Anorexia Nervosa in the Congenitally Blind: Theoretical Considerations

The recent preoccupation with dieting, exercise, and thinness as a feminine ideal in Western culture has been blamed for the exponential increase in eating disorders in young women. Advertisements, prominent female celebrities, fashion models, and popular publications all tend to present slenderness as equivalent to success and desirability. The number of feature articles on dieting and weight loss in six major women's magazines during the past 20 years has increased, as has the popularity of slender Miss America winners and Playboy centerfolds (Schwartz et al., 1982). The emphasis on appearance, specifically a slim one, is particularly prominent in the teen years. Orbach (1986) notes that “one thing that adolescent magazines uniformly preach as a solution to the crisis of adolescence is dieting and weight control” (p. 47).

The temporal correlation between our cultural fascination with feminine slenderness and the prevalance of eating disorders in women points to a social basis for this form of psychopathology. However, anorexia nervosa existed prior to our modern preoccupation with thinness as an aesthetic ideal. Bruch found clinical descriptions of anorexia dating back to the 1600s and noted a steady, if modest, stream of reports in the literature since then, including during times when feminine corpulence was highly esteemed. In these cases, it is harder to see how cultural values influenced women to develop eating disorders. These past examples of anorexia may be different from today's cases in terms of etiological conflicts, manifestations, and prognosis. Modern-day anorexia nervosa may represent a final pathway for a variety of developmental difficulties facing contemporary adolescents, difficulties compounded and, perhaps, in some, created by the value