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About 40 years ago, anorexia nervosa was a rare condition, and generally regarded in the psychiatric community as strange and unintelligible. Of the few cases seen, most were preadolescent or early adolescent girls, painfully thin, reluctant to eat, and at times having to be forcibly fed to maintain life. They stood out in contrast to the general community, in which people were generally well rounded, but although there were some excessively obese people, especially among the young, their number was relatively small.
Today, there has been an enormous increase in the number of anorexia cases. Of course, it may reflect more accurate diagnosis. But I think this is perhaps not surprising in the light of the tremendous societal preoccupation with dieting. Food faddism has grown, but genuine concern about the nutritional value of food is also present, in part a consequence of the promotion and acceptance of junk foods, mushrooming of fast-food chains, recognition of the unhealthy doctoring of food to preserve its “shelf-life.” But this is only the superficial side of the picture. The compulsive quest for youth, the narcissistic concern with appearance, the fashion dictum that we must be scarecrow clothesracks to look proper in clothes, all contribute to the social attitude about body image. It is therefore perhaps surprising that the other end of the spectrum, extreme obesity, especially in the young, and particularly young women, has also burgeoned.
Let us consider another social phenomenon before turning more directly to the conditions mentioned. Women have been struggling to become liberated, that is, to have lives of their own beyond their caretaking role. Motherhood has taken its lumps, been denied as essential or important, and day care