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The Political Economy of Bulimia
Nervosa
Iain Pirie
a
a
Politics and International Studies, University of Warwick,
Coventry, CV4 7AL, United Kingdom
Version of record first published: 15 Jan 2011
To cite this article: Iain Pirie (2011): The Political Economy of Bulimia Nervosa, New Political
Economy, 16:3, 323-346
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New Political Economy, Vol. 16, No. 3, July 2011
The Political Economy of Bulimia
Nervosa
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IAIN PIRIE
Bulimia Nervosa constitutes a major social problem. There have, however, been
few, if any, attempts to understand the distinctive features of this disorder from
within the social sciences. Rather, the increasing prevalence of all forms of
eating disorders are understood as a product of how the concepts of ‘femininity’
and the ‘controlled body’ are constructed within contemporary society. Bulimia
and anorexia are ultimately seen to have their roots in the same social phenomena.
While recognising the insights that the existing literature offers, we argue that in
order to fully understand the rise of bulimia we must focus on the food system.
More precisely, we must examine how the commercialisation of food preparation
has led to a partial breakdown in meal structures and the rise of ‘everyday’
bingeing. The rise of extreme forms of disordered consumption associated with
bulimia can be related to broader changes in the eating regime.
Keywords: gender; eating disorders; food systems
Introduction
In 1996 Ben Fine published a paper in Appetite on the political economy of
anorexia nervosa.1 The arguments of this initial paper were presented in a more
developed form in his 1998 monograph The Political Economy of Diet, Health
and Food Policy. Unfortunately these publications have not had the effect of
encouraging other critical political economists to turn their attention to eating
disorders and Fine’s work remains one of the few explicit attempts to develop a
political economy of eating disorders focused on the food industry itself (see
also Guthman and DuPuis 2006). In many respects this is surprising given that
eating disorders are one of the most set of significant social problems facing
advanced capitalist societies today.
This article seeks to build upon Fine’s initial work through a more focused study of
how the organisation of food provisioning systems in contemporary capitalism has
created a generalised disorder in patterns of food consumption. This disorder can,
Iain Pirie, Politics and International Studies, University of Warwick, Coventry, CV4 7AL, United
Kingdom. E-mail: [email protected]
ISSN 1356-3467 print; ISSN 1469-9923 online/11/030323-24 # 2011 Taylor & Francis
DOI: 10.1080/13563467.2011.519020
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Iain Pirie
we would argue, be related to the rise of bulimia since the mid 1970s. In attempting to
do so the article does not pretend to offer a comprehensive analysis of bulimia. Rather,
it seeks to draw attention to how a focus on food systems can enrich existing sociological analysis of the growth of eating disorders, which tend to focus on the nature of
femininity and the media, in advanced capitalist societies.
Existing sociological accounts have focused far more closely on anorexia rather
than bulimia (see for example Nagel and Jones 1992; MacSween 1993; Germov
and Williams 1996; Bordo 2003). While the linkages between the two conditions
are highly complex, with many former anorexics later becoming bulimic, their
exists important differences between these conditions. In physiological terms an
obvious major difference between the two conditions relates to levels of food
intake. While a large minority of anorexics may engage in binge/purge behaviour,
there exists a marked difference in overall levels of food intake between those
individuals categorised as being bulimic and anorexic. In order to be classified
as bulimic by a medical professional it is necessary to maintain a relatively
normal weight, otherwise the individual will simply be defined as binge/purge
anorexic (Palmer 2003). This physiological difference reflects the fact that
bulimics will exercise less control over consumption (simply eat more) than
both binge/purge and pure restricting anorexics. Second, as we argue in the
next section of the article, bulimia only emerged as a major social problem in
the 1970s whereas anorexia has a far longer and more complex history.
Analysis of the social conditions that gave rise to the rapid growth of anorexia in
the post-war era has a great deal to tell us about bulimia. The omnipresent concern
with the female body that dominates much of the contemporary media and the
complex contradictory pressures that young women face, the two major leitmotifs
with the literature, are equally relevant considerations when analysing bulimia
(Fallon et al. 1994; Hesse-Biber 1996; Bordo 2003; Wykes and Gunter 2005).
However, this work cannot be understood as offering an entirely adequate analysis
of bulimia. This literature cannot explain why anxieties surrounding food, body
image and the broader set of contradictory pressures that individuals (particularly
young women) face have resulted in increasing levels of bulimia (and binge
eating disorder, BED) rather than anorexia since the 1970s.
The central argument of this article is that it is only possible to develop a satisfactory analysis of the rise of bulimia as a social phenomena by synthesising a
focus on the social (particularly media) construction of the body and gender
with an analysis of changes in the food provisioning system. The rise of bingebased eating disorders must be related to changes in the temporal patterns of
food consumption and the size of eating events generated by the commercialisation of food preparation. At the same time, we need to remain conscious that
women are disproportionally represented among anorexics, bulimics and sufferers
from BED and that an overly developed concern with body image is a common
trait among all three conditions (Cargill 1999). It is important, therefore, to pay
attention to gender relations and the centrality of the body in the contemporary
media in explaining these disorders.
In the absence of particular socially constructed norms surrounding the control
of the body or wider gendered divisions within society, changes in food systems
may lead to particular individuals engaging in fairly regular binge eating but they
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The Political Economy of Bulimia Nervosa
are unlikely to lead to the emergence of a new set of fully fledged eating disorders.
Equally, the compensatory behaviours associated with bulimia cannot be satisfactorily explained by a focus on the food system itself, and the question’ ‘why
purge?’ can only be fully answered by reference to more long-standing analytical
concerns (concerning gender and the body). However, the question never presents
itself if the initial drive to binge is absent. It is this drive that can be at least
partially explained with reference to the food provisioning system. The creation
of a disordered regime cannot explain why certain population groups have
proven more vulnerable to bingebased eating disorders. Nevertheless, the creation
of a food regime, in which both the temporal structure of meals and size of eating
events are in a flux, constituted a necessary condition for the development of largescale bingebased eating disorders
The structure of the article reflects its central argument that a focus on food
systems is a necessary but not sufficient condition for the development of
bulimia. It is divided into three main sections. The first seeks to address a series
of questions regarding the categorisation (as medical disorders/social phenomena),
definition and measurement of the prevalence of eating disorders among different
population groups. The second offers a critical overview of what we would identify
as the key themes in the existing social science literature on eating disorders. The
purpose of this review is twofold. First, this section introduces the literature to
general readers of the journal with no specialist knowledge of eating disorders.
Second, it seeks to highlight the explanatory power and limitations of this literature
with particular reference to bulimia. Against this context the final section of the
article focuses directly on the food system itself. In the early part of this section
we outline the existing work on eating disorders and the food system. The majority
of this section concerned with how we could expand upon this analysis to draw linkages between changes in food provisioning systems and bulimia.
Eating disorders: the nature and scale of the problem
The construction of eating disorders as medical conditions has been the object of
sustained scrutiny by Foucauldian scholars (Malson 1998; Hepworth 1999).
Hepworth argues that female self-starvation was effectively constructed as a
medical condition in the 19th century with the ‘discovery’ of anorexia. Prior to
this female self-starvation had existed but had been understood as being linked
with religious observance. The terms on which medicalisation took place is
understood to have been determined by prevailing gender structures and to have
reflected the dominance of the ‘male gaze’. Medicalisation is understood as
being problematic for two main reasons. Firstly, it defined ‘anorexics’ as
passive malfunctioning subjects to be managed. The anorexic was denied any
agency and the complex ‘codes’ and meanings attached to self-starvation were
ignored. Secondly, the definition of anorexia as an illness led to the individualisation of the condition. Medicalisation led to a discourse that attempted to explain
anorexia largely in terms of the pathologies of individual young women and the
relationships between young women and their mothers within the family structure.
By way of contrast feminist scholars, both post-structuralist and Marxist, argue
that any analysis of anorexia must foreground the oppressive manner in which
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the concept of femininity operates in contemporary society (Bartky 1990; Malson
1998; Hepworth 1999; Bordo 2003).
It is important to recognise mainstream psychologists have themselves abandoned ‘strong’ versions of the individual pathology thesis that dominated early
work from within the medical establishment. Julie Hepworth’s (1999) interviews
with mental health professionals give the overwhelming impression that this group
admits that eating disorders are a complex multicausal condition within which
broader social conditions (the fashion industry and media images) play a role.
Anyone who cares to glance at a collection of essays written by eating disorder
professionals will be struck by the range of issues the medical establishment are
now willing to consider when seeking to explain vulnerabilities to eating disorders
(see for example Treasure et al. 2003; Thompson 2004). Indeed, rather than make
any arrogant claim to possess a monopoly of knowledge the medical profession
collectively admit the limitations of their understanding of the causes of eating
disorders.
While the medical establishment may not ignore the social dimension of eating
disorders for Hepworth the problem remains that they employ an inside/outside
framework. So contemporary psychologists may accept that the social is important
but would still look to analyse how the broader social environment interacted with
the internal characteristics of the patient. For Hepworth this is folly as the
‘internal’ psychological makeup of individual women is itself a product of the
social construction of femininity. The division, therefore, has no meaning.
This article aims to be sensitive to the concerns raised by these scholars. In
particular we would stress the need to understand eating disorders as social
phenomena rather than individual pathologies. Indeed, the central thesis of the
article is that the development of extreme forms of disordered eating associated
with bulimia must be related to a broader movement towards societywide disordered eating that can be dated to the 1970s. A major difference of emphasis
between Hepworth (1999) and ourselves lies in the role that material changes in
levels of self-destructive eating in the nineteenth century played in the construction of the disease of ‘anorexia nervosa’. Many scholars sympathetic to Hepworth’s analysis of medical establishment would maintain that their was a sharp
increase in levels of self-starvation in the nineteenth century (see for example
Vanderycken and von Deth 1994; Brumberg 2000). Understood against this
context, the medical profession did not so much create ‘anorexia’ as colonise
and define an emerging social problem within its area of expertise. Equally significantly, we remain open to the idea that there may be certain biological factors that
render certain individuals more vulnerable to eating disorders than others. A complete rejection of an internal/external framework of analysis effectively renders a
consideration of these factors impossible.
There are also practical issues in terms of how we engage with the medical literature. While rejecting medically based understandings of eating disorders,
Helen Malson (1998) employs statistics taken from the medical literature on the
prevalence of eating disorders in framing her study. This is not a criticism. Any
social analysis of eating disorders must concern itself with questions of epidemiology. Major funded epidemiological studies have been conducted under the supervision of medical scientists. Claims that eating disorders constitute a major social
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pathology unavoidably rest upon an analysis of data drawn up using standard
medical definitions of these conditions. In a sense, even when seeking to criticise
standard medical definitions of disordered eating, we are trapped within these
definitions.
A willingness to use medical statistics does not, however, resolve the problem
of measurement. Statistics on the epidemiology of eating disorders are highly
unreliable. However, some sense of the scale of the problem can be gained
from Daphne Van Hoeken et al. (2003) overview of the available empirical
studies. Van Hoeken et al. (2003: 14) estimate that approximately 0.3 per cent
of young women in North America and Western Europe suffer from full-scale
clinical anorexia. Bulimia is more prevalent with 1 per cent of the same population
group suffering from clinicallevel bulimia and up to 7 per cent displaying sub-clinicallevel symptoms. It has also been suggested that appropriately 3 per cent of all
Americans suffer from BED (Hudson et al. 2007). These figures reflect ‘the
medical gaze’ in terms of how they defined eating disorders but they are based
on large-scale surveys and provide a reasonable working base for analysis.
In order to make sense of these numbers it is necessary to understand how
eating disorders are defined. Importantly, anorexia is the default definition.
If an individual enters the medical system and they are seriously underweight
as a result of psychological rather than physical problems, they will be classified
as anorexic. Individuals who engage in binge and purge behaviour and are
seriously underweight cannot be classified as bulimic, as an initial definition of
anorexia excludes this. In order to be defined as suffering from clinicallevel
bulimia it is necessary to binge/purge consistently whilst maintaining a relatively
normal weight (Palmer 2003).
It is quite normal for a bulimic to engage in 13 or more binges a week in which
they will on average consume approximately 52000 calories 2 in addition to
calories consumed in normal meals (Cooper 2003: 26– 7). The structure of
consumption is transformed from a logical cyclical one in which consumption
is alternated with substantive periods of abstention – in which the use value
(calorific content) of food is exhausted 2 to one based on sporadic consumption
binges unrelated to physical need. The entire process of consumption is accelerated. Food is consumed quickly (as many as 4000 calories in half a hour) and
the point at which consumption may begin again (at which the physical properties
of food are exhausted) is accelerated through purging (Ibid: 2528). Binge eating
(whether linked to bulimia or not) necessarily represents the antithesis of a temporally well-defined eating regime based upon ritualised social events (meals)
linked to biological need.
Bulimia was only formalised as a distinct condition in the mid to late 1970s
(Boskind-Lodahl 1976; Russell 1979). This formalisation reflected the increasing
prevalence of bulimic behaviours in the core capitalist world from the late 1970s
onwards. Before this point there was a substantial population of anorexics who
binged/purged but these practices seem to been relatively uncommon in individuals of a normal weight, to have involved the consumption of non-foods and have
been confined to those who had suffered from severe psychological trauma
(e.g. infant refugees from Nazi Germany) (Blinder and Chao 1994). The issue
of BED is a difficult one. BED is currently defined as a research category rather
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than a distinct condition and academic research is still at a nascent stage. Similar
patterns of consumption are found in individuals suffering from bulimia and BED.
However, rather than engage in compensatory activities (vomiting), these individuals frequently become obese. Individuals suffering from BED are differentiated
from standard overeaters through the psychological distress associated with the
binge and the frequency of these events (Engel 2009). While BED is not explicitly
dealt with in our analysis of food systems it is easy to see how the same arguments
concerning the temporal restructuring of consumption and the normalisation of
binge could apply to an analysis of this condition.
As we have already suggested, an overdeveloped concern with body image is
commonly understood to lie at the heart of all three conditions (Goldschmidt
2009). It is also true that many former anorexics suffer from subsequent problems
related to bulimia. It is necessary to analyse both the general conditions that lie at
the heart of all eating disorders and the social changes that underpin changes in the
relative significance of different disorders. The conditions are not reducible to
each other but possess strong ‘family resemblances’.
Comparative analysis of the prevalence of eating disorders is virtually impossible. There are numerous nationally based non-comparable (due to differences in
population groups studied and method of data collection) studies on the prevalence of eating disorders that yield wildly varying results (see van Hoeken et al.
2003). The task of comparing historical data ascertained from within a single
state is very difficult. For example, in their attempt to assess comparative levels
of eating disorders in western states, Makino et al. (2008) include surveys conducted between two supposedly representative groups of young women in the
US in 1990 and 1992 that indicate rates of Bulimia of 1.3 and 5.1 per cent respectively. Nobody seriously believes that the prevalence of Bulimia increased by
almost 400 per cent over a two-year period. Rather, these changes obviously
reflect inconsistencies in data collection.2
In terms of gender composition, there is broad agreement that both anorexia and
bulimia are overwhelmingly female conditions. While there is no agreement
concerning the exact gender balance, it is frequently claimed that approximately
96 per cent of all bulimics and 90 per cent of all anorexics are women (van
Hoeken et al. 2003). Hepworth (1999) suggests that because these conditions
have been normalised as female, many men who meet the criteria are not in
fact classified as suffering from an eating disorder. This is a reasonable argument
and it is plausible that these conditions are more common in men than the medical
literature would suggest. Equally, bulimia is in many respects easier to conceal
that anorexia. Given the greater taboo associated with male eating disorders, the
higher female to male gender ratio among bulimics than anorexics may simply
reflect the decisions of men to conceal their disordered eating. Despite these distortions it is clear women are far more vulnerable to both anorexia and bulimia
than men. Women are also disproportionally represented in the BED population.
However, the gender imbalance is less severe with men constituting approximately 30 per cent of suffers (De Zwaan 2001).
There have been efforts to determine how class and race affects vulnerability to
eating disorders. The results of these studies are disputed. There is a reasonable set
of evidence to suggest that bulimia is more common in poorer social groups.
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However, this has been contested and it is impossible to say with confidence what
(if any) relationship exists between eating disorders and social class (van Hoeken
et al. 2003). Equally, while there was an early assumption that white women were
more vulnerable to eating disorders than ethnic minority women, recent research
has cast any simple correlation between eating disorders and race into doubt. It is
likely that eating disorders are less common in black women than their white
counterparts, but it is difficult to say with any degree of certainty (Root 1990;
Striegel-Moore 2003).
Based purely on data from the UK, there does appear to be a broad consensus
that incidence rates of anorexia stabilised in the 1970s and that incidence of
bulimia ceased to increase at some point prior to 1996 (van Hoeken et al. 2003;
Currin et al. 2005). Clearly Britain has not simply been in state of osmosis for
the last 14 years. If we understand eating disorders as being purely a result of
social pressures, it would be difficult to explain this relatively long-term stability.
These statistics may suggest that we need to be open to the idea that eating
disorders have a biological component. There is a large scientific literature on
the ‘multifactoral’ nature of eating disorders and the importance of biological
factors in predisposing certain individuals to problems (see Treasure et al.
2003). Malson (1998) rightly highlights the failure of this literature, when assessed
in its own terms, to offer conclusive proof of the existence of a clear biological
foundation to eating disorders. Her point is well taken and we are not arguing
that such a foundation definitely exists. Rather we would simply suggest that
we should remain open to the possibility. Equally, should such a foundation
exist it should not negate the importance of the social. Without social stimuli an
individual’s biological predisposition will remain dormant. Therefore, it may be
the case that men have as strong a potential to suffer from eating disorders as
women, but the way that masculinity has been constructed renders them less
vulnerable.
The purpose of this section has been to briefly consider how we ought to define
eating disorders, and assess their prevalence and the importance of gender in
accounting for individuals’ vulnerabilities to these conditions. To clarify the position of the article, it is that eating disorders must be primarily understood as
social phenomena for which an explanation ought to be sought at a macro level.
In a sense it is contemporary society, not simply the individual bulimic or anorexic,
who requires treatment. Nevertheless, we remain open to idea that these conditions
have an important biological component and for practical reasons employ standard
medical definitions of these conditions in order to assess their prevalence.
The opening section has performed the necessary task of establishing the foundations upon which we will construct our analysis. We shall now turn our attention
to attempts of major feminist scholars to understand the problems of eating disorders. This forms a necessary part of any analysis of bulimia but does offer a
complete answer as to why bulimia has emerged as a major social problem.
Femininity, media and the post-1945 anorexia crisis
The last three decades have seen the development of a vast social science literature
on eating disorders – primarily anorexia (Nagel and Jones 1992; MacSween 1993;
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Germov and Williams 1996; Bordo 2003). While there is considerable nuance
within this literature, different scholars continually return to the same three key
analytical points. It is upon these points of consensus that we wish to focus.
First, the majority of the literature (implicitly or explicitly) treats ‘modern’ anorexia as a post-1945 phenomena (Bordo 2003; Fine 1998). In so doing, the literature does not attempt to deny that female self-starvation has a long history. As has
been well documented, in the pre-modern era there existed a number of ‘fasting
saints’ (Vandereycken von Deth 1994). These women were celebrated for starving
themselves in order to demonstrate their indifference to the pleasures and pains of
the sensual world and their commitment to God. To post a direct link between
these religious anorexics and women who are currently experiencing eating disorders is unsustainable, given the profound differences in their lives and
motivations.3
The relationship between the modern and the nineteenth-century experiences of
anorexia is more complex. Although it is difficult to assess whether the rising
prevalence of any psychological disorder reflects improved recording techniques
or genuine increases, it does appear that anorexia emerged as an important social
disorder among young upper middle class women in the Victorian era. The causes
of the increased prevalence of anorexia have been located within the practices of
the bourgeois family. As family size declined and the income of the bourgeoisie
grew, children were transformed from being little adults to special creatures
requiring protection. Middle class women were not expected to marry until at
least 20 and could expect a long period under the ‘protection’ of their families.
This period was filled with a set of disciplines and anxieties principally centred
upon the need to secure an appropriate matrimonial match. Food played a key
role in the entire child/parent relationship as it was through food that parents
expressed love and exercised control by limiting consumption of deviant foods
(vegetables before cakes) and denying consumptive rights to disobedient children
(go to bed without your tea). The anorexic subverted parental control by refusing
to eat (Brumberg 2000).
While the exact nature of the pressures that contemporary and Victorian
families place on young women may be very different, the pressures that young
women face during the transition from childhood to adulthood continues to be
recognised as a significant factor in contemporary anorexia. Equally problematic
for those wishing to draw a clear distinction between nineteenth-century and
modern anorexia, there is evidence that concerns with body image played a significant role in nineteenth-century eating disorders. The rise of Victorian anorexia
needs to be understood within the context of changing ideas of physical attractiveness. For the middle class to be overweight shifted from a symbol of success to one
of a lack of self-control (Vandereycken and von Deth 1994).
Despite the existence of certain similarities between nineteenth-century and
contemporary anorexia we would argue that the distinction posted within the literature between pre and post 1945 eating disorders remains useful provided it is
treated flexibly. There is a broad consensus, across both the social science and
medical literature, that the scale of contemporary eating disorders is quite different
from anything seen before (Fallon 1994; Fine 1998; Bordo 2003; Treasure et al.
2003). Furthermore, while concern with body image is not necessarily new, the
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overwhelming dominance of such concerns in contemporary eating disorders is
distinct. Yet even here we must urge caution. There is evidence that a minority
of contemporary anorexics display a relative disinterest in body image and that
their behaviour often simply represents a visceral reaction to previous psychological trauma (Lee et al. 2001).
The second critical aspect of contemporary anorexia that the literature highlights is the importance of the dual (or even triple) set of pressures that young
women face in explaining this particular population group’s vulnerability to this
disorder (Bordo 2003). The increasing integration of women into the professions
has demanded that women compete in the public sphere. However, as they reach
adulthood women are simultaneously confronted with intense pressures to
conform to more traditional roles as nurturing figures and objects of sexual
desire. The far greater vulnerability of young women to eating disorders is seen
as a result of the unique myriad of pressures that they face (Fallon et al. 1994;
Fine 1998; Bordo 2003; Treasure et al. 2003).
The study of these pressures is linked to a more overarching analysis of the alienating and oppressive nature of contemporary concepts of femininity (Chapkis
1986; Bartky 1990; Bordo 2003). At the risk of gross oversimplification the argument is that the concept of ‘femininity’ has been constructed from without by a
male dominated culture, in a similar manner to how the meaning of ‘blackness’
has been constructed and is maintained by prominently white Eurocentric
culture. Importantly, however for women, in contrast to ethnic minorities, there
is no native culture, or myth of a native culture, to draw from in seeking to
construct alternative meanings. Hence the scale of the problem that the feminist
movement faces in seeking to create an ideational environment in which
women possess the autonomy to define for themselves what it actually means to
be female. Equally, for Sandra Lee Bartky (1990) being a woman involves alienation from ones own body and sexuality. The female body is socially constructed
as something to be admired by the male gaze rather than something for itself.
The idea of beauty itself is understood as a mode of social control. Naomi Wolf
(1990) argues that the concept of beauty acts as an impediment to female solidarity,
diverting women’s attention from challenging gender inequalities and competing
fully as economic actors. The concept of beauty is seen as forcing women into competition with one another (as competing beauties) and hindering the development of
collective political organisations. Equally, because ideals of beauty are ultimately
unachievable (or least difficult to achieve), their pursuit involves both immense
effort and failure. This failure is seen as having important implications for the collective self-confidence of women. The idea of difficulty is important to the marketing of beauty. It is important that beauty requires extensive financial outlays if it is to
support a significant arena of capitalist accumulation. If beauty was delinked from
fetishisation of the image of youth and embraced the marginally overweight, then
we may find that standard lifestyles in late capitalist societies allowed us to effortlessly achieve this without the need for specialist products.
Within this literature there are important differences between those accounts
that seek to integrate gender within a broader radical critique of contemporary
capitalism and accounts that large abandon Marxism and traditional socialism.
In the former, how these practices relate to the broader structures of late capitalism
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Iain Pirie
is more clearly drawn out (Bartky 1990; Kilbourne 1999). Furthermore, gender is
not understood as an axis of social division that can be properly understood outside
the context of class based racist society. Certain texts that entirely abandon
Marxism, for example Wolf (1990), fall into trap of fetishising gender. As we
read it, in Wolf’s work gender is frequently treated as the social division in contemporary society rather than a critical division in society. Following on from this
Wolf frequently refers to the use of beauty to protect the ‘power structure’. To my
mind, this is a vague term and the logics that govern the actions of these ill-defined
power elites seem simply to be to preserve the power of men over women. This
seems somewhat conspiratorial and unconvincing. Socialist feminists who highlight how oppressive notions are functional (even necessary) for the functioning
of capitalism offer a stronger analysis of contemporary society.
The third key theme within the literature on eating disorders, which clearly
follows from more general theories concerning the nature of femininity, relates
to the importance of media representations of the female body. In different
places the argument takes slightly different forms. In its most basic form the analysis suggests that we are increasingly surrounded by images of the slender body that
are positively associated with other socially desirable traits (Hesse-Bider 1996;
Wykes and Gunter 2005). Women (and to a lesser extent men) come under
pressure to emulate these images and this is the primary source of our society’s
anxieties towards food. The behaviour of anorexics is simply a more extreme
form of the anxieties that the majority of us experience.
Textual analysis has been strengthened through interview-based studies that
seek to question individuals in order to explore how they are affected by the
images they consume. Two of the key studies that have sought to this, Dawn
Currie (1999) and Melissa Milkie (1999), have focused upon the impact of adolescent girls’ magazines on their readers. These studies confirm that magazines have
a clear influence on the behaviour of their readers but that readers have complex
and contradictory relationships with these magazines. Currie argues that they
recognise clear gaps between their own lives and the modes of life and particularly
the (unachievable) body images portrayed in these forums. In other words, readers
are influenced by magazines while simultaneously acknowledging that they represent a fantasy. The gap between the reality of readers’ lives and the modes of
life (based upon traditional femininity) portrayed within magazines creates a
potential for a partial or complete rejection of these media. How individuals ultimately come to view (and be affected by) any image will depend on a myriad of
factors relating to the details of their everyday life (their circle of friends, family
etc). Milkie argues that black girls’ self-image tends to be less affected by girls
magazines and that they suffer from fewer media-induced concerns about body
image. These results are clearly consistent with the wider argument that suggests
that black women generally enjoy high levels of body esteem than their white
counterparts (Molloy 1998; Abrams and Stormer 2002). It is important to note,
however, that this argument is disputed and that we need to be careful in
making judgements about race and self-esteem lest we repeat the mistakes of
early literature on eating disorders (Shaw 2004).
Analysis of the impact of images on viewers has also increasingly focused on
young men (Labre 2002; Agliata and Tantleff-Dunww 2004; Hargreaves and
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Tiggemann 2004; Field et al. 2005). The results of this research are somewhat
ambiguous. It is possible to find studies that suggest that overall levels of body
dissatisfaction among young men are lower than of young women and studies
that demonstrate relatively little difference (Labre 2002; Agliata and TantleffDunww 2004). Equally, there are scientific papers which argue that exposure to
an ‘ideal’ set of body images has a significantly less negative effect on men’s perception of their own bodies than women’s, and others that suggest a more uniform
impact (Hargreaves and Tiggemann 2004; Field et al. 2005). Historically men
have been shielded from pressures relating to body image by the less forceful compulsion to be beautiful and their lack of alienation from their own bodies.
However, there is evidence that these conditions may be changing.
Male body dissatisfaction is more focused upon a desire to develop greater
lean muscle than a desire to achieve greater slenderness. While this could lead
to conventional eating disorders, it may be more likely that young men will
develop a set of pathological activities centred upon exercise. Indeed, Frances
Connan (1998) argues that there are linkages between female bulimics sufferers
and male bodybuilders. Both groups share an obsessional interest in body shape
and organise their life around the achievement of a particular body image.
Equally, competitive bodybuilders will engage in cycles of bulking (binging) in
order to gain size, in which they may consume over 9000 calories a day, and
abstention in which they seek to reduce body fat to unhealthy levels. The question
of male exercise/eating disorders is an important one but beyond the scope of this
study.
An issue with the study of the impact of media representations of the body
relates to the scope of its analysis. Many studies focusing on the effects of
visual images draw upon a clearly delineated set of images from a limited
range of media (Currie 1999; Kilbourne 1999; Milkie 1999; Bordo 2003). The
impact of the content of teenage girls’ magazines and print advertising have
proven to be relatively popular themes. This approach is productive and avoids
the serious methodological problems that would be associated with any attempt
to draw out the impact of the full galaxy of images that individuals consume.
However, it is important to recognise that the ideal body types presented in different media are likely to differ and so is their impact. For example, the highest-paid
female singer and most heavily sponsored sportswomen at the time of writing
were Beyonce Knowles and Serena Williams. It is reasonable to believe that
many readers of teenage magazines, within which slender white models dominate,
will also have an interest in either sport or music. The most high-profile female
participants in these arenas clearly differ from the dominant figures in girls’ magazines not simply in terms of race but in terms of weight, representing ‘middle’ and
heavily muscled body types. Systematic wide-ranging analysis of images in print
and television tend to confirm the under-representation of the overweight
(especially overweight women) far more clearly than the dominance of a particularly slender image (see Wykes and Gunter 2007: 100). A focus on fashionoriented forums within which very slender bodies dominate may exaggerate the
social significance of this particular aesthetic ideal.
A more productive approach than focusing on the slender body is offered by the
concept of multiple aesthetics and the controlled body. Susan Bordo (2003) argues
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that it is no longer necessary for individuals to achieve radical slenderness in order
to demonstrate their dominance over their own bodies. Rather, it is perfectly acceptable for individuals to be somewhat heavier provided that this is ‘controlled’
weight. One may cultivate a very slender body or alternatively one may seek to
achieve a somewhat more substantial body that is toned and devoid of excessive
body fat. What both bodies demonstrate is a capacity to maintain a strict regime
of bodily control. In the first instance a regime is based around not eating, and
the second around moderate consumption and a strict exercise regime. While
these bodies may be different in a purely physiological sense they both represent
examples of the controlled body; both are products of ideology of beauty.
O. Wayne Wooley (1994) presents an interesting variation on the theme of multiple aesthetics. Wooley argues that the post-war era witnessed both a geomantic
increase in pornography/erotica and the emergence of a class of independent
female workers/consumers. The ‘normal’ (middle) body came to be colonised
by erotica in its various forms. At the same time, it became necessary to construct
a different body disassociated with erotica in those media that sought to service the
new independent female consumer. Long-standing taboos concerning ‘fat’ effectively ensured that a larger alternative to the ‘normal body’ of erotica could not be
constructed and made it inevitable that the dominant image in women’s magazines
would be that of the slender body.
Wooley’s analysis is interesting but suffers from certain empirical limitations
and theoretical shortcomings. Despite the explosion of academic interest in the
growth of pornography and the eroticisation of everyday life, there have been
no real concrete empirical of the effects of pornography/erotica on body image
(see O’Toole 1998; McNair 2002). Given the sheer volume of pornography that
is consumed in advanced capitalist states, it is certainly reasonable to argue that
it has an impact. However, it is impossible to say with any confidence what that
impact actually this. One feature of contemporary pornography that Laura
Kipnis (1999) highlights, which complicates Wooley’s conception of the middle
body, is the existence of substantial subgenres of pornography focused on
extreme bodies. A more serious problem with Wooley’s analysis lies with his conception of how pornography is produced and consumed. Wooley argues that pornography is simply a male construct from which independent women must retreat
and differentiate themselves. However, a key theme of recent studies of pornography has been the complexity of women’s relationship with the pornographic and
the gendered relations that govern its production and consumption (Juffer 1998;
Kipnis 1999 Gibson 2004; Williams 2004).
In particular this work has been keen to highlight how some forms of erotica
have been defined as female (textually based material) and others as male.
For Jane Juffer (1998) pornography does not possess a static meaning but is
being consistently redefined as gendered terms of access to the genre, for both consumers and potential producers, is transformed. Juffer stresses the need to analyse
the potential for the entry of pornography directly into home (through cable television and the internet) to reconfigure gendered terms of access. The importance
of this work lies not in a rejection of the concept of repulsion that informs
Wooley’s work, but rather the need to develop a more sophisticated theory than
the idea of a complete retreat from the entire genre.
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The importance of the various debates on the dominance of the slender body or
multiple dominant aesthetics can easily be overstated. The significance of the
particular images that are produced in contemporary society is secondary to
issues generated by the volume of attention that is devoted to the gendered body
in the contemporary media. Leaving aside the overtly erotic, we see how media primarily targeted at women demonstrate an obsession with monitoring the body
shapes of the famous and continuously floods readers with advice about controlling
their own bodies. For example, Maggie Wykes and Barrie Gunter (2005) argue that
large sections of the Daily Mail, the British newspaper with the proportionally
highest female readership (Mail Classified 2009), are consistently devoted to ‘disciplining’ celebrity bodies and highlighting any weight gain.
The focus of the existing literature on the significance of media images and the
nature of contemporary femininity is critical to any analysis of eating disorders. We
accept the basic argument concerning the oppressive aspects of mainstream femininity and the importance of media images in generating insecurities relating to
the body. Looking beyond the impact of print adverts and women’s magazines in
general could strengthen analysis of the importance of media images. Clearly
these are highly significant arenas. Nevertheless, there are other media that are
potentially as significant whose impact has been under-analysed. In particular we
would stress the potential benefits that could be gained through an analysis of
erotica. There is a considerable literature that deals with the exponential growth
of this media since the 1970s (O’Toole 1998; McNair 2002; Hardy 2008). It is certainly worth investigating the importance of this genre in constructing notions of
femininity/masculinity and influencing how individuals perceive their own bodies.
A focus on the conditions that create widespread anxieties concerning the
female body cannot explain why we have seen a shift in the relative levels of
bulimia and anorexia. In order to explain this shift it is necessary to focus on
the food system itself. It is necessary to combine an analysis of the social construction of femininity and the media portrayal of the ‘disciplined’ body with a study of
the rise of society-wide patterns of disordered eating related to the commercialisation of food systems. In the absence of either a fetishisation of managed body/the
ideology of beauty or the restructuring of the food consumption regime, it seems
unlikely that bulimia could have developed on the scale that it has.
The late capitalist food regime and bulimia nervosa
There exists a limited number of studies that focus on the role of the food system
itself in generating patterns of disordered eating (Fine 1998; Guthman and DuPuis
2008). In addition, to these studies there is a feminist literature that seeks to draw
attention to the way in which food is marketed to women (Kilbourne 1999; Bordo
2003). A theme that Fine (1998) and Jean Kilbourne (1999) both develop, from
different theoretical perspectives, is the importance of the functional commercial
relationship between the diet and broader food industries. Kilbourne argues that
food marketing directed towards women encourages them to develop an emotional
relationship with products. Food is marketed as a method through which you may
compensate for the failings in the human relationships that structure life and even
improve these relationships through provision of food to husbands and children.
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If everything else in your life is falling apart, it is still possible to have a reciprocal
loving relationship with ice cream. At the same time, however, women are subjected to a contradictory set of advertising messages from the diet industry
encouraging them to remain relatively slender – although Kilbourne does not
suggest that the pressure to slim can be reduced to marketing efforts of diet
firms. Kilbourne (1999: 123) argues ‘that the dieter is the ideal consumer. She
will spend a lot on food and even more to lose weight – and the cycle never
stops. Sales of low-fat yogurt soar, but so do sales of high-fat premium ice
cream.’ The marketing strategies of the two industries (diet and mainstream
food) imply a mutual dependence. Diet foods can only market themselves as virtuous non-foods because of the existence of a wider industry concerned with the
production of calorific sensuous foods. Equally, it is only possible for high-fat
foods to market themselves as deviant (‘naughty but nice’) because of the pressure
to abstain and be virtuous.
Fine’s arguments are similar but he places greater emphasis on material
changes in food provisioning systems that have create a hyper-availability of
food and the broader ‘anti-eating’ complex of which the diet industry is a
component part. For Fine, as a result of changes in how markets are organised,
government policy and domestic technologies (freezers, microwaves), even relatively poor citizens of core capitalist states are faced with constant opportunities/
pressures to consume. At the same time, instead of focusing exclusively on the diet
industry, Fine employs the concept of the anti-eating complex. In addition to the
diet industry, this would include other professionals with an interest in managing
bodies such as the exercise industry (commercial gyms) and public health
professionals who repeat various mantras concerning the dangers of being overweight. Nevertheless, the diet industry is at heart of, and dominates, the antieating complex. Where this not the case a commercial tension would develop
between the eating and non-eating industries, the pressures not to consume
would affect the profitability of the eating industries. Importantly, Fine argues
that there is no particular reason why the fashion industry should prefer the
slender body to alternative forms. The fashion industry cannot, therefore, be
understood as the dynamic agent in constructing the desirability of the slender
body. By way of contrast, the prospects for accumulation in the ‘non-eating’
industries are critically dependent on the maintenance of the slender body ideal.
In promoting a slender body image the fashion industry is simply following the
lead established by the ‘non-eating industries’.
On this last point we would partially depart from Fine’s analysis. The important
point regarding the fashion and related cosmetics industries is that, as we have
already suggested in our analysis of beauty, they are based upon the notion that
attractiveness is something that must be worked upon. In a sense we consume
to correct our natural faults. If a full range of actually existing bodies were
regarded as meeting aesthetic norms, individuals may feel intrinsically attractive
and sales of cosmetics and clothing may fall. The fashion industry has an interest
in the maintenance of a gap between standards of the desirable body and the full
range of actually existing bodies. This is not to deny the importance of pressures
from the anti-eating industries, but simply to highlight the need to adopt a pluralist
analysis with regard to this particular issue.
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From a more Foucauldian perspective, Julie Guthman and Melanie DuPuis
(2006) argue that neo-liberalism creates a duel imperative on citizens to
consume and maintain control over their bodies. On the one hand, the neoliberal
project has witnessed the removal of constraints on the rise of commercialised
eating (particularly the fast food industry). This industry offered one mode of
escape from the crisis of over accumulation in the 1970s by creating an arena
where surplus food could be used and where profits could be made from deregulated, highly exploited labour. The state could offset pressures to regulate
food consumption through an appeal to the notion of consumer sovereignty. On
the other hand, however, the concept of consumer sovereignty is seen to highlight
individual responsibility to manage ones own ‘freedom’ responsibly. Food regulation, in neoliberal societies, is based upon classification and education rather
than direct control of the food systems. A new Focauldian form of discipline is
seen as being exercised by the state through an ideological war against the
obese – those who do not use their freedom responsibly. Gutham and DuPuis
argue that the construction of the obese as a deviant group serves as a warning
for the general population and is unlikely to lead to generalised weight loss.
Drawing from Foucault’s analysis of sexuality, they argue that detailing deviances
(obesity) simply highlights their existence and makes these practices more
common.
An important point that highlights and reinforces Gutham and DuPuis analysis
of deviance, self-control and weight is how the concept of being overweight is
defined by the medical establishment. The evidence concerning the health consequences of maintaining a BMI over 25 but under 30 is ambiguous. It cannot be
decisively demonstrated that you are likely to enjoy a longer healthier life if
you maintain a BMI of 24 rather than 29. Given the ambiguity of the evidence
the setting of the threshold for defining overweight at BMI 25 rather than 30 is
a decision that must be explained in social and political terms, punishing the
deviant (Flegal et al. 2005).
Despite its strengths, a weakness of Gutham and DuPuis’ analysis lies in its
failure to explain why the state needs to create an obese other to warn the
population at large about their behaviour. Their analysis is stronger in terms of
providing an analysis of how power is exercised rather than exposing the underlying logics of to what ends power is ultimately exercised. Ultimately, Fine and
Kilbourne provide the more compelling accounts of the role that the food industry
plays in promoting anxieties surrounding the body.
This article accepts the key arguments of the literature outlined above concerning the hyper-availability of food, the promotion of overeating by the food industry itself and the pressures to diet generated by the non-food industries. What is
critical, however, if we are to understand how changes in food provisioning
systems relate to the development of bulimia, is that we understand the precise
forms that the drive to consume has taken. If pressures stemming from the restructuring of the food industry had simply led to fairly uniform increases in meal size,
then they may have led to a greater proportion of the population suffering from
problems relating to excess weight. However, we are not convinced that such
developments could explain the rise of binge-based eating disorders. As we
have already made clear in bulimia, BED and ‘Machismo nervosa’ (Connan
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1998), the temporal organisation of eating and the size of eating events become
fundamentally misaligned with both (normal) biological requirements and historically defined norms. It is important to analyse the broader breakdown in longstanding, relatively stable temporal structures of eating and the normalisation of
sporadic, very large eating events since the 1970s. The extreme forms of disordered eating that we find in bulimics represent an manifestation of a wider
move towards more chaotic eating.
Since the 1970s the most important development in Western food systems has
been the increased commercialisation of food preparation. In 1972, 44 per cent of
the total cost of food in the US was attributable to farm share. By 1997 this figure
had fallen to 22 per cent (Cutler et al. 2003: 106). While there exist clear issues
relating to the market power of major retailers, this shift primarily reflects the
rise of commercial preparation. Food is increasingly sold in semi-prepared/
prepared rather than basic forms.
This in turn has led to significant changes in the temporal organisation of consumption. Two related points can be made in this regard. First, the nature of food
preparation has been transformed. The average time that a typical American
spends per day on food preparation fell by more than half between 1965 and
1995 (Ibid: 101). This decline is even more pronounced when we consider that
the number of eating events has increased with the rise of snacking over the
same period, and how the increase in (particularly male) ‘hobby’ cooking has
led to disproportionate quantities of time being devoted to one or two ‘special’
meals each week (Short 2006). Significantly, greater female employment does
not offer an entirely satisfactory explanation for these changes as time spent preparing food has fallen by an approximately equal amount for both working and
non-working women (Cutler et al. 2003: 106). Instead, these changes must be
understood primarily in terms of the success of the food industry itself in marketing partially prepared food (as modern and quick) and the rising prevalence of
eating out.
The decline in food preparation time has transformed general patterns of eating.
As food can be prepared almost instantly, we have moved from a consumption
pattern based on clearly defined collective eating events to one based primarily
on grazing. Virtually the entire increase in food consumption per capita in the
US since the 1970s has been the result of a 102 per cent increase in snacking
(Cutler et al. 2003). Nor should this be understood as a purely Anglo-Saxon
phenomenon. Indeed, while France is frequently understood to possess one of
the most stable meal structures in Europe, the French Ministry of Health recently
felt compelled to require firms advertising food to include the warning ‘for your
health, try and avoid snacking between meals’ on their products (Hercberg
et al. 2007: 71). In comparison to the majority of developed states, meal patterns
do appear more resilient in France. However, this is a relative stability. The ‘ritual’
of the meal has been undermined with meal preparation time falling by over 30 per
cent between 1974 and 1998 and the proportion of citizens who cook regularly
falling continuously over the same period (Warde et al. 2007). The market for
ready meals in France is worth almost $5 billion per annum – only slightly less
than the British market of $5.1 billion (Business Insights 2009). We are witnessing
a slow but constant destructuralisation of meal structures (Poulain 2002).4
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Interestingly Clare Pettinger et al.’s (2007) analysis of French meal structures, that
seeks to highlight the stability of eating patterns in Southern France, reveals that
approximately 25 per cent of adults eat less than 3 standardised meals on a daily
basis and that only half cooked meals from raw ingredients most days. The meal
structures of young French adults are actually less well defined than those of
mature English adults. At the same time, there exists very clear evidence concerning the restructuring of traditional food systems across Mediterranean Europe in
last two to three decades (Gracia and Miguel 1999; Alexandratosa 2006). The
snack food industry’s own reports indicate solid medium term growth of over 5
per cent per annum in all major European markets (Business Insights 2006).
Emerging consumption patterns where food is an ever-present backdrop to be
consumed in moments of boredom clearly promote overeating and serve to partially divorce consumption from physical need. The important point is not that
we are witnessing a universal increase in the frequency of eating; particular individuals may as a result of weight concerns limit the frequency with which they eat.
Rather it is that consumption has become chaotic – a calorie-restricting individual
may skip a traditional breakfast but replace this with a snack taken at some random
point in the morning. The exact eating patterns proscribed by any given society
have always reflected the economic and social practices of that society.
However, on the basis of ethnological research Matty Chiva (1997) identifies
the existence of ‘regularity and rhythm’ in meal patterns in all agriculture-based
(post-hunter-gatherer) human societies 2 with some snacking between meals
being permitted in times of surplus. While the precise nature of meal patterns
varied markedly, they all possessed clear ordered patterns of consumption
within which periods of eating were interspersed with periods of relative abstention. The food consumption system was a cyclical one within which food was consumed and the calorific value of that food was expanded and than the process was
repeated 2 the process being intimately related to the use value of food.
The commercialisation of food preparation has not simply enabled a drive
towards increased snacking but it has afforded major corporations with the
capacity to actively promote these patterns of eating. We have seen particular
forms of processed food being explicitly designed for (in terms of portion size)
and marketed towards snacking. The move towards greater commercial preparation allows for the ever closer linking of particular foodstuffs with particular
eating events (snacking/meals). Branding and the active construction of the
social meaning of basic foodstuffs through advertising is possible – see for
example Tate and Lyle’s campaign to promote sugar as a natural and healthy
ingredient or the marketing of ‘British’ beef (Fine et al. 1996). However, the
capacity of private capital to market and activity shape the social meanings surrounding particular products reaches its full potential with the development of
pre-prepared branded (Ginsters Pies, Pot Noodle) food products (Gallo 1999).
It is entirely logical that capital should use this capacity to promote new eating
patterns based on more frequent and disordered consumption. Indeed, we could
argue that an important function of advertising in the economy as a whole is to
accelerate turnover time in consumption; to encourage consumers to replace
products due to aesthetic or fashion considerations before ‘technical considerations’ (the product no longer working) necessitate.
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As the entire food preparation process has become increasingly commercialised, the same logics that apply to other products have increasingly come to structure food consumption. A shift is taken place from the cyclical eating regimes that
have existed for millennia to a rather unstructured system in which their exists no
clearly defined periods of abstention and consumption. In their attempts to develop
a Marxist analysis of the ‘post-modern’ condition, David Harvey (1990) and
Frederic Jameson (1991) both argue that a profound reorganisation (and acceleration) of social time has taken place since the 1970s as a result of capital’s attempts
to manage a prolonged profitability downturn, and that this reordering has had
potentially significant physiological effects (particularly in relation to schizophrenia) as individuals lose any clear sense of temporal rhythm in their lives.
Whatever conclusions we may reach regarding Harvey’s wider arguments it
seems plausible to suggest that the displacement of clearly established temporal
structures and the separation of eating patterns from biological need is generating
a permissive environment for the growth of binge eating disorders (such as
bulimia) associated with unstructured consumption patterns. The point is that
there no longer exists a clear ‘normal’ food consumption pattern. The temporal
disorientation associated with the binge/purge (in which the entire consumption
cycle is massively accelerated) needs to be linked to the wider temporal disorientation of eating patterns in the same manner as generalised pressures to diet have
been linked to the extreme set of body image concerns often found among individuals suffering from eating disorders.
A more direct linkage between wider changes in the food provisioning regime
and bulimia relates to the normalisation of low-level binging. It is difficult to see
how it is possible to argue that there is no relationship between the growth of bingeing throughout society and the growth of binge-based eating disorders. As eating
patterns have become unstable and partially divorced from biological need, lowlevel bingeing has simultaneously come to be integrated into the mainstream
food consumption regime. In terms of both speed of eating and the quantity of
calories consumed, a trip to an average fast food establishment resembles a binge
as much as a traditional meal. According to McDonalds’ own website, a meal consisting of a double quarter pounder with cheese, large French fries and an extra large
chocolate milkshake contains 2400 calories – approximately a day’s recommended
intake for an adult male.5 Historically, a ‘normal meal’ has been defined as providing 420 to 840 calories (de Castro 1993). In addition to being exceptionally large the
average McDonalds eating event is exceptionally quick. In America the typical
McDonalds consumer finishes their food within 13 minutes (Rozin et al. 2003:
253). Equally, the prevalence of unrefined carbohydrates in the majority of fast
foods results in short and pronounced spikes in blood glucose levels after which
the consumer is likely to once again feel hungry. Interestingly, fast food portion
size only became misaligned with historically ‘normal’ meals in the 1970s and
1980s (Young and Nestle 2002: 246 –9). The rise of the fast food binge is almost
completely synchronised with the rise of bulimia. It is the US, where the market
is arguably less restrained than Europe, which has seen the greatest acceleration
of eating times and volume, although the rise of fast food chains has ensured that
this has become a global phenomena.
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The most pure form in which the ‘binge’ has come to integrated into the food
regime is through the increasing prevalence of ‘all you can buffet restaurant’.
By the mid 1960s these were common in Las Vegas casinos (Pearson 1966).
Since this point they evolved first into a nationwide US and than a global phenomena. Unfortunately there are no accurate figures relating to how prevalent these
establishments are. However, it is clear that a consumer in any reasonably sized
town in the UK enjoys a choice of several establishments offering such an
eating experience for very limited cost – often under £5.6 In 2008 the ‘Pizza
Hut’ chain became the first nationwide fast-food franchise to introduce an allyou-can-eat option. What was once a curiosity is becoming mainstream. In the
US research has already been conducted on the effects of all-you-can-eat
buffets on the weight of particular population groups (university students and
rural communities) and the behaviour of diners within these establishments
(Levitsky et al. 2004; Casey et al. 2008; Wansink and Payne 2008). Since their
inception there have been a sense that these establishments were inviting customers to ‘take on the house’ 2 to attempt to consume food costing more than
the price of admission to the buffet. In 2008 the Times felt obliged to offer its
readers a guide to maximising food consumption at these eating establishments
(The Times, 2008). The sociology of ‘eating out’ is transformed. The complex
set of social interactions associated with eating out (see Warde and Martens
2000) are reduced to an form of competitive consumption. A successful trip is
not one in which you have eaten a moderate quantity of aesthetically satisfying
food while enjoying convivial conversation, but rather one in which you leave
feeling mild discomfort from having overeaten.7 The purpose of eating is
simply to eat 2 we consume to consume.
The significance of the fast food and the buffet industries is not that they introduced the binge, the consumption of a vast number of calories in a relatively short
period of time, to human society. Rather, it is that they have embedded the binge
into the fabric of everyday life and divorced it from well-defined collective
TABLE 1 Share of total food expenditure spent on home-prepared food by demographic group
(per cent)
Single elderly women
Single elderly men
Elderly couples
Single-parent families
Couples with children
Single young women
Young childless couples
Single young men
1975
1999
94.9
84.6
95.3
86.4
85.1
81.9
82.9
66.6
86.3
83.1
79.6
73.4
68.2
67.7
65.5
56.6
By 2004 the average adult under 30 spent 123 per cent of total home food expenditure outside the
home. The average adult between 30 and 49 spent 92 per cent total home food expenditure outside
the home
Source: United Kingdom Office for National Statistics 2003, 2008
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celebrations. What would technically be defined as binge eating is not a activity
confined to the celebration of particular feasts or the preserve of a small elite,
but a regular mass activity.
A necessary condition for the institutionalisation of the binge can be understood
as the move towards the commercialisation of food preparation. Since the mid
1970s there is evidence of a steady rise in the proportion of food spending that
takes place outside the home (see table 1 for UK figures). As consumption
outside the home becomes a routine event for an substantial proportion of the
population, the social significance of how that consumption is organised
becomes critical. The data on serving sizes would suggest that a number of
firms in the low-cost restaurant sector have sought to construct notions of ‘good
value’ around offering a day’s food in one swift sitting. The move towards offering vast portion sizes may be seen as a commercial necessity for outlets operating
in highly competitive markets and explicitly marketing themselves as providing
low-cost food within an environment where the real costs of basic food ingredients
are experiencing long-term declines.
Developments within the food sector and the changing structure of eating since
the early 1970s need to be understood against the background of a broader set of
changes in the organisation of labour markets. While the evidence is not unambiguous, and there is a need for a more comprehensive empirical database, research
within the US suggests that the breakdown in family meal structures appears to
be most advanced in situations where both the male and female work (Goebel
and Hennon 1983; Siega-Riz 1998). However, these linkages are complex in that
higher levels of female employment in many states in continental Europe have
not had the same severity of impact on meal structures. What is much clearer are
the linkages between variable working hours, casual employment and meal structures (Bohle et al. 2004). Perhaps predictably, employees who work non-standardised hours also have irregular eating patterns based upon snacking. While the
extent of the shift away from standardised working patterns since the 1970s can
perhaps be exaggerated, the key debates within the literature concern the extent
of the shift across the developed world, not the reality of that shift (Brewster
et al. 1994).
Conclusion
This article has sought to argue that there are clear logical links between changes
in the food provisioning regime and the rise of bulimia. However, we do not wish
to make an unsustainable set of claims for the arguments advanced here regarding
the relationship between changes in the overall organisation of the food system,
labour markets and bulimia. Any analysis of bulimia must pay attention to the
nature of femininity, the influence that the media has on body image and the development of generalised patterns of disordered eating. Scholars working on eating
disorders must, as has already been recognised, seek to develop multi-causal
explanations of social conditions underpinning the problem. The arguments
presented here do not constitute an attempt to prove any form of comprehensive
analysis; rather, they simply seek to make a contribution by focusing on the
temporal breakdown of food consumption patterns and the rise of commercialised
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The Political Economy of Bulimia Nervosa
bingeing. We accept that it is impossible to understood eating disorders without
reference to the broader sociological literature. Nevertheless, any analysis of
why we have seen a large increase in the relative importance of binge-based
disorders cannot ignore changes in the organisation of food systems. Bulimia
required the dominance of a particular conception of femininity and surrounding
media pressures to reach endemic status. However, it has also required the breakdown in temporal structures of eating and the institutionalisation of the binge; the
generation of a more widespread chaos in the food consumption regime. A key
policy conclusion that suggest itself from the, albeit incomplete, analysis of
bulimia presented in this article is that action to address bulimia must be
focused not only on improving treatment for individuals but also on reforming
dysfunctional food provisioning systems that are damaging the physical and
mental health of the populations they are meant to serve. These systems are as
‘disordered’ as any individual suffering from bulimia.
Notes
1. For the sake of convenience Anorexia Nervosa and Bulimia Nervosa will simply be referred to as Anorexia
and Bulimia.
2. The poor state of data on eating disorders is itself significant in that it is at least partially a product of an official
reluctance to fund a proper statistical effort.
3. Nevertheless, as Bordo (2003) argues, women’s relationship with food continues to be structured by the millennia old link in western culture between female appetite and sexuality. For a woman to demonstrate too
strong a desire for food has long been regarded as evidence of a wider inability to subordinate her bodily
desires to ‘higher more responsible pursuits’.
4. Poulain argues that surveys assessing eating patterns are influenced by perceptions of ‘proper food habits’
(particular in an environment were national culinary systems are perceived to be threatened). As such they
partially reflect what people believe ought to be the case rather than what is the case.
5. Information obtained from McDonalds’ USA Nutrition Facts for Popular Menu Items (http://nutrition.
mcdonalds.com/nutritionexchange/nutrition_facts.html).
6. A telephone survey of 40 Chinese and Indian restaurants taken at random from the Yellow Pages in Central
London revealed that 34 of these establishments offered buffet service at some point during the week. Two of
these firms specialised in providing buffets. This is significant as almost half of total UK spending on restaurant food is accounted for by Chinese and Indian restaurants (Mintel Oxygen 2008).
7. Between February and March 2009 the author made 15 visits to all-you-can-eat Chinese buffets in London and
15 visits to a Chinese restaurant serving from a standard menu to observe the behaviour of customers between
6– 8 PM. Obviously, this is a very limited empirical basis and any observations need to treated as suggestive
rather than conclusive. Nevertheless, it was interesting to note that average eating time was considerably
shorter in the former establishment (27 minutes as opposed to a 1 hour 17 minutes). Indeed, there was an
hour time limit at the buffet. Furthermore, it was far more common for dinners to eat alone (20 per cent as
opposed 4 per cent). While it is difficult to quantify there was a clear sense in which eaters at the buffet
spoke less than at the more conventional restaurant – the experience of eating out is transformed into in
which nothing is allowed to impede physical consumption.
Notes on Contributor
Iain Pirie is Associate Professor at the University of Warwick. He maintains a diverse set of research interests in
Korean Political economy, media representations of economic crisis and the political economy of disordered
eating.
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Iain Pirie
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