Feeding Anorexia

Gender and Power at a Treatment Center

Feeding Anorexia

Body, Commodity, Text

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Book Pages: 304 Illustrations: Published: August 2003

Anthropology > Cultural Anthropology, Gender and Sexuality > Feminism and Women’s Studies, Medicine and Health > Public Health and Health Policy

Feeding Anorexia challenges prevailing assumptions regarding the notorious difficulty of curing anorexia nervosa. Through a vivid chronicle of treatments at a state-of-the-art hospital program, Helen Gremillion reveals how the therapies participate unwittingly in culturally dominant ideals of gender, individualism, physical fitness, and family life that have contributed to the dramatic increase in the incidence of anorexia in the United States since the 1970s. She describes how strategies including the meticulous measurement of patients' progress in terms of body weight and calories consumed ultimately feed the problem, not only reinforcing ideas about the regulation of women's bodies, but also fostering in many girls and women greater expertise in the formidable constellation of skills anorexia requires. At the same time, Gremillion shows how contradictions and struggles in treatment can help open up spaces for change.

Feeding Anorexia is based on fourteen months of ethnographic research in a small inpatient unit located in a major teaching and research hospital in the western United States. Gremillion attended group, family, and individual therapy sessions and medical staff meetings; ate meals with patients; and took part in outings and recreational activities. She also conducted over one hundred interviews-with patients, parents, staff, and clinicians. Among the issues she explores are the relationship between calorie-counting and the management of consumer desire; why the "typical" anorexic patient is middle-class and white; the extent to which power differentials among clinicians, staff, and patients model "anorexic families"; and the potential of narrative therapy to constructively reframe some of the problematic assumptions underlying more mainstream treatments.


"Feeding Anorexia certainly raises questions in relation to the notorious high level of relapse in mainstream treatments. Acknowledging that any suggestion for a cure is too distant to comprehend, Gremillion's epilogue--devoted to the potential benefits of narrative therapy--does open up the possibility of re-addressing some of those cultural, naturalised understandings in treatment regimes for anorexia which may be hindering recovery." — Georgia Ovenden , Australian Feminist Studies

"Feeding Anorexia is a terrific work of sensitive and insightful ethnography, of feminist poststructuralist practice, of medical sociology, and of embodied theory. It will be of great interest for feminists, students and scholars of the sociologies of the body and medicine, and therapists and other clinicians." — Victoria Pitts, American Journal of Sociology

"Feeding Anorexia is a well-researched academic work, painstakingly written with detailed citations and footnotes. Although not an easy read by any means, it is a worthwhile one. Ms. Gremillion turns eating disorder treatment inside out, and she does a superb job of it. . . . Feeding Anorexia is sure to stimulate discussion and controversy, which keeps ideas flowing and ultimately generates progress." — Carolyn Costin , Eating Disorders Today

"Feeding Anorexia will be of most interest to scholars of anthropology, psychology, women’s studies, and/or family studies. The book is well organized and written in a way that makes it accessible to both upper-level undergraduate and graduate social science students." — April Morgan , Medical Anthropology Quarterly

"[A] rich and sensitive ethnography. . . . Feeding Anorexia interweaves theory and ethnographic detail well and covers many themes. . . . Gremillion's text does justice to complex themes pertaining to anorexia, and these include health, fitness, the female body, family life, class, and ethnicity. Copious notes also provide plenty of additional background and references. Gremillion's work manages to add new facets to discussions about anorexia in particular, but also contributes to our understanding of how categories - such as the female body - are constructed." — Rachel Gooberman-Hill , Journal of the Royal Anthropological Institute

"[A]n incisive ethnographic critique. . . . Feeding Anorexia is an outstanding book of interdisciplinary importance. Through her detailed ethnographic work, insightful analysis, and cogent framing of a critical anthropology of the body, Helen Gremillion contributes significantly to scholarship in medical anthropology; and by skilfully integrating and interpreting themes from psychology and feminist analysis, she also considerably enhances discourse within these disciplines. Gremillion's work, moreover, transcends the boundaries of academia, as her sensitive and innovative treatment of the issues surrounding therapy for anorexia has the potential to spark a critical debate among those personally involved in the treatment of, and recovery from, eating disorders." — Karin Eli, Journal of Biosocial Science

"[O]ffers a thorough bibliography and commendable discussions of Western cultural demands on women and views of women. . . ." — Elaine L. Phillips, Psychology of Women Quarterly

"Extensive, detailed, and well referenced. . . . The most enjoyable parts of the book are the specific case studies, sample dialogues between therapist and patient and/or staff conversations." — E. R. Patterson , Choice

"Gremillion has developed an important perspective on anorexia treatment and, more broadly, on the complex relationships between medicine, illness, and identity. . . . Feeding Anorexia is a terrific work of sensitive and insightful ethnography, of feminist poststructuralist practice, of medical sociology, and of embodied theory. It will be of great interest for feminists, students and scholars of the sociologies of the body and medicine, and therapists and other clinicians." — Victoria Pitts , American Journal of Sociology

"Gremillion's vivid account of a prestigious North American psychiatric program for adolescent girls with anorexia is an insightful and welcome addition to an already vast sea of literature that is replete with textually based, discourse orientated analyses. . . . Feeding Anorexia is one of the most significant books to appear on this topic. . . . Gremillion's work stands as a model for ethnographic research that can have a direct application in the lives of the people we work with." — Megan Warin, The Australian Journal of Anthropology

"I find Gremillion's critique devastating. Happily, an epilogue discusses a promising alternative, narrative therapy." — Richard O'Connor, Canadian Review of Sociology and Anthropology

"Overall, Feeding Anorexia is interesting and thought-provoking. Most of the points Gremillion makes in her critical analysis seem intuitively accurate. . . . [T]his book should raise consciousness about the social and cultural context that pervades the treatment of anorexia nervosa in North America." — Marion P. Olmsted , Journal of Nervous and Mental Disease

"This is one of the more interesting books that I have had the opportunity to review because it deliberately sets out to challenge the prevailing assumptions regarding the treatment of patients with anorexia nervosa." — Stephen Touyz , Clinical Psychologist

“Helen Gremillion has presented an intellectual tour de force in this book. She has taken one of the most contentious and resistant expressions of women's and girls' subjectivity, anorexia, and provided us with a dynamic social and political framework by which to understand its perplexing operations.” — Elizabeth Grosz, author of Volatile Bodies: Toward a Corporeal Feminism

“Many have sensed that anorexia makes visible in some way pathologies that are particular to liberal consumer society, but few have grasped its nature and significance as acutely as Helen Gremillion. Her account is as compelling as it is compassionate.” — Jean Comaroff, University of Chicago

“This is a wonderful, beautifully written, intelligent account of anorexia nervosa—and I say that as someone in feminist theory, women’s studies, and medical discourse analysis who had hoped she would go to her grave without ever having to read another word about anorexia nervosa. This really is a fresh interpretation, and the ethnographic material is stunning, dramatic, and described with precision, sophistication, and telling novelistic detail.” — Paula A. Treichler, author of How to Have Theory in an Epidemic: Cultural Chronicles of AIDS

"Time after time in my conversations with hospital patients I was bewildered when they informed me 'I became more anorexic for the doctors!' and when their mothers told me 'They said I shouldn't love my daughter so much!' Feeding Anorexia helps us all to comprehend such unintended consequences of mainstream treatments. It should lead to the reconsideration of anorexia itself and its treatment by professionals such as myself." — David Epston, coauthor of Biting the Hand That Starves You: Inspiring Resistance to Anorexia/Bulimia


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Author/Editor Bios Back to Top

Helen Gremillion is Assistant Professor and Peg Zeglin Brand Chair in the Department of Gender Studies at Indiana University, Bloomington.

Table of Contents Back to Top
Acknowledgments ix

Prologue xv

Introduction: In Fitness and in Health 1

1. Crafting Resourceful Bodies and Achieving Identities 43

2. Minimal Mothers and Psychiatric Discourse about the Family 73

3. Hierarchy, Power, and Gender in the "Therapeutic Family" 119

4. "Typical Parents Are Not 'Borderline'": Embedded Constructs of Race, Ethnicity, and Class 157

Epilogue: A Narrative Approach to Anorexia 193

Notes 211

Bibliography 247

Index 271
Sales/Territorial Rights: World

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Additional InformationBack to Top
Paper ISBN: 978-0-8223-3120-9 / Cloth ISBN: 978-0-8223-3133-9
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