Body image and eating disorders: adolescence and gender. (The Mortification of the Flesh).

This work forms part of a research project entitled "Gender, Development and Image Disorders: Psychosocial Bases for Social and Educational Action" National Research Plan, Sector Program, CICYT-Ministry of Labor and Social Affairs, Women and Gender Studies, 1997-1999, to be published by Spain's Instituto de la Mujer (Women's Institute). The authors are professors of psychology at the Instituto Universitario de Estudios de la Mujer (University Institute of Women's Studies) at the Universidad de Valencia.

1. Introduction

Body image and aesthetic norms affect the psychological development of both men and women, but preadolescent and adolescent girls are those most likely to suffer from eating problems and conflicts in the construction of their body image. Ninety-five percent of those who suffer from eating disorders are women. Although image conflicts are not exclusive to women, standards of beauty and thinness are especially rigid for females (Dolan and Gitzinger, 1995; Thompson et al., 1999) and condition them to strive for an exacting model of socially-accepted femininity.

Faced with inflexible indicators of femininity defining the "essence" of "a real woman," adolescent girls question the transformations of their bodies that distance them from the sexual ideal. Their concern is concentrated in the conflictive anatomical zones which embody sexual attractiveness according to the gender stereotype, which prevents them from constructing a comprehensive personal image.

Today, eating disorders have reached serious social and psychological dimensions. The number of people suffering eating disorders has increased and is reaching ever wider sectors of the population. Worrisome signs are found even in behaviors long-considered habitual and even desirable, such as dieting and excessive exercise. Although anorexia and bulimia are not new, the level of morbidity and mortality associated with these disorders is increasing. Epidemiological studies indicate that eating disorders affect roughly 1% of the population, with risk peaks at ages 13-14 and 17-18. According to Toro (1996), between 1% and 2% of adolescent girls suffer from anorexia nervosa, with a male-female ratio of 1:10. This author also estimates the prevalence of bulimia to be between 2% and 3% of the adolescent population, with a similar male-female ratio.

Although adolescence is a particularly critical period given the role played by body image in the formation of identity, these alterations occur during other life stages as well. Furthermore, the age of onset of eating disorders is dropping, and onset is occurring at increasingly later ages as well. Affected groups include not only those in the typically vulnerable occupations which require a "trim" personal appearance and bodies in top shape (stewardesses, models, athletes, dancers), but also populations and social classes previously considered immune, such as low-income groups and immigrants. Even citizens of underdeveloped countries have begun to suffer from these disorders under the growing influence of western consumer culture.

The rise of eating disorders can be understood as a "cultural disturbance" (Gordon, 1994) in which the "ideal of thinness" becomes not just an aesthetic norm but an ethical value, a component which defines the individual and his or her personal and social success. From this perspective, eating disorders are not just disturbances of the individual's alimentary function but culturally-modulated conflicts in the elaboration of body image. The factors which predispose individuals to eating disorders are not only personal but familial and socio-cultural. In addition to problems of development and maturation, conflicts in sexual, family and group relations also are involved, all occurring in a context of strong demands for control and assumption of cultural gender-model guidelines.