Analyzing Eating Disorders in Film from a Clinical and Cultural Perspective with Consideration of Feminist Theory // Stephanie Steele-Wren, M.S.


Almost every woman, and even men, will admit to the fact that their lives often revolve around food.  We need it to survive and it nourishes our growth, but it also causes us to become preoccupied with our weight and appearance.  When analyzing eating disorders (EDs), it is not only important to view the typical symptoms of sufferers, but to relate those symptoms to causes by many sociocultural factors.  Not only are EDs physical illnesses, they are largely mental illnesses.  EDs start with vulnerable individuals who cannot find a balance in their lives or do not feel they live up to the standards of others, or their own.  The media has a detrimental influence on EDs, especially in women, and rarely do we see the media depicting celebrities with EDs.  It is not all that glamorous to look emaciated with your eyes sunken in, so the media just leaves that out of its reports.  Psychologists have their views on why EDs develop, but feminists also have their own.  However, there is some overlap between these two academic disciplines.  In this paper, I will provide an overview of the diagnostic criteria of EDs (namely Anorexia Nervosa and Bulimia Nervosa), epidemiology in the United States, as well as theories to etiology.  I will then go on to discuss three films: Girl Interrupted, The Woman in the Moon, and Eating: A Very Serious Comedy about Women and Food and how these aspects of EDs are manifested or inaccurately portrayed.  In addition, I will offer some feminist perspectives from Helen Mason, Susan Bordo, and Naomi Wolf that help to validate the portrayal of EDs in these three films.  Although much of this paper will focus on a clinical slant, it is important to include and analyze cultural and feminist perspectives to paint a full picture of EDs . 
The most common EDs are Anorexia Nervosa and Bulimia Nervosa.  When people think of anorexia, they see women with their bones sticking out who refuse to eat.  With bulimia, the common vision is of a woman throwing up constantly after eating voracious amounts of food.  There is much more to these disorders and how they develop, but it is important to put these illnesses into perspective within western culture.  An estimated 0.6 percent of the adult population in the U.S. will suffer from anorexia and 1.0 percent from bulimia (Hudson, 350).  The most updated mortality rate among people with anorexia is estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population (Sullivan, 1074).  These numbers may not seem that high, but in a large population, like the United States, they do raise concern. 
When diagnosing EDs, a clinician must pay attention to certain key factors.  The most noticeable symptoms are an intense fear of gaining weight and a negative or distorted self-image (Sandstrom).  This has to do with the idea that many women have high body dissatisfaction.  They are three times as likely to develop anorexia (0.9 percent of women vs. 0.3 percent of men) and bulimia (1.5 percent of women vs. 0.5 percent of men) during their life (Hudson, 350).  Those of Caucasian descent, heterosexuals, and those with high socioeconomic status are at a much higher risk for developing EDs for the simple reason of cultural values within their ethnicity, race, or sexual orientation (Sandstrom).  Women who have genetically larger body types and more fat in their hips, thighs, and buttocks are also more prone to being dissatisfied with their bodies.  However, it is obvious that not every woman who highly dislikes her body will develop a full blown eating disorder.  People need to also have self-regulatory and emotional problems in combination with body dissatisfaction (Sandstrom).  This means when a women hates the way she looks, she cannot work through or control her emotions and her obsession with her image and weight spirals out of control (Sandstrom).   Going through puberty at a young age also causes much stress because the young girl is confused about her body and that it is not like those around her and she often gets teased for being “fat”, when it is simply her body changing.  This is another high risk and adds to body dissatisfaction greatly.   
Aside from cognitive defects with self-image and body, there are a plethora of sociocultural factors that may cause EDs to develop.  These are what feminists are especially interested in.  Even as young children, girls typically play with Barbie dolls, which already familiarize them with a body impossible for any human.  The average model is 5’11 and weighs 117 lbs, meaning she is over 20 percent under a healthy body weight (Barlow, 272).  We see airbrushed pictures that make models and celebrities seem flawless.  This “perfect” body and appearance is impossible for real women and unfortunately, the perceived “perfect” image of a woman has gone under severe changes since many centuries ago.   During the Victoria era, the “ideal” woman was plump, fleshy, and full-figured (Barlow, 273).  Since then the “ideal” body has fluctuated from really thin flapper’s binding their breasts, Marilyn Monroe bringing curves back in style, to today where boyish, prepubescent celebrities are trendy or very thin women with enormous fake breasts (thesite.org).  Women are bombarded every day with these messages from the media, as well as men, which makes for many highly disappointed individuals.
With these nearly unattainable body images circulating constantly in our society, it makes many women vulnerable and dissatisfied with how they measure up to everyone in popular culture.  But, imagine being critiqued on every aspect of your body by your mother, or someone very close to you.  When family members are intrusive, the victim feels she has no real control over her life.  When this happens, there are often other numerous personal problems building up such as depression, feelings of ineffectiveness, extreme self-criticism, impulsivity, and emotional reactivity or getting upset, angry over little things (Barlow, 277).  There is not one magical formula for diagnosing EDs, but I think all of these symptoms and causes need to be taken into account when assessing a patient.  To some, this may all seem fascinating, yet bewildering, but to others grotesque and masochist for a woman to do this to herself.  Therefore, how do directors portray such mental illnesses in their films without turning audiences away? 
The most mainstream of the three chosen films, with big names like Winona Ryder, Brittany Murphy, Angelina Jolie, and Whoopi Goldberg, is called Girl, Interrupted.  Directed by James Mangold, this film is an adaptation of Susanna Kaysen’s memoir of her experience in a mental hospital.   Ryder’s character attempts to commit suicide, Jolie’s character is a sociopath, Goldberg’s is a nurse in the ward, and Murphy’s has been sexually abused and has an eating disorder.  Overall, the way the disorders are portrayed is as if the writers read the Diagnostic and Statistical Manual of Mental Disorders (DSM) and based their characters off of the main symptoms listed.  From a clinical perspective, no one patient is the perfect instance of for example, being anorexic or depressed.  Each patient has her own combination of symptoms and often multiple disorders, referred to as comorbidity.  For example, Susanna is a depressed patient, in which the film depicts her trying to kill herself with a bottle of aspirin and vodka.  She is shown like she has a flat affect and no interest in life.  Not every person with depression may look like Susanna, some may seem happy on the outside, but could have strong suicide ideations that nobody knows about.  Also, the treatment facility is a very traditional mental hospital, yet patients are able to escape and freely go into each other’s rooms, which is very contradictory in such an institution.  From the very beginning of the film, I cannot say it portrayed most of the mental illnesses accurately.
However, Brittany Murphy’s character, Daisy, does a decent job of manifesting an eating disorder.  Obviously, she is painfully thin, but she also isolates herself from pretty much everyone by staying in her room.  She will not eat in front of anyone, which is another common symptom, and alludes to the fact that she is highly concerned about how others perceive her and doesn’t want to look like she eats a lot.  She is addicted to laxatives and will only eat chicken, and only in her room.  Excessive laxative use is another typical part of the routine of anorexics and bulimics and is an alternative to throwing up constantly.  They feel it gets rid of the few calories they consume, when in actuality, the calories are basically absorbed once they reach the stomach.  Although it is never said explicitly, it is implied throughout the movie that Daisy has been sexually abused by her father, who visits her often in the hospital.  This goes back to the point about family enmeshment and being intrusive on their children’s lives.  If the father is abusing her sexually and continually doing so, he is really messing with her mind.  She has no way out and feels a lack of control over her own body as a result of it.  Therefore, she rarely eats most likely because it is one thing nobody else can make her do and for once she feels she has some control.  Also, it is evident that she has many problems with accepting herself as she is and has severe emotional regulation.  For instance, when Lisa (Jolie) verbally attacks her by saying she is having incestuous sex with her father, Daisy cannot handle the emotional distress of this confrontation.  It is thought that the confrontation causes her to hang herself that night.  EDs cause death either by victims withering away or by killing themselves because they often get so depressed with themselves and their lives and lose their identity.  Daisy’s eating disorder may not have been the forerunner of the mental illnesses in Girl, Interrupted, but of all the disorders in the film, this one seemed to capture the truest essence of the complexities eating disorders entail.
Unlike Girl, Interrupted with every character having her own disorder, the film, The Woman in the Moon, tells a story of three women each dealing with EDs in her own way.  The main character, Spider, represents the director, Ariadne Kimberly, and her battle through an ED and treatment.  Like Daisy, Spider cannot eat in front of people and says that she “likes vegetarian food”, but is “just not too hungry”, when a fellow patient asks her why she is not eating.  She is having painful withdrawal from what seems like a dependence on sleeping pills, which also sheds light on the issue of comorbidity.  Spider used to be a ballerina and speaks of how competitive it was.  She was also kidnapped at a very young age, which is evident from recurring flashbacks.  I believe that her eating disorder is the result of a combination of sociocultural factors of having to be thin as a dancer and of the early trauma of being abducted.  In both situations she felt a loss of her sense of control and therefore, the development of her ED is similar to Daisy’s in that she desires some control over her life and body.  There are also numerous scenes of Spider talking to an image of herself where she tells the image to stop controlling her.  This actually shows one step to recovery: examining her own thought processes via introspection, or looking into herself. 
In contrast to Spider, Portia de Rossi’s character, Shawna is feisty and has a whole different history.  She denies that she has a problem.  When the therapists attempt to counsel her she is reluctant to say anything honest or really think about the problem.  For her, it seems easier to just say that food is “disgusting”.  Another common feature of EDs is denial and still believing one is fat when she is painfully thin.  Shawna admits that she still thinks she is fat to her counselor.  This shows a cognitive disconnect from reality that consumes an anorexic or bulimic’s mind.
Randi is the least “girly” of the three by her deep voice and personality.  She talks about how she could not “act like a sissy in front of Dad” and that she wanted to show him that he “couldn’t break her.”  It seems that Randi comes from a very intrusive family that is over-involved, so much that her dad is able to control her emotions and make her feel like she could not cry when she got run over at one point.  The underlying reason for her bulimia may be that she, as most of the women mentioned, has control for once, and can use it to rebel against her controlling father.  Randi also makes a great deal of jokes about everyone’s EDs and tries to lighten up the situation, but this does not go over too well with the others or herself.  When Shawna antagonizes her with ice cream by shoving it in her face, Randi gets extremely upset and belligerent because she feels she has done well in treatment by only throwing up once since she got there.  In this particular film, early experiences seem to be the main trigger in each of the women’s EDs and that they define themselves by past experiences rather than who they truly are.
As I began touching upon in this paper, many American’s lives revolve around food.  We wake up and eat, we tend to socialize at lunch while eating, and then we have the largest meal of the day, dinner, with our spouses or friends at night.  Some of us have snacks throughout the day and at parties and get-togethers food seems to be the driving force for guests to come and have a good time.  In Eating: A Very Serious Comedy about Women and Food, directed by Henry Jaglom, young and middle-age women gather for a friend’s birthday and converse the entire time about food and what it means to them.  Helaine is celebrating her 40th birthday by having a party at her home.  Helaine's French houseguest, Martine, is filming Californian women's attitudes about food and it is later revealed that she is motivated by an eating disorder in her own past.  There are some notable quotations from the film to set up the discussion about how this film pertains to EDs and the effects perceptions about food have on them.  "I'm no longer involved with food”, as if she and food had a relationship, and “I wear clothes to conceal it", says Nancy.  Comically, Jennifer says, “It's the safest sex you can have: eating", but I think this is a somber joke because eating does have repercussions just as sex does.  If you eat too much of something or have unprotected sex, your health and emotions will be severely affected.  You will feel guilty for indulging or in extreme cases become obese from eating so much.  I feel that the main message of this movie is that food can be analogous to an abusive relationship.  These women feel themselves to be at the mercy of food.  It’s supposed to be enjoyable, but has so many strings attached to it.  
It is interesting that Helaine decides to do this film considering she had an eating disorder herself.  She obviously has not recovered completely because everyone keeps complimenting her on her figure and she keeps saying she is not that attractive and does not think she has a great body.  It seems she still has self image issues and negative cognitive attributions to the way she looks.  The other women show some similar thinking patterns to that of victims of EDs.  An example is when Nancy says she wears clothes to conceal it.  She feels guilty for eating as much as she does and feels she has to cover up her overindulgences, which she believes are shown by her appearance.  These women seem to define themselves by what they eat or what they don’t eat.  They are clearly obsessed with food.  There is a scene where they are passing a piece of cake around and no woman wants it.  This is a perfect example that women cannot be comfortable enough around each other even to enjoy food, which is characteristic of anorexics and bulimics.  This is because everyone in the group has competition engraved into their minds by society that they need to be skinnier than everyone else, so here we see cultural factors playing a major role in these women’s feelings about food.  Eating is a basic human function that gets taken too far in how it is done and analyzed in our society.
The basis of these films certainly makes them feminist films, but how do feminist perspectives fit into the whole realm of EDs?  Helen Malson, a social psychologist and editor of Feminism and Psychology, claims that eating disorders are a way for women to be controlled by patriarchal society.  She explains how women’s ‘natural needs’ are obstructed by cultural prescriptions of thinness and passive femininity and goes further to say, “While such prescriptions are undoubtedly oppressive, their analyses rest upon a false dichotomy- the natural female body versus its social oppression in which ‘the body’ is understood outside of (rather than as constituted in) culture” (97).  She thinks that women need to eat, but feels they cannot do so to the amount they biologically should because they quarrel with social oppression and women having to listen to men and look physically appealing for them.  Patriarchy wins out over nature and basic functions of living.  She also says that masculinity is defined independently of physical appearance, while femininity is highly dependent on being thin (106).  This is clearly shown in Eating, where the women’s lives are centered around food and the way it makes them look physically and as people.  What I mean is that they feel they are judged by others on their personalities, for example, based on their decisions about what they eat.  Malson would say that there is an underlying principle that eating great amounts of food reflects badly on a female and shows that she is selfish and not following her role in society.  Also, EDs are a sickness and being sick is considered weak, therefore it contributes to women’s fragility and them not being able to handle things like men can.  In general, Malson feels EDs develop as a result of men emphasizing thinness as attractiveness. 
Similarily, Virginia Wolf provides a theory where patriarchal society sees the anorexic woman as how all women should be.  Wolf explains that "the anorexic may begin her journey defiant, but from the point of view of a male dominated society, she ends up as the perfect woman.  She is weak, sexless, and voiceless, and can only with difficulty focus on a world beyond her plate" (197).  Patriarchy does not want to see women who speak their own minds and make their own decisions.  Anorexics and bulimics are completely overtaken by thoughts of food and their weight.  They cannot stand up for themselves nor even confront their own problems.  They let the media, which is mainly governed by men, tell them they should look extremely thin or they will not be successful.  Daisy rarely leaves her room and cannot deal with any pressure or confrontation.  Spider, Shawna, and Randi all seem to have problems with the way their fathers treat them or run their families, but have not stood up to them.  And, of course, in Eating the women all speak about how they try to hide their imperfections and that eating a piece of cake would be a horrible thing to do.  If none of these women cared about society and how women are “supposed” to be, food would be something enjoyable without so many thoughts and negative feelings attached to it. 
This concept of women taking up less space is also a major theme in Susan Bordo’s book, Unbearable Weight, where she claims that the fear of women's fat is actually a fear of women's power.  In other words, as women gain power in society, their bodies must suffer to make up for it.  She states that "female hunger-for public power, for independence, for sexual gratification- [must] be contained, and the public space that women be allowed to take up be circumscribed, limited... on the body of the anorexic woman such rules are grimly and deeply etched" (171).  Women have come a long way in society, but they still have many limitations as to what they can do.  According to Wolf, in order for them to have higher power status, women have to trim down their bodies and thus, calories.  You do not see too many overweight women as CEOs, Program Directors, or department heads in academia.  With power comes a price for women.  This is again portrayed in Eating where some of the women seem to be well off and have decent jobs, but still feel guilty about eating a piece of cake!  However, in Girl, Interrupted and The Woman in the Moon, the women do not seem to be independent at all.  They are sent to a treatment facility because they cannot take care of themselves and show no power over any of the men in their lives, especially Daisy.  As much as this theory sounds interesting, these movies as well as the nature of the disorders do not provide any evidence in favor of it.     
Consequently, what should we take from these films and the discussion they have sparked about EDs and feminism?  Living in a male-dominated society and with so much technology, the average woman has a lot to compete with.  The three films discussed do portray some aspects of EDs accurately, but my biggest concern is the fact that the EDs themselves are minimized and not taken that seriously.  The Woman in the Moon shows women who seem pretty light-hearted about their disorders despite going through the toughest time in their lives.  They can still form normal relationships through the process of anorexia or bulimia, which may be inspirational, but is not typical of someone suffering such a severe disorder.  Even though it is based on a true story, a little more struggle would have pulled more at viewer’s heartstrings.  Girl, Interrupted glamorizes psychological disorders and makes them dramatic and sometimes even “fun” for cinematic reasons, not for awareness.  Daisy’s death is not taken solemnly- some of the patients are sad, but they seem to move on fast to another crisis and forget about her.  Eating just shows women kind of joking about their concerns with food and dieting, even though deep down it haunts them all each day and runs their lives completely!  These movies all send negative messages about EDs in a way that they are not all that serious and that the way in which women are expected to consume food and look is satirical.  But it is something due to many factors of our society and can be extremely dangerous when it becomes a full-blown disorder.  From a clinical psychology perspective, these films could have made their EDs more realistic and rough or at least having more clear reasons as to why the characters each developed an ED.  It worries me, and probably all the theorists mentioned, that some people may watch these films and completely disregard the women’s problems with eating or not find the messages the directors and writers may want to convey.  To further this point of increasing awareness of EDs, a recent empirical study showed that simply teaching women feminist theory who are being treated for EDs, without any explicit mentioning of how they are connected, has shown these women have more successful recoveries and less relapses (Carolan et al.)  This gives light to the idea that eating disorders are more than a mental disorder placed outside of culture and the environment; external factors seem to be key.

By: Stephanie Steele-Wren, M.S.


Works Cited
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