The rise and fall of a fact: the increase in anorexia nervosa.

Abstract

Over the last thirty years, it has regularly been asserted that the incidence of anorexia nervosa is increasing. The paper examines the background of this idea, traces its origins, and analyses the process whereby it became widely accepted within the medical and sociological literature. The study is based upon a citation list of all the epidemiological studies of anorexia nervosa with publication dates between 1960 and the end of 1990, which has been used to identify the most important publications on the prevalence and incidence of the disease. Scrutiny of the content of these key publications has allowed us to follow the emergence, and then the partial break-up, of a broad consensus -involving clinical psychiatrists and psychoanalysts, as well as medical sociologists and historiansaround the assertion that anorexia nervosa was increasing in incidence. In the course of this historical reconstruction, four distinctive patterns of citation behaviour were revealed. The paper also examines the changing nature of the explanation offered for the putative rise in the numbers of sufferers and suggests reasons why such a perspective upon the disease was widely supported by clinicians and by a variety of other commentators.

“Most Girls Want to be Skinny”

“…As women around the world retool their identities in the face of globalization, eating disorders now affect women from different ethnic backgrounds and sociocultural milieus (Becker, Fay, Gilman, & Striegel-Moore, 2007;Lake, Staiger, & Glowinski, 2000;Miller & Pumariega, 2001;Soh, Touyz, & Surgenor, 2006;Tsai, Curbow, & Heinberg, 2003;Wildes, Emery, & Simons, 2001). Clearly, as eating disorders are diagnosed in places once thought "immune" to these illnesses, their cultural boundedness, salient illness expressions (i.e., fat phobia), and prevalence have been questioned, raising concern over the sociocultural Qualitative Health Research 21(10) determinants of eating disorders (see Lee, 1997;van't Hoft & Nicolson, 1996).…”

Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology.

“…We begin by evaluating whether rates of eating disorders have increased significantly over recent decades because evidence of a secular increase has been used as the cornerstone of arguments that they are caused by the recent emphasis on thinness (Garner et al, 1980;Russell, 1985). However, this evidence has been challenged by several investigators (Fombonne, 1995(Fombonne, , 1996Lucas, 1992;Pawluck & Gorey, 1998;Van't Hof & Nicolson, 1996), sparking considerable debate on this point. We then examine the crosshistorical and cross-cultural evidence for eating disorders.…”

Language use as Social Strategy: A Review and an Analytic Framework for the Social Sciences

“…Making good stories for influence is not confined to influencing children and readers. There are many other examples of analyses of stories (Kuusisto, 1998; MacMillan & Edwards, 1998; Szuchewycz, 1994), including examples in “science” of scientists continuing to follow an idea or theory because “it made a good story” (Pullum, 1991; Van't Hof & Nicolson, 1996). This even goes by the name of “parsimony,” and it is sometimes considered a good feature of science.…”