Page 75 - Humanism 2019

In the Journal of American Medical Association in 1938, case studies on anorexia published in the Journal of the
a case study of eight anorexic patients concluded, “this American Medical Association. One study included a 14-
metabolic disorder is based primarily on psychologic year old patient that “with the help of an insurance
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disturbance and that its various manifestations should not pamphlet … put herself on a diet.” In addition,
be attributed to dysfunction of any endocrine gland.” insurance companies created standardized tables that
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Furthermore, it advocated psychotherapy in order to showed acceptable weight for every height.
change the attitude of the patient toward food to insure a
permanent recovery, as opposed to temporary hormonal At the same time, the emergence of “flappers” in popular
therapies that did not address the underlying mental fashion and media brought displays of fit and
conflict. By 1940 many physicians abandoned the breathtaking dancers into everyday life. In 1908, Parisian
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biological model in favor of psychological treatment. designer Paul Poiret created fashion pieces that deviated
from the previous Victorian voluptuous shape when he
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Physicians began to construct an “anorexic personality.” formed a new image of beauty that emphasized thin hips,
The common qualities of anorexic patients that physicians flat chests, and long legs. Women of all ages adored the
in the mid-20th century noticed were similar to the “flapper” image of the 1920s, and in order to meet the
patients that went to Gull 50 years prior. More often than growing demand for the new fashion, the American
not, they were intelligent, high-achieving, “had done well garment industry utilized standard sizing for efficient
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at school,” and were at the head of their class. They were mass production. Women became acutely aware of their
sensitive, hypercritical, and ambitious young women who body shape as they tried to fit into the limited
“dreaded mediocre standing” standardized clothing sizes in
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and always received high department stores.
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grades in school.
More often than not, they were Metropolitan Life Insurance
Yet anorexic patients of the Company (MLIC) data that
mid-20th century endured a intelligent, high-achieving, “had tracked the progression of male
unique struggle with body done well at school,” and were and female weight through the
image and dieting generally 20th century shows how
absent in the experience of at the head of their class. They females embodied social
anorexics in Victorian times. were sensitive, hypercritical, pressures to be thin. In the
In the case studies of anorexia study, short men had gained 5
published in the 1930s and and ambitious young women pounds compared to previous
1940s, most of the girls began who “dreaded mediocre counterparts in studies
refusing food after being teased conducted from 1885-1900 and
about their weight. One young standing” and always received 1909-1927, and average height
woman confessed she began to high grades in school. men had gained 1 to 3 pounds.
diet “after hearing a remark at Women on the other hand,
a party about her plumpness.” affected by the early 20th
Another girl resented her size century’s obsession on thin
after “teachers, her older brother and others called her a bodies and diets, lost weight. Twenty-five year olds were
‘heifer.’” In a different case, the girl didn’t eat because she 5 to 6 pounds lighter, and women thirty-five to fifty-five
felt that boys “did not like a fat girl.” were 2 to 4 pounds lighter.
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What social changes of the 20th century were responsible In the period after World War II, Dr. Hilde Bruch
for the rise in a zealous desire to be thin? One of them is developed new, multi-faceted and extensive psychiatric
the rise of obesity-related illness and the emergence of views on eating disorders that continue to the present
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health insurance companies who informed Americans day. She ushered in the modern understanding of
that, in general, thinner bodies were healthier ones. By anorexia nervosa with her book Eating Disorders (1973)
1912, the Actuarial Society of America had published that included thirty years of her work with not only
studies that indicated a strong correlation between being anorexic patients, but with a variety of individuals who
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overweight and premature mortality. As a result, exhibited disordered eating. She argued that traditional
insurance companies and doctors issued diet manuals to method of psychoanalysis, in which patients would
patients that included calorie charts. By the 1930s, confess private fears or thoughts to a doctor who
doctors told Americans that the previously cited figure, interpreted their unconscious meanings, was ineffective.
3,000 calories a day, was too high; for middle-class By telling their patients the significance of their food
Americans with sedentary jobs, 2,400 calories was ideal. refusal, Bruch believed doctors were depriving their
The influence of these pamphlets is evident in a series of patients of the chance to understand the illness on their

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