Feeding Anorexia: Gender and Power at a Treatment Center

Feeding Anorexia challenges prevailing assumptions regarding the notorious difficulty of curing anorexia nervosa. Through a vivid chronicle of treatments at a state-of-the-art hospital program, Helen Gremillion reveals how the therapies participate unwittingly in culturally dominant ideals of gender, individualism, physical fitness, and family life that have contributed to the dramatic increase in the incidence of anorexia in the United States since the 1970s. She describes how strategies including the meticulous measurement of patients' progress in terms of body weight and calories consumed ultimately feed the problem, not only reinforcing ideas about the regulation of women's bodies, but also fostering in many girls and women greater expertise in the formidable constellation of skills anorexia requires. At the same time, Gremillion shows how contradictions and struggles in treatment can help open up spaces for change. Feeding Anorexia is based on fourteen months of ethnographic research in a small inpatient unit located in a major teaching and research hospital in the western United States. Gremillion attended group, family, and individual therapy sessions and medical staff meetings; ate meals with patients; and took part in outings and recreational activities. She also conducted over one hundred interviews-with patients, parents, staff, and clinicians. Among the issues she explores are the relationship between calorie-counting and the management of consumer desire; why the "typical" anorexic patient is middle-class and white; the extent to which power differentials among clinicians, staff, and patients model "anorexic families"; and the potential of narrative therapy to constructively reframe some of the problematic assumptions underlying more mainstream treatments.