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Anorexia Nervosa

The revival of a feminist hoax


New life for a hoax that had been debunked and laid to rest a long time ago.

On October 14, 1999, on the early-evening news, CITV (Edmonton, Alberta, Canada) carried an item about a young woman with anorexia nervosa.  The closest the woman's appearance could be described would be as being to some extent like a terminal cancer patient that had been wasting away for a long time and is in the last stages of his disease or as being like the people in some of those photos that we see of concentration camp survivors.

In the closing paragraph of the item, the female announcer said that 8 million North American women suffer from some kind of eating disorder and that about 480 thousand of them die.  Aside from the fact that the mortality rate for all of these women is seriously under-estimated, because eventually everyone dies, even women, whether they have an eating disorder or not, let's see what the experts have to say about the disorder.

A large variety of descriptions of the symptoms, etiology and treatment of anorexia nervosa can be found on the Internet.  Here is a small sample of excerpts

http://www.emedicine.com/EMERG/topic34.htm

Frequency:

  • In the U.S.: The incidence of anorexia nervosa is approximately 1/100 for adolescent females and is most frequently found in middle to upper class families. Most recent studies have suggested no increased incidence in anorexia nervosa over the last four decades. There appears to be a familial component.
  • Internationally: The rate of anorexia nervosa appears to be similar in all developing countries with high economic status.

Mortality/Morbidity: The mortality rate for anorexia nervosa ranges between 5-10% and is greater in bulimic patients.

Race:  Anorexia nervosa is significantly more frequent in white populations than in nonwhite. The co-existent effect of socioeconomic class, however, is difficult to separate out.

Sex: The female to male ratio is 10-50:1 in developed countries.

Age: Anorexia nervosa is primarily a pubertal and early adult phenomenon, although premorbid determinants and long-term outcomes are still being defined.

Let's see. Multiply the 8 million women mentioned by the CITV news announcer with the incidence rate just mentioned above and assume that it holds true for all eating disorders, and, voila, we have 800 million women in North America, about ten times as many than are of the age of 12 or older.

Credit must be given to the authors of the webpage.  They provide anyone who selects a phrase longer than five words with a warning that a large amount of text has been selected.  I guess they want to protect the innocent, because it seems that they don't want anyone to know that their incidence rate is a bit too high.  Surely it couldn't be so high as to tell us that about ten times more women suffer from it than exist in North America.  Or could it be that CITV pulled a boner?  Clearly, either the information provided by CITV or the web page or both are wrong.

Who suffers from anorexia nervosa?  According to the information available at http://www.eatright.org/aeatingdisorders.html, apparently based on the Diagnostic Standards Manual (DSM-IV), all who insist on dieting to the extent that they fail to maintain their body weight in the order of at least 85% of the body weight that would be normal for their age and height is a sufferer.

Aside from the fact that there may be many other reasons for having a body weight that low, there must also be some psychological reasons (usually hard or often impossible to measure) that are contributing factors, not the least of which is apparently race, age and residence in a wealthy developed nation, as it is said that it is predominantly rich, young Caucasian women in wealthy developed nations who suffer from the affliction.

307.1 Anorexia Nervosa

     Diagnostic criteria for anorexia nervosa:

     A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
     B. Intense fear of gaining weight or becoming fat, even though underweight.
     C. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
     D. Amenorrhea in postmenarchal women, that is, the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her menstrual periods occur only after administration of hormones such as estrogen).

At http://www.medstudents.com.br/endoc/endoc2.htm it is stated that "The disorder afflicts predominantly white, young females (95 per cent). The disorder is associated with higher social class, occurring in up to 1 in 250 adolescents students in private schools.

Considering that emphasis is placed on private schools and that 95% of the patients afflicted with anorexia nervosa are white, it must be assumed that the authors of this web page consider the overall incidence of anorexia nervosa in the general population to be far lower and that they think it is primarily a disease that afflicts the daughters of well-to-do parents who sent their daughters to private schools.

It seems from that and other indications given at the page that the disease isn't so much a psychiatric disease as it is a psychologically induced condition.  However, from the numbers given at this web page, it seems hardly possible to extrapolate to a total of afflicted women that comes even close to the 8 million figure mentioned in the CITV newscast.

The web page at http://www.pgi.edu/progress/prog1/hagopian.htm appears to focus on that aspect of the disease.  It considers the disease a "psychosociological disease which affects young and healthy girls primarily in adolescence."

Anorexia nervosa is a psychosociological disease which affects young and healthy girls primarily in adolescence (Bruch, 1978). It is predominantly a woman's disease which has been around for many centuries. Over the last two decades however, the incidence of this disorder has risen to alarming proportions. As many as one out of every 100 girls between 12 and 18 may develop the disorder (DSM-III-R, 1987). It is characterized by the refusal to maintain body weight over a minimal normal weight for age and height; intense fear of gaining weight or becoming fat even though underweight; a distorted body image; and, amenorrhea. Most often, its onset occurs around puberty (in the junior and senior years of high school) or when going off to college (Hsu, 1983). Both of these periods signify the emergence of adulthood and separation from parents.

"As many as one out of every 100 girls between 12 and 18" get the disease it says here, but even though all of the qualifiers that were given at the preceding web page were omitted, it would still be unreasonable to assume that the incidence rate would hold true of all women in North America.

Considering that there are about 80 million women in total in North America and that at the very most one in hundred are afflicted, it would seem that the figure mentioned by CITV, and without any doubt by other TV networks as well, is sensationally over-stated.  The total number of victims couldn't possible exceed 800,000, according to the information quoted from the DSM-III and the DSM-IV.  It would be a serious error to assume that more than half of them die from the disease, because it is stated at various sources that the recovery rate from the disease is quite good.

The risk of death from anorexia nervosa is assessed at
http://www.noah.cuny.edu/wellconn/eatdisorders.html#How Serious Are Eating Disorders

Complications of Bulimia Nervosa without Anorexia.

. . .
Long Term Outlook.  There are few major health problems for bulimic people who maintain normal weight and do not go on to become anorexic. In general, the outlook is better for bulimia than for anorexia. It should be noted, however, that in one study of bulimic patients, after six years the mortality rate was 1% in women who were in therapy. Another study found that 20% of women with bulimia were still battling the disorder after ten years.
. . .

Complications of Anorexia Nervosa.

. . .
Risk of Death.  Many studies of anorexic patients have found death rates ranging from 4% to 20%. The risk of death is significant when weight is less than 60% of normal. Suicide has been estimated to comprise half the deaths in anorexia. (One can reasonably take the position that all cases of anorexia are suicide attempts.) The risk for early death is twice as high in bulimic anorexics as it is in the diet-restrictor types. Other risk factors for early death include being sick for more than six years, previous obesity, personality disorders, and dysfunctional marriages. Males with anorexia are at particular risk for life-threatening medical problems, probably because they are usually diagnosed later than girls.

That item states what the range of the mortality risk was in "many studies" but it doesn't state what those studies investigated.  Were the samples randomly selected or were they based on anecdotal evidence?  At any rate, it appears that the incidence of death from anorexia nervosa is so low that it has yet to raise sufficient concern to be measured without any bias by the "researchers" involved in investigating it.

It seems that none of the web pages indicated in the above provide any information that permits to draw accurate conclusions in that respect.  Nevertheless, all of them appear to indicate that the CITV news items isn't only wide off the mark but not even in the right ball park.

However, the feminist hoax acquired new life on account of the newscast and will reverberate once more through feminist propaganda for a long time to come.

It should be possible to determine what the true facts are.  Christina Hoff-Sommers did that in "Who stole feminism?" and determined that around 150,000 women in the US suffer from anorexia nervosa and that only 54 per year die from health complications that arose from that affliction, a very far cry from figures that rival deaths from cancer of the prostate or from breast cancer.

My copy of the book was lent out and hasn't been returned yet.  I'll supply the pertinent information when the book is returned to me.  In the mean-time, here are a few partial quotes relating to what Christina Hoff Sommers reported on in her book.  The quotes are shown at http://www.vix.com/men/books/sommers/whostole.html

"In Revolution from Within, Gloria Steinem informs her readers that 'in this country alone...about 150,000 females die of anorexia each year.' That is more than three times the annual number of fatalities from car accidents for the total population. Steinem refers readers to another feminist best-seller, Naomi Wolf's The Beauty Myth. And in Ms. Wolf's book, one again finds the statistic, along with the author's outrage. ...

"Where did Ms. Wolf get her figures? Her source is Fasting Girls: the Emergence of Anorexia Nervosa as a Modern Disease, by Joan Brumberg, a historian and former director of women's studies at Cornell University. ... Professor Brumberg, in turn, attributes the figure to the American Anorexia and Bulimia Association.

"I called the American Anorexia and Bulimia Association and spoke to Dr. Diane Mickley, its president. 'We were misquoted,' she said.  In a 1985 newsletter the association had referred to 150,000 to 200,000 _sufferers_ (not fatalities) of anorexia nervosa."

A more comprehensive and on-line version of what Christina Hoff Sommers found is in a series of articles she had published in the National Review: Figuring out feminism - how feminists abuse statistical information to serve their political agenda - Cover Story, National Review,  June 27, 1994

It appears that the CITV newscast came close to Gloria Steinem's and Naomi Wolf's sensationalist claims and, with respect to the numbers quoted of women suffering from eating disorders, trumped the experts at the American Anorexia and Bulemia Association by a factor that may be better than 50 and as high as 80.  That is quite a feat of sensationalist reporting.

The moral of this story:  You can't trust everything you are being told in newscasts by feminist-dominated TV networks that unquestioningly accept items of information fed to them by feminist propagandists.  The question is: How far can anyone trust these networks?

However, with a little bit of work and a few minutes of time spent searching for such information, CITV could have done much better, but then they would not have had a sensationalized news item for the evening news.  Still, for the sake of the truth, if that should matter at all to CITV, they could easily have sorted the wheat from the chaff.  Here is information I found within two minutes of searching with google.com:

Long-term Survival of Patients With Anorexia Nervosa: A Population-Based Study in Rochester, Minn

SERGIO R. KORND—RFER, MD; ALEXANDER R. LUCAS, MD; VERA J. SUMAN, PHD; CYNTHIA S. CROWSON, BS; LOIS E. KRAHN, MD; L. JOSEPH MELTON III, MD

Mayo Clin Proc. 2003;78:278-284 — 2003 Mayo Foundation for Medical Education and Research

Abstract

  • Objective: To estimate long-term survival of unselected patients with anorexia nervosa from Rochester, Minn.

  • Patients and Methods: In this population-based retrospective cohort study, all 208 Rochester residents who presented with anorexia nervosa (193 women and 15 men) for the first time from 1935 through 1989 were monitored for up to 63 years. Subsequent survival was compared with that expected for Minnesota white residents of similar age and sex, and standardized mortality ratios were determined on the basis of age- and sex-specific death rates for the US population in 1987.

  • Results: Survival was not worse than expected in this cohort (P=.16). The estimated survival 30 years after the initial diagnosis of anorexia nervosa was 93% (95% confidence interval, 88%-97%) compared with an expected 94%. During 5646 person-years of follow-up (median, 22 years per patient), 17 deaths occurred (14 women and 3 men) compared with an expected 23.7 deaths (standardized mortality ratio, 0.71; 95% confidence interval, 0.42-1.09). One woman died of complications of anorexia nervosa, 2 women committed suicide, and 6 patients (5 women and 1 man) died of complications of alcoholism. Other causes of death were not increased.

  • Conclusions: Long-term survival of Rochester patients with anorexia nervosa did not differ from that expected. This finding suggests that overall mortality was not increased among the spectrum of cases representative of the community.

Mayo Clin Proc. 2003;78:278-284

For those (such as feminists at large and those at CITV) who have trouble understanding what that says, in plain English it states that anorexics live just as long as people normally do.  Pursuing the obsession of anorexia nervosa neither harms the life expectancy of anorexics nor does it lengthen it.


Looking at anorexia nervosa from another perspective

Back to Anorexia-Nervosa Index Page

Back to Index of Health Issues

_______________
Posted 1999 10 14
Updates:
2001 01 25 (format changes)
2002 02 26 (a few grammatical changes)
2006 11 16 (added reference to Long-term Survival of Patients With Anorexia Nervosa: A Population-Based Study in Rochester, Minn)
2008 03 06 (added reference to Figuring out feminism - how feminists abuse statistical information to serve their political agenda)