February 26, 2014

Anorexia Nervosa: from the Inside-Out. ~ Tabitha Farrar

anorexia psa

It’s National Eating Disorder Week, and for many of us that are professionals in the field, this week brings conflicted feelings.

While I spend my life speaking out about eating disorders, have written a book on my story through Anorexia and coach others to find their own path out, NEDA week brings with it a news-stream decorated with titles such as “dying to be thin” or others that claim Anorexia is about ‘control.’

There is so much misunderstanding that comes from trying to understand—I wonder is this ‘awareness’ week doing more harm than good? I often feel this week creeping up on me with a sense of dread. And here is why:

Anorexia is not caused by the media, the sufferers’ parents or a desire to be thin.

Anorexia is not the same as dieting because one wants to lose a few pounds.

Anorexia is a complex mental disorder and needs to be respected as such.

But it’s a new thing right? Only been about since we started watching TV so much; it stands to reason that Anorexia is a product of negative body image…


The first medical description of Anorexia nervosa was written up by Richard Morton in 1689 in a paper where he referred to it as a ‘wasting condition.’ Sir WIlliam Gull coined the term Anorexia Nervosa much later in 1868. (I like the sound of this Gull fellow as he was one of the first to speak out on the subject of women being allowed to enter the medical profession. In February 1886 he chaired a meeting at the Medical Society in Cavendish Square to establish a medical scholarship to be awarded to women.)

In 1868, he addressed the British Medical Association in Oxford with what he referred to as ‘a particular form of disease occurring mostly in young women between the ages of 16 and 23 characterised by extreme emaciation.” His case studies of three of his patients led him to observe “extreme and peculiar restlessness.”

There were reports of Anorexia in the Hellenistic period, that is the period of ancient Greek and mediterranean history between the death of Alexander the Great in 323 BC and the emergence of the Roman Empire in 31 BC. Holy anorexics abused their bodies, rejected marriage and sought religious asylum where many perished and apparently became saints.

I am not religious, but I get this, there certainly was some feeling of moralistic virtue that I found in restricting food.

Anorexia Mirabilis interests me. It seems similar to Anorexia Nervosa but with the additional restriction of other pleasures, so lifelong virginity, sleeping on beds of thorns and whipping one’s own flesh. All these things seemed to be a way to get close to Christ in the separation of body and spirit. The concept being that the spirit was so much stronger than the physical body.

Anorexia Mirabilis can be translated to mean miraculous lack of appetite; it refers to women in the Middle Ages who would starve themselves to the point of death in the name of God. Both Angela of Foligno (1248-1309) and Catherine of Siena (1347-1380) were said to be Anorexia Mirabilis sufferers. Catherine of Siena at age six claimed to see Christ, and by age 7 she made a vow of perpetual virginity. Her older sister demonstrated fasting behaviors in order to attempt to control her husband’s attitude and Catherine followed suit after her sister’s death. For her entire life Catherine’s diet consisted of vegetables and water. She died of starvation age 33.

In the Middle Ages, self-starvation was a common behavior among religious women; suffering was regarded as a path to Christ—to suffer how he suffered.

I have read that Anorexia Nervosa overtook Anorexia Mirabilis in popularity as a term to describe what seems fundamentally to be the same disorder. I think that Anorexia Nervosa may well be the modern day translation of Anorexia Mirabilis. I do not think that sufferers understood it then and I do not think that we understand it now, so we grasp at the closest route to explanation.

In the time of Catherine of Siena, claiming that emaciation was for the good of God may have seemed like the most fitting excuse for this wasting disease, nowadays claiming that Anorexics are trying to be like catwalk models seems more fitting and relevant to our fat-shaming society. It all seems to be the same thing expressed differently to me.

And my feelings? I certainly felt supersiduous when I was anorexic. Or at least, a part of me did, as I would simultaneously know that I was abnormal and suffering from something that I did not truly understand. But I did feel it, and had I lived in a time where I could excuse my emaciation as a blessing or a superior way of moral conduct you can be sure I would have done that, to protect my ego if nothing else.

Anorexia succeeds and ends in death more frequently than any other psychiatric disorder, and it is my personal opinion from my experience as a sufferer that the desire to be thin in order to look good was a very low motivating factor for me. I looked good before I developed Anorexia—and I look good now—but when I was six foot and 96 pounds, I looked like death.

This disorder has been about far longer than the fashion industry and the media. Its deeper than that. I am telling you it is far deeper than words can describe. I think that there are some eating disorders and behaviors that do come about as a result of social pressure to look good, but not Anorexia Nervosa. Not in my personal experience.

Anorexia is so deep that something as superficial as good looks just do not even feel like they fit into the same category. I consult my intuition more than anything else when I read and research into theories, and although it appeals to me to believe that Anorexia is a result of a sick media world, I know deep within me that is not true.

Why would I want to believe that?

Well, because I would love some mud to sling at the media’s representation of the modern day ideal woman being a size zero with huge breasts. I really would love to be able to blame that for my Anorexia because it would make me feel justified. I would love to place the blame on something external and claim that Anorexia was done to me. I have done that. I tried that on for a while.

But it felt wrong. It felt good for a bit, I felt very justified in screaming at society and supporting women’s rights; I still do feel justified about supporting these important issues. But I have learnt to leave my Anorexia out of it.

I know that my Anorexia came from within me not from outside of me.

And this week I would love for awareness to be brought to the fact that clinical disorders such as Anorexia cannot be caused by parents, the media or a will to be thin. These factors may come into triggering Anorexia—should that person be predisposed to it—but they cannot alone cause what is a life threatening mental disorder.

Anorexia is not a lifestyle choice any more than schizophrenia is. Anorexia it is not wanted by those that it affects any more than the flu is.

Pointing the finger at the media as a cause for Anorexia is not raising awareness, it is damaging sufferers further by reinforcing a fictitious stereotype.

I personally was too ashamed to admit my Anorexia to anyone for years because I was sure that I would be judged as someone that was trying to be thin, watched too much TV and silly a catwalk model wannabe. This misrepresentation of my disease by society is what kept me hiding for so long.

National Eating Disorder Awareness week should be our chance to educate rather than accuse. Anorexia Nervosa is a complex mental disorder and needs to be respected and treated as such.

Anorexics are not dying to be thin but they are dying to be given the encouragement that they need to seek treatment.

Recovery is possible, but for many of us it is the stigma attached to our disorder that keeps us from seeking help.



Saint Catherine of Siena: A Study in the Religion, Literature, and History of the Fourteenth Century in Italy. Gardner, 1907.

Diets and Dieting: A Cultural Encyclopedia. Sander L. Gilman, 2007.

Religion and Psychiatry: Beyond Boundaries. Peter Verhagen, Herman M. Van Praag, Juan José López-Ibor, Jr., John Cox, Driss Moussaoui. 2010.

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