The (dis)embodied self in anorexia nervosa

A feminist phenomenological approach to the analysis of body maps: Childhood trauma and anorexia nervosa

Body mapping is an arts-based research technique that uses a life-sized outline of the participant's body and symbols that visually represent their lived experiences. In this article, we describe the methods of body mapping and analytic techniques used in a research inquiry exploring how child abuse influenced the embodied processes in anorexia. We aim to contribute to methodological research practice in anorexia using a method that can potentially add value in other areas of ED research or be adapted for treatment settings. Our research findings suggest that body mapping can add value to the interview method and extend the range of methods for researchers interested in interrogating the hard-to-reach subjective embodied processes.

Eating Disorders and Psychosis as Intertwined Dimensions of Disembodiment: A Narrative Review

Although psychosis is not one of the most commonly recognized psychiatric comorbidities of Eating Disorders (ED), there is an increasing empirical evidence of associations between these psychopathological conditions. Indeed, ED as well as early manifestations of schizophrenic psychosis emerge during developmental years and might present some affinities in the presentation at onset. For example, adolescents with anorexia nervosa (AN) may report psychotic-like eating-related symptoms such as delusional-like body image distortions and/or "anorexic voice". Conversely, early expressions of schizophrenia spectrum vulnerability might involve altered bodily experiences, delusional ideation on food and eating as well as pseudo-anorectic behaviors. From a phenomenological perspective, this partial symptomatic overlap may lie on common features of disturbed corporeality in terms of disembodiment, although these alterations of embodiment are presumably rooted in distinct pathogenetic pathways (e.g., primary childhood ontogenetic pathway in schizophrenia vs. a secondary adolescent ontogenetic pathway in AN). A clinical-phenomenological attitude could be important not only to better discern potential overlaps and affinities between the two conditions, but also to better conceptualize and treat those background alterations of the embodied self. In particular, a phenomenological exploration of the experiential side of eating-related behaviors could be a decisive step to support early differential diagnosis and treatment appropriateness.

An open invitation to productive conversations about feminism and the spectrum of eating disorders (part 1): basic principles of feminist approaches

Despite the long history of feminist research in the field and the clear relevance of questions of gender to this sphere, many continue to question the relevance of feminism for understanding and treating eating disorders in 2022. In this set of two papers, we explore some of the tensions, omissions and misconceptions which surround feminist approaches to eating disorders. At the core of these two papers is our assertion that such approaches can make significant contributions in the eating disorders field along six key lines: enriching the science of eating disorders, unpacking diagnostics, contextualizing treatment and prevention, attending to lived experiences, diversifying methodologies, and situating recoveries. In this first paper, we outline what feminist approaches are and dig into some key tensions that arise when feminist approaches come to the table. These include critiques of sociocultural approaches to understanding eating disorders, the relationship between feminist approaches and biological and genetic attributions for eating disorders, and the role of men. We then offer a key contribution that feminist approaches have made to eating disorders scholarship: an invitation to unpack diagnostic approaches and situate eating disorders within the landscape of food, weight, and shape concerns in the twenty-first century.

The disappearing body: anorexia as a conflict of embodiment

Anorexia nervosa is often regarded primarily as a disorder of the body image, with affected individuals submitting themselves to the dictate of a predominant model of slenderness. However, even though this frequently functions as a gateway to the disorder, the paper intends to show that the actual conflict in anorexia consists in a fundamental alienation of the self from the body. In order to analyze this alienation from a phenomenological point of view, the paper introduces the polarity of lived body (body-as-subject) and physical body (body-as-object). It then explores the phenomenology of anorexia, drawing on characteristic self-reports as well as on the phenomenological, psychoanalytic and cultural science literature. The anorexic conflict of embodiment arises in adolescence, where the body becomes an object of the other's gaze in a special way. Starting with an attempt to comply with the ideal body image, the anorexic patient increasingly fights against her dependency on her body and its uncontrollable nature, above all its hunger and femininity. To be in total control of her body and to gain independence from it, becomes the source of a narcissistic triumph. Thus, in striving for autonomy and perfection, the anorexic patient alienates herself from her embodiment. This results in a radical dualism of 'mind' and 'body': pursuing the ideal of an asexual, angelic, even disappearing body. Anorexia is thus conceived as a fundamental conflict of embodiment.

Material Environments and the Shaping of Anorexic Embodiment: Towards A Materialist Account of Eating Disorders

Anorexia nervosa is a paradoxical disorder, regarded across disciplines as a body project and yet also an illness of disembodied subjectivity. This overlooks the role that material environments-including objects and spaces-play in producing embodied experiences of anorexia both within and outside treatment. To address this gap, this paper draws together two ethnographic studies of anorexia to explore the shared themes unearthed by research participants' engagements with objects that move across boundaries between treatment spaces and everyday lives. Demonstrating how the anorexic body is at once both phenomenologically lived and socio-medically constituted, we argue that an attention to materiality is crucial to understanding lived experiences. A materialist account of anorexia extends the literature on treatment resistance in eating disorders and offers a reconceptualisation of 'the body in treatment', showing how  objects and spaces shape, maintain, and even 'trigger' anorexia. Therefore, against the background of the high rates of relapse in eating disorders, this analysis calls for consideration of how interventions can better take account of eating disordered embodiment as shaped by material environments.

Toward an Affective Political Ecology of Obesity

This article argues for an affective approach to obesity that destabilizes the conceptual boundaries between the biological and the social aspects of food, eating, and fatness. Its approach foregrounds visceral experience, attends to food both inside and outside the body, and explores how bodies labeled “obese” consume their political, economic, and material environments. This approach is termed affective political ecology. The authors’ aim is to draw attention to how the entanglements between the physiological and social aspects of eating tend to be absented from antiobesity public health rhetoric. By exploring a range of ethnographic examples in high-income countries, they illuminate how such interventions often fail to account for the complex interplays between subjective corporeal experience and political economic relations and contend that overlooking an individual’s visceral relationship with food counterproductively augments social stigma, stresses, and painful emotions. They demonstrate, then, how an approach that draws together political economic and biomedical perspectives better reflects the lived experience of eating. In so doing, the authors aim to indicate how attending to affective political ecologies can further our understanding of the consumption practices of those in precarious and stressful social contexts, and they offer additional insight into how the entanglement of the biological and the social is experienced in everyday life.

Embodiment as a Paradigm for Understanding and Treating SE-AN: Locating the Self in Culture

There has been a growing call for sociologically engaged research to better understand the complex processes underpinning Severe and Enduring Anorexia Nervosa (SE-AN). Based on a qualitative study with women in Adelaide, South Australia who were reluctant to seek help for their disordered eating practices, this paper draws on anthropological concepts of embodiment to examine how SE-AN is experienced as culturally grounded. We argue that experiences of SE-AN are culturally informed, and in turn, inform bodily perception and practice in the world. Over time, everyday rituals and routines became part of participants' habitus', experienced as taken-for-granted practices that structured life-worlds. Here, culture and self are not separate, but intimately entangled in and through embodiment. Approaching SE-AN through a paradigm of embodiment has important implications for therapeutic models that attempt to move anorexia nervosa away from the body and separate it from the self in order to achieve recovery. Separating experiences-literally disembodying anorexia nervosa-was described by participants as more than the loss of an identity; it would dismantle their sense of being-in-the-world. Understanding how SE-AN is itself a structure that structures every aspect of daily life, helps us to understand the fear of living differently, and the safety that embodied routines bring. We conclude by asking what therapeutic treatment might look like if we took embodiment as one orientation to SE-AN, and focused on quality of life and harm minimization.

Identity, Subjectivity, and Disorders of Self in Psychosis

Alterations in self-experience are increasingly attended to as relevant and important aspects of schizophrenia, and psychosis more broadly, through a burgeoning self-disorders (SD) literature. At the same time, issues of self, subject, and subjectivity within schizophrenia-spectrum illnesses have also gained attention from researchers across the social sciences and humanities, and from ethnographic research especially. This paper examines the subjective experience of disruptions in self-identity within a cohort of first episode psychosis (FEP) service users, critically engaging with the SD literature and bringing it into conversation with social sciences and humanities scholarship on self and schizophrenia. Drawing findings from an ongoing ethnographic study of young peoples' experiences with psychosis, we explore meanings of mental distress relating to psychotic episodes and attend to issues of self, identity, and subjectivity. We critique the division between "normal" and "pathological" self-experience that is endorsed within the SD literature, arguing against the notion that fragmentation of self-experience in schizophrenia-spectrum illnesses is indicative of psychopathology. We highlight how experiences categorized as psychosis are also important and complete aspects of one's social world and inner life and explore the ways in which at least some aspects of disruptions of self-identity stem from clinical situations themselves-in particular, from asymmetries of power within the mental health system. Relating our findings to feminist, postcolonial, and disability studies' approaches to the "self," we emphasize the complex interplay between interpersonal, cultural, and structural aspects of self-experience within FEP.

Understanding each other in the medical encounter: Exploring therapists' and patients' understanding of each other's experiential knowledge through the Imitation Game

The ability of health-care professionals to understand the lived experiences of their patients has become increasingly important but has been a difficult topic to investigate empirically because it involves two distinctive research strands: interpretative phenomenological analysis and patient-provider communication. While interpretative phenomenological analysis focuses on experiences and illness narratives of patients, but not on therapist's understanding of those, patient-provider communication surveys focus primarily on effective forms of communication without addressing the actual illness experiences of patients. There is a need for empirical research that combines both strands to investigate not only the experiences of patients but also whether professionals are able to understand these. This study combined both strands by means of a novel research method called the Imitation Game (combined with other qualitative methods). This sociological method was developed to investigate what different social groups know of each other's lifeworld. It focused on the important domain of eating disorder treatment to investigate whether therapists were able to understand the experiences of their patients and vice versa. This study provides insights into the domains in which therapists and patients were able to develop insights into each other's experiential knowledge (and where they had difficulties in doing so). The findings also implicate the high potential of the Imitation Game as an interdisciplinary research method. We propose that the Imitation Game may be particularly valuable as a 'can opener' that enables the development of in-depth, qualitative insights into the substantive themes that matter in the lifeworlds of patients and therapists.

Anthropological Perspectives on Eating Disorders: Deciphering Cultural Logics

In the last three decades, anthropological analyses of eating disorders have peeled away layers of 'common sense' to reveal tacit and often contradictory forces that inhere in people's bodies, practices, and lives. From investigations of institutional practices to analyses of embodied experiences, anthropologists have developed insightful accounts of how local, shared worlds shape disordered eating, and of the grounding of disorder in social structures and relationships that tend to be obscured in clinical and popular interpretations. In this introductory essay, we offer a brief review of anthropological work on eating disorders, with particular emphasis on studies published in the last decade. Attending to person, structure, and bodily being-in-the-world, these anthropological studies reveal multiple cultural logics within which disordered eating practices are embedded. The deciphering of cultural logics forms the basis for this special issue, whose constituent papers interrogate recurring and ongoing eating disorders, with analyses that focus on relapse, ambivalence toward treatment, and the persistence of disordered eating practices. In their shared focus on long-term eating disorders, the papers offer anthropological responses to clinical questions about the low rates of treatment success. As such, the special issue conveys the potential for new productive collaborations between anthropology, policy, and clinical research and practice for the prevention of and effective intervention in eating disorders.

Childhood trauma and anorexia nervosa: from body image to embodiment

Contemporary understandings of anorexia nervosa are framed by the body-image paradigm. The body-image framework considers that women's bodily experiences are reflected through distorted mental images of their bodies or disordered thinking and behavior around food and eating. Body image has come to symbolize all that can go wrong with women's relationships with their bodies, food, and eating. The problem with this approach is its failure to consider the experience of women who have survived childhood abuse. Women's bodily disturbances are not easily discernible through objective measures because they lie within the inner subjective realm of the embodied 'self' and embodied emotional experience. Consideration of the different ways that women inhabit their bodies informs this paper's examination of the conceptual framework of embodiment as an alternative to the body-image paradigm.

Beyond the clinic? Eluding a medical diagnosis of anorexia through narrative

The persistence and recurrence of anorexia nervosa poses a clinical challenge, and provides support for critiques of oppressive and injurious facets of society inscribed on women's bodies. This essay illustrates how a phenomenological, linguistic anthropological approach fruitfully traverses clinical and cultural perspectives by directing attention beyond the embodied experience of patients diagnosed with anorexia nervosa to those who are not clinically diagnosed. Extending a model of illness and recovery as entailing sufferers' emplotting of past, present, and imagined future selves, I argue that women's accounts of their experiences do not simply reflect lived reality, but actually propel health-relevant states of being by enlivening and creating these realities in the process of their telling. In indexical interaction with public and clinical discourses, narratives' grammar, lexicon, and plot structures modify subjects' experiences and interpretations of the events and feelings recounted. This article builds on the insight that linear narratives of "full recovery" that adopt a clinical and feminist voice can help tellers stay recovered, whereas for those "struggling to recover," a genre of contingent, uncertain, sideshadowing narratives alternatively renders recovery an elusive and ambivalently desired object. This essay then identifies a third narrative genre, eluding a diagnosis, which combines elements of the first two genres to paradoxically keep its teller simultaneously sheltered from, and invisible to the well-meaning clutches of medical care, leaving her suffering, yet free, to starve. This focus on narrative genres illustrates the utility of linguistic analyses for discerning and interpreting distress in subclinical populations.

Distinct and Untamed: Articulating Bulimic Identities

Bulimia nervosa and anorexia nervosa are inextricably linked, with substantial clinical and epidemiological overlaps. Yet, while anorexia has been analyzed extensively in medical anthropology, bulimia remains under-theorized. This is, perhaps, because, compared to self-starvation, binge eating presents a logic of practice that is difficult to reconcile with culturally reified notions of self-control, transcendence, and hard work. Thus, although anthropologists have analyzed anorexic subjectivities as imbued with a sense of cleanliness and purity, moral superiority, and heroics, similar analyses have not been extended to bulimic subjectivities; instead, bulimia has been subsumed, as a tangential disorder, into analyses of anorexia. In this paper, I aim to move bulimic identities from the margins to the centre of anthropological analysis. Based on participant narratives, I analyze bulimic identity as articulated by six Israeli women who identified as bulimic and received treatment for bulimia. The women's narratives show that bulimic identity is aligned with concepts of distinct selfhood. For these women, to be bulimic was to be framed as 'abnormal'; but this 'abnormality', albeit a source of social stigma and shame, held meanings that went beyond pathology. Through the claiming of bulimic identity, the women positioned themselves as untamed, non-conforming subjects, who acted against gendered and classed expectations-and even against the limitations of the body. Their constructions of bulimic distinction highlight the need for anthropological work that situates bulimia not as a footnote to anorexia, but as a structurally and culturally meaningful condition in its own right.

René Girard and the Mimetic Nature of Eating Disorders

French historian and literary critic René Girard (1923-2015), most widely known for the concepts of mimetic desire and scapegoating, also engaged in the discussion of the surge of eating disorders in his 1996 essay Eating Disorders and Mimetic Desire. This article explores Girard's ideas on the mimetic nature and origin of eating disorders from a clinical psychiatric perspective and contextualizes them within the field of eating disorders research as well as in relation to broader psychological, sociological and anthropological models of social comparison and non-consumption. Three main themes in Girard's thinking on the topic of eating disorders are identified and explored: the 'end of prohibitions' as a driving force in the emergence of eating disorders, eating disorders as a phenomenon specific to modernity, and the significance of 'conspicuous non-consumption' in the emergence of eating disorders.

Interoception and Autonomic Correlates during Social Interactions. Implications for Anorexia

The aim of this study is to investigate the bodily-self in Restrictive Anorexia, focusing on two basic aspects related to the bodily self: autonomic strategies in social behavior, in which others' social desirability features, and social cues (e.g., gaze) are modulated, and interoception (i.e., the sensitivity to stimuli originating inside the body). Furthermore, since previous studies carried out on healthy individuals found that interoception seems to contribute to the autonomic regulation of social behavior, as measured by Respiratory Sinus Arrhythmia (RSA), we aimed to explore this link in anorexia patients, whose ability to perceive their bodily signal seems to be impaired. To this purpose, we compared a group of anorexia patients (ANg; restrictive type) with a group of Healthy Controls (HCg) for RSA responses during both a resting state and a social proxemics task, for their explicit judgments of comfort in social distances during a behavioral proxemics task, and for their Interoceptive Accuracy (IA). The results showed that ANg displayed significantly lower social disposition and a flattened autonomic reactivity during the proxemics task, irrespective of the presence of others' socially desirable features or social cues. Moreover, unlike HCg, the autonomic arousal of ANg did not guide behavioral judgments of social distances. Finally, IA was strictly related to social disposition in both groups, but with opposite trends in ANg. We conclude that autonomic imbalance and its altered relationship with interoception might have a crucial role in anorexia disturbances.

Material Bodies and the Transformation of the Social

In 1992, Emily Martin pronounced ‘the end of the body’ as we know it. In considering why and how ‘the body’ has come to resume center stage as a site of theoretical analysis in social scientific and humanistic inquiry, Martin suggested that we are undergoing fundamental changes in how our bodies are organized and experienced. As a result, the ‘problem’ of the body has been thrown into relief. Ian Burkitt’s Bodies of Thought: Embodiment, Identity and Modernityand John Hassard, Ruth Holliday and Hugh Willmott’s collection Body and Organizationare two notable additions to the growing literature on embodiment, which grapples with how to make sense of what Martin characterizes as the end of one kind of body and the beginning of another. This review essay considers these two texts within the context of larger contemporary theoretical debates about modernity, embodiment and the generation of social and personal meaning.

Unsettling `body image'

This article critiques contemporary feminist theory's frequent ocularcentric readings of the anorexic body as a surface of cultural inscription or as a paradigmatic sign of the female body's alienation through sexual difference. In an initial speculative attempt to find a theoretical framework that might sustain a more generative and embodied account of anorexia, I read anorexia through Butler's theory of gender as psychic `incorporation' because she problematizes an interior/exterior topography of the subject. This Butlerian framework proves problematic because, by establishing an association between visibly queer gender and subversion, it effectively designates as hegemonic any sense of gender as a felt interiority. In a second framework, I draw on Prosser's anti-ocularcentric reading of transsexual `body narratives' derived from Anzieu's theory of the `skin ego'. Filtering Butler's theory of melancholia through this skin ego framework, I find a theoretical space for anorexia as a transitional embodied subjectivity which both re-lives and relieves the melancholic trauma of gender.

Empowerment and bariatric surgery: negotiations of credibility and control

Today obesity is understood as a chronic illness. Programs developed to deal with obesity often build on an explicit aim to "empower" patients to take increased responsibility for their health, in line with contemporary neoliberal discourses. There is little empirically based knowledge about this so-called empowering process. In this article we focus on how an empowering program for patients diagnosed as morbidly obese worked on individuals' identity. The program encompassed a course in lifestyle change, bariatric surgery, and aftercare. We conducted qualitative interviews with 9 individuals at different stages of their treatment process and applied discourse analysis to interpret their constructions and negotiations as they progressed through the program. We found that dimensions of control and credibility framed the respondents' identity work. Based on the findings we suggest that contemporary discourses of empowerment as practice might leave the participants "trapped" within the ambivalence of freedom and control.

Subjective and physical dimensions of bodily self-consciousness, and their dis-integration in anorexia nervosa

The present investigation concerns the multidimensionality of self-consciousness. I will specifically address this general issue by focusing on bodily self-consciousness and by considering how one is conscious of one's body through consciousness of both its physicality and its subjectivity. Here, physicality is defined as the belongingness to the physical world; subjectivity is defined as the fact of being a subject of conscious experience. Once subjectivity and physicality are differentiated from each other, the difficulty is to clarify the integration of these dimensions of bodily self-consciousness into a single experience of one's body: how does the consciousness of one's body integrate one's consciousness of one's body-as-subjective and one's consciousness of one's body-as-physical? In this investigation, I describe different forms of bodily self-consciousness in ways that shed light on the intermingling of subjectivity and physicality. I argue that being conscious of one's body-as-subjective involves experiencing one's belongingness to the physical world; conversely, being conscious of one's body-as-physical involves experiencing it as one's own; either way, such forms of bodily self-consciousness involve experiencing both the subjectivity and the physicality of one's body. The hypothesis here is that the imbalance of these dimensions relative to each other would be pathological. I will thus underline the normal multidimensionality of bodily self-consciousness by considering its pathological breakdown as it happens in anorexia nervosa.

Body awareness, eating attitudes, and spiritual beliefs of women practicing yoga

This research evaluated attitudes about body image and eating in women practicing postural yoga. Study 1 described scores from questionnaires on variables related to body awareness, intuitive eating, spirituality, and reasons for practicing. Scores were favorable on all measures with significant correlations (p < .01) among all main variables except between spiritual readiness and intuitive eating, and between BMI and both body awareness and spiritual readiness. Reasons for practicing did not affect scores. Study 2 evaluated interviews in a sub-sample. Qualitative data reported improvements in body satisfaction and disordered eating due in part to yoga and its associated spirituality.

The body projects of university students with type 1 diabetes

Young adults with type 1 diabetes are a "forgotten group." Their perspectives are rarely addressed by research studies, meaning that we know little about the reasons why they engage (or not) in diabetes self-care practices. The limited work that has investigated these young people's perspectives suggests that they experience a tension between being healthy and being normal. In this article, I examine this tension from the viewpoints of a particular group of young adults with diabetes: university students. I examine what being normal means for these students and how their attempts to be normal impact upon their diabetes control. I argue that normalcy for these students is constructed and maintained through the body. Respondents attempt to be normal by engaging in what Shilling refers to as "body projects." Each of the body projects that students are involved in developing is intended to produce a particular kind of normal embodied identity that is unaffected by diabetes. Unfortunately, the constitutional practices of particular body projects often undermine those of others, and can be risky for students' diabetes control. As such, students have to reach a balance between their different body projects. This article helps to address the lack of research on the perspectives of young adults with diabetes, and contributes to theoretical research on the concept of body projects.

Governing the contagious body: genital herpes, contagion and technologies of the self

Genital herpes is a prevalent sexually transmitted viral infection. While genital herpes is not life-threatening, it can cause physical discomfort and psychosocial difficulties, and may increase the risk of contracting HIV. Given that genital herpes cannot be cured, both the condition itself, and the possibility of passing it on to others, becomes a part of the everyday reality of those individuals diagnosed with genital herpes. In this article we explore the ways in which people with genital herpes attending the Sexually Transmitted Infections (STI) clinic govern their `contagious bodies'. The discussion draws on the Foucauldian concept of governmentality, and uses Foucault's idea of ethics as a framework to identify the technologies of the self by which individuals with genital herpes govern their own thoughts and behaviours in relation to the contagiousness of the condition. Implications for practice and other ways of thinking about what happens in the STI clinic context are suggested.

'Why I won't eat': patient testimony from 15 anorexics concerning the causes of their disorder

The following article describes the reasons given by 15 anorexic patients for their illness. The patients were asked the following question in an open-ended interview-'What would you say were the causes of your illness?' In reply detailed complex narratives were gathered from which a number of themes could be identified. These included unhappiness, control, being in a downward spiral, obsession and perfectionism. Most patients, for example explained that they were unhappy. To address their unhappiness, they adopted a strategy of control over food. Being able to exert this control gave patients a sense of enjoyment and pride and enabled them to address their underlying fear that a loss of control may be just around the corner. This pride persuaded patients to restrict further their food in the hope they would experience even greater enjoyment. Patients were thus caught in a dangerous 'spiral' of restriction, weight loss, euphoria and further food refusal. This spiralling behaviour resulted in many patients describing their illness as an obsession. Several patients equated this obsessional behaviour with a perfectionist trait in their personalities. In the following article, these themes of unhappiness, control, spiral, obsession and perfectionism, are presented, along with the patient testimony on which each theme was based.

Diets and discipline: the narratives of practice of university students with type 1 diabetes

Type 1 diabetes is one of the most common chronic conditions of adolescence and young adulthood. It is characterised by a demanding and complex management regime. Individuals with diabetes must engage in continual self-care actions such as eating healthily and exercising if they are to minimise their risks of developing long-term diabetes' complications. Research has demonstrated, however, that many young adults experience difficulties with exercising and eating healthily. Narrative approaches could provide important insights into the reasons why young people do or do not experience difficulties here. In this article I examine the food consumption and exercise narratives of a particular group of young adults with type 1 diabetes, university students, to see what personal, social and cultural factors influence their practices.

THE CULTURAL POLITICS OF BODY SIZE

Scholarly interest in body size has increased in concert with recent efforts to shape and assess bodies in particular ways within industrialized social contexts. Attending to both overt and covert references to Eurocentric body projects, this chapter reviews literature in anthropology, sociology, and cultural studies that addresses the cultural politics of body size in various parts of the world. It begins with a discussion of biocultural paradigms, which accept certain biomedical categories even when challenging or reconfiguring their hegemonic power. Next is a survey of works analyzing body size within “non-Western” groups as well as European and North American subgroups. These studies often employ culturally powerful “Western” constructs as foils, an approach that risks cultural othering. The analysis then turns to the extensive literature that unpacks dominant Euro-American body practices and discourses. Here, diverse perspectives on several key concerns in sociocultural anthropology are considered; concepts of culture and power, theories of the body and embodiment, and understandings of human agency vary in instructive ways. The chapter concludes with a review of scholarship on postcolonial processes and representations that incorporates a critical perspective on Eurocentric preoccupations with body size.

Disciplining the feminine: the reproduction of gender contradictions in the mental health care of women with eating disorders

This paper provides insights into the way gendered assumptions operate within health care interventions for women with eating disorders. A multidisciplinary sample of Australian health care workers were interviewed about their approaches to treatment, and discourse analysis was used to uncover the discursive dynamics and power relations characterising their accounts of intervention. The paper demonstrates a contradictory positioning of anorexic patients in relation to autonomy and control within the two common psychiatric interventions of bed rest intervention and psychotherapy. The paper argues that this is based on gendered assumptions about selfhood and femininity in eating disorders that are reproduced in the therapeutic relationship through the operation of a gendered parent-child dynamic, with the health care worker as father or mother, and the anorexic patient as daughter. One of the main effects of this is to re-inscribe rather than challenge the discursive 'double bind' of femininity that has been widely implicated by post-structural feminists in producing eating disorders in the first place. The paper also considers the widely acknowledged problem of resistance to treatment in anorexia as a function of controlling treatments, and discusses psychiatrists' perspectives on addressing this dilemma. Finally, the paper examines the potential of feminist-informed understandings of eating disorders for overcoming the gendered dilemmas inherent within the dominant psycho-medical treatment paradigm.

A "coca-cola" shape: cultural change, body image, and eating disorders in San Andrés, Belize

Eating disorders have been associated with developing nations undergoing rapid social transition, including participation in a global market economy and heavy media exposure. San Andrés, Belize, a community with many risk factors associated with the cross-cultural development of eating disorders, has shown remarkable resistance to previously documented patterns, despite a local focus on female beauty. Drawing on longitudinal person-centered ethnography with adolescent girls, this article examines why this community appears exceptional in light of the literature. First, community beauty and body image ideals and practices are explicated. Then, a protective ethnopsychology is proposed as a key mediating factor of the rapid socio-cultural change among young women. Finally, possible nascent cases of eating disordered behavior are discussed in light of their unique phenomenology: that is, having to do more with economic opportunity in the tourism industry and less with personal distress or desire for thinness. Close, meaning-centered examination of eating and body image practices may aid understanding and prevention of eating disorders among adolescents undergoing rapid social change in situations of globalization and immigration.