAL. WHY DOES
TELLING THIS AS GLOBAL STORY
MATTER? AND CAN YOU DISCUSS HOW
HISTORY OF EATING DISORDER
DEVELOPED IN OTHER COUNTRIES
BRIEFLY AND SIMILARITIES AN
DIFFERENCES THE STORIES YOU TOLD
ABOUT THE UNITED STATES
SPECIFICALLY?
>> THANK YOU VERY MUCH. SO ONE
OF THE THINGS THAT WAS MOST
IMPORTANT FOR ME, I'M A EUROPEAN
HISTORIAN, BY TRAINING NOT AN
AMERICANIST SO I ACTUALLY BEGAN
THIS PROJECT AS A GERMAN
HISTORIAN WORKING WITH GERMAN
AND BRITISH ARCHIVES. THAT'S
PARTICULARLY IMPORTANT IN THE
CHASE OF ANOREXIA AND EATING
DISORDERS MORE GENERALLY BECAUSE
THEY ARE OFTEN FRAMED OR SORT OF
IMAGINED AS BEING AMERICAN
DISEASES. EVEN OUTSIDE OF THE
U.S., THEY ARE OFTEN -- OFTEN
HAVE BEEN IMAGINED AS SORT OF AN
AMERICANIZING DISEASE ASIDE OF
AMERICANIZATION I MYSELF ASSUMED
ANOREXIA FIRST EMERGED THE THE
U.S. AND THEN SPREAD OUT. BUT IN
FACT THAT IS NOT THE CASE. IN
FACT, THE NARRATIVE ANOREXIA IS
NOT BY NO MEANS AMERICAN. EVEN
WHEN LOOKING AT THE MEDICAL
NETWORK OF EXPERTS WHO WERE
TREATING AND DIAGNOSING ANOREXIA
FROM THE 19TH CENTURY ONWARD IT
HAS NEVER BEEN A PRIMARILY
AMERICAN AFFLICTION. THAT IS
SOMETHING THAT CHANGES HOW WE
UNDERSTAND ANOREXIA BUT ON THE
OTHER HAND ALSO AN OBVIOUS ISSUE
ABOUT THINKING THE HISTORY OF
MEDICINE. WHICH IS OFTEN FOR
OBVIOUS ARCHIVE REASONS NARRATE
Z AS IMPLICITLY NATIONAL STORY
TO LOOK AT HISTORY OF A DISEASE
IN ONE NATION STATE. ON THE ONE
HAND THAT MAKES SENSE BUT ALSO
IMPLIES MEANINGFUL LINKS BETWEEN
NATION STATE AND THE ILLNESS.
SOMETIMES THERE ARE BUT IN THE
CASE OF ANOREXIA OR OTHER EATING
DISORDERS, I DON'T THINK THAT IS
THE CASE. SO WHILE EATING
DISORDERS HAVE THEIR OWN
PARTICULAR TRAJECTORIES OR AS I
SAIDOR SAY IN THIS TALK THEIR
OWN ARCHIVES, THESE ARCHIVES ARE
EMERGING AROUND THE WORLD AND
REALLY DISTINCT WAYS. SO JUST TO
GIVE ONE VERY DIFFERENT EXAMPLE,
IN ISRAEL HAS A HUGE EPIDEMIC IN
EATING DISORDERS AT THE SAME
TIME AND IN FACT ISRAEL I THINK
TODAY HAS HIGHEST RATE OF ANY
COUNTRY IN THE WORLD AND
ANOREXIA IN THE 70s AND 80s
EATING DISORDERS WERE
SPECIFICALLY LINK WITH HOLOCAUST
SURVIVORS, THIS WAS A KEY RISE
OF EATING DISORDERS IN ISRAEL
AND AMONG THE JEWISH DECEDENTS
OF HOLOCAUST SURVIVORS WAS
PIVOTAL TORR FOR EMERGENCE OF
THEORY OF INTERGENERATIONAL
TRAUMA, THE IDEA TRAUMA HANDED
DOWN FROM SUFFERER TO CHILD AND
EVEN TO GRANDCHILD. AND THAT
THIS TRANSMISSION OF TRAUMA
HAPPENS BY VIA EATING DISORDERS.
SO THIS IS A TOTALLY DIFFERENT
WAY OF CONCEPTUALIZING EATING
DISORDERS THAN THE GOLDEN CAGE
FOR EXAMPLE. AND AGAIN THE STORY
IN GERMANY AND GREAT BRITAIN IS
DIFFERENT AS WELL. THAT IS WHAT
I'M THREING TO DO, I'M NOT GOING
TO BE COMPREHENSIVE IN COVERAGE
BUT POINT IS THESE AFFLICTIONS
HAVE A MULTITUDE OF STORIES AND
I DON'T WANT TO PUSH AGAINST
THIS IDEA OF THERE BEING ONE
NORM AND THEN THE IMITATIONS OF
THAT NORM.
>> THANK YOU. ANOTHER DIMENSION
OF THE STORY CERTAINLY BE GRACE.
ANOTHER QUESTION RECEIVED IS
OBSERVING YOU BRIEFLY MENTIONED
HBCUs IN YOUR TALK. CAN YOU
DISCUSS HERE A LITTLE BIT HOW
RACE IS PART OF YOUR STORY?
>> ABSOLUTELY. SO VERY
GENERALLY, DISORDERED EATING IS
MY TOPIC OF RESEARCH SO I TO
OUTS CANNED ON ANOREXIA AND THEN
TO A LESSER EXTEND BULIMIA. BUT
I'M ALSO VERY INTERESTED IN
BINGE EATING. SO FROM THE
1970s ONWARD, THERE WAS A VERY
CLEAR RACIALIZATION OF THESE
DISEASES IN WHICH ANOREXIA WAS
AFFILIATED WITH WHITENESS AND
OVEREATING OR BINGE EATING WAS
AFFILIATED WITH NON-WHITENESS.
SO IN THE U.S. IT WAS PRIMARILY
LINKED WITH AFRICAN AMERICANS
BUT OTHER COUNTRIES IT WAS LINK
WITH OTHER POPULATIONS, SO FOR
EXAMPLE IN BRITAIN IT WAS
ESPECIALLY LINKED -- THERE WAS
CONVERSATIONS AROUND SOUTHEAST
ASIAN IMMIGRANTS AND GERMANY
CONCERN AROUND TURKS SO IT
BECOMES, THESE AFFLICTIONS ARE
RACIALIZED BODIES THOUGH THE
RACE OF THE BODIES THEMSELVES IS
DISTINCT DEPENDING ON CONTEXT.
IN H THE CONTEXT OF AFRICAN
AMERICANS OR IN THE CONTEXT OF
U.S., THIS IS A CONVERSATION
MANY ARE FAMILIAR WITH, THERE IS
BEEN RECENT WILL I A GREAT DEAL
OF PUSH BACK AGAINST THE IDEA
THAT EATING DISORDERS ARE WHITE
AND FEMALE. THAT PUSH BACK WAS
TAKING PLACE IN THE 1970s,
THERE WAS DATA ALWAYS THAT
SHOWED IN FACT THERE WERE PLENTY
OF BOYS AND MEN WHO HAD EATING
DISORDERS WHO DEVELOPED ANOREXIA
AND BULIMIA AND THEREUPON PLENTY
OF NON-WHITE PEOPLE WITH IN THIS
DISEASES SO THE DATA WAS THERE,
AND IT WAS ACKNOWLEDGED SO THERE
WAS NEVER LIKE A FIGHT OR A
CONTESTATION OF THAT DATA BUT
SIMPLY NEVER IMPACTED THE
NARRATIVE OF THESE ILLNESSES. SO
I HAD A STUDENT FOR EXAMPLE WHO
WAS INTERESTED IN TRYING TO
TRACE THE WAYS EATING DISORDERS
WERE STUDIED AMONG NON-WHITE
POPULATIONS IN THE US. AND SHE
WAS GATHERING ARTICLES THAT
STARTED TO STUDY THIS. THERE WAS
ONE WIDELY CITED ARTICLE THAT
WAS TITLED RATES OF EATING
DISORDERS AMONG ASIAN
IMMIGRANTS, HISPANIC IMMIGRANTS
AND AFRICAN AMERICANS. THEN THE
OPENING PARAGRAPH IT SAID
UNFORTUNATELY THE DATA WE
GATHERED FROM AFRICAN AMERICANS
DID NOT SUPPORT OUR HYPOTHESIS.
SO WE HAVE NOT INCLUDED THE DATA
IN OUR ARGUMENT. BUT THE ARTICLE
GOES ON TO MAKE STATEMENTS ABOUT
EATING DISORDERS WITHIN AFRICAN
AMERICANS COMMUNITIES. SO THE
MEDICAL CONVERSATION HOW RACE
INTERSECTS WITH EATING DISORDERS
IS DEEPLY TROUBLED BUT HAS
CONTINUED TO -- IT WAS HAPPENING
THROUGHOUT THIS ERA. THAT IS
SOMETHING TRYING TO PHRASE. WHY
IS RACE LINKED WITH CATEGORIES
AND HOW HAS IT BEEN NEGOTIATED.
>> THANK YOU. LET'S TAKE ONE
MORE QUESTION. LET'S FOLLOW ON
YOUR ANSWER TO THE LAST ONE. CAN
YOU TALK ABOUT THE KNOWLEDGE WE
CERTAINLY HAVE EATING DISORDERS
AS YOU SAY WIDESPREAD AMONG MEN,
AS WELL AS TRANSAND NON-BINARY?
CAN YOU SAY MORE ABOUT THE
POPULATIONS AND HOW THIS FACT AS
WELL RELATES TO STORIES THAT YOU
TOLD TODAY.
>> THIS SOMETHING I'M REALLY
INTERESTED IN, SO DISCURSIVELY
EATING DISORDERS ARE PROFOUNDLY
GENDERED CATEGORY. THAT IS NOT I
THINK LINKED TO THE SPECIFIC
DISORDERS BUT TO THE WAYS GENDER
-- WHICH FOOD CONSUMPTION AND
PRODUCTION HAS BEEN PROFOUNDLY
GENDERDFROM THE MODERN WORLD. SO
THAT THIS IDEA THAT WOMEN'S
CONSUMPTION OF FOOD IS A SOURCE
OF PATHOLOGY, IS REALLY DEEPLY
EMBEDDED IN OUR SOCIE SOCIETY. D
IN SOCIETIES AROUND THE WORLD.
THIS IS A CLASSIC 20 -- 19TH AND
20TH CENTURY IDEA. SO WITHIN
THAT CONVERSATION, THERE IS NOT
REALLY SPACE FOR MALE PATHOLOGY,
THAT IS TO SAY FEMALE APPETITES
ARE INHERENTLY TROUBLING, IF
WOMEN EAT TOO MUCH OR TOO
LITTLE. MEN MIGHT EACH TOO MUCH
OR TOO LITTLE BUT DOESN'T POSE A
DILEMMA THE SAME WAY. SO THAT'S
SOMETHING I'M TRYING TO UNPACK
AND HEAR. ANOTHER ASPECT OF ONE
ASPECT OF THAT I FOUND
PARTICULARLY INTEREST INTERESTIN
MEN WERE TALKED ABOUT IN
RELATIONSHIP TO EATING
DISORDERS, THEY WERE ALMOST
ALWAYS GAY. SO ALMOST ALWAYS GAY
OR BISEXUAL. THEIR SEXUALITY WAS
SEEN AS BEING IMPLICITLY CENTRAL
TO THEIR EATING DISORDER SO THEY
ARE KIND OF OTHERRED OR PERVERSE
SEXUAL DESIRES WAS THE SORT OF
PATHWAY OR GATEWAY TO THEM
DEVELOPING THESE FEMINIZED
ILLNESSES. THAT WAS ALWAYS
STATED THAT GAY MEN HAVE MORE
EATK DISORDERED THAN OTHER MEN.
WITH SORT OF ASSUMPTION THAT WAS
OBVIOUS BECAUSE OF THEIR
PERVERSE SEXUAL DESIRES THEY
HAVE DISORDERED EATK HABITS BUT
OF COURSE THAT DOESN'T SEEM TO
BE ADEQUATE ANSWER SO I'M TRYING
TO EXPLORE THE WAYS IN WHICH THE
QUEER COMMUNITY ENGAGE WITH
EATING DISORDERS FOR EXAMPLE,
LOOKING AT THERE IS A REALLY
POWERFUL LESBIAN FAT LIBERATION
MOVEMENT TRYING TO UNPACK THESE
CATEGORIES BETWEEN QUEERNESS AND
DISORDERED EATING. THAT'S ONE OF
THE THING I PARTICULARLY TRY TO
TRACE IN MY MORE RECENT
RESEARCH.
>> THANK YOU FOR THAT. THANK YOU
FOR THIS FANTASTIC TALK. IT WAS
EXCELLENT AND YOUR RESEARCH IS
EXCELLENT. MY COLLEAGUES AND I
HERE AT NATIONAL LIBRARY OF
MEDICINE AND CERTAINLY EVERYONE
WATCHING WISH YOU CONTINUED
SUCCESS IN YOUR RESEARCH. PLEASE
DO REACH BACK TO US AT NATIONAL
LIBRARY OF MEDICINE THE WE CAN
BE A RESOURCE AND HISTORY OF
MEDICINE AND ARCHIVES AND
LIBRARIES AWAIT YOUR VISITS BOTH
VIRTUALLY AND PHYSICALLY. DR.
WEINREB, THANK YOU VERY MUCH FOR
YOUR TALK TODAY FOR SPENDING
THIS TIME WAS. BEFORE WE LEAVE,
THANK YOU AGAIN FOR PREPARING, I
WANT TO REMIND EVERYBODY WHO IS
WATCHING THE NEXT TALK WHICH IS
GOING TO BE HELD ON THURSDAY
APRIL 25TH, (INDISCERNIBLE) A
NURSE HISTORIAN AND Ph.D.
CANDIDATE AT (INAUDIBLE) NURSING
HISTORICAL INQUERY AT SCHOOL OF
NURSING UNIVERSITY OF VIRGINIA
WILL BE JOINING US TO SPEAK ON
THE SUBJECT UNFIT TO NURSE.
EFFICIENCY AND DISCIPLINE AT THE
PHILIPPINE GENERAL HOSPITAL 1989
TO 1916. PLEASE JOIN US THEN.
ONCE MORE, WE THANK DR. ALICE
WEINREB FOR HER FANTASTIC TALK.
WISH HER WELL IN NEXT STEPS AND
RESEARCH AND RESULTING BOOK AND
LIKELY ALSO VOLUME 2 OF THAT
PROJECT ONE DAY. DR. WEINREB
THANK YOU VERY MUCH FOR JOINING
US AND FOR TUNING IN TODAY. WE
LOOK FORWARD TO SEEING YOU IN
THE FUTURE. DON'T HESITATE TO
CAN'T CONTACT THE NATIONAL
LIBRARY OF MEDICINE IF WE CAN BE
A RESOURCE FOR YOUR AND YOUR
RESEARCH. THANK YOU VERY MUCH.
HAVE A GOOD AFTERNOON.
>> THANK YOU.