The Daisy Duke Diet
Does America's obsession with Jessica Simpson's waistline represent a health hazard?


Jessica Simpson, the Texas-born singer/actress/model who famously could not tell chicken from tuna, has apparently been downing more chicken-fried steak recently: She gained an estimated 30 pounds over the last few years. Supporters of the reupholstered Jessica point out that she now merely resembles an average woman; while her chief selling point was always that she did not resemble an average woman, the fuss over her fluctuating avoirdupois raises the question of why we are so obsessed with pop stars’ weight troubles, and whether paying such close attention may be harmful to impressionable young girls.

In particular, does it cause anorexia nervosa, the terrible mental illness whose victims starve themselves, sometimes to death?

Prof. Christy Greenleaf of the University of North Texas thinks so. She has written:

Girls and women, in our society, are socialized to value physical appearance and an ultra-thin beauty that rarely occurs naturally and to pursue that ultra-thin physique at any cost. Research demonstrates that poor body image and disordered eating attitudes are associated with internalizing the mediated (i.e., commodified, airbrushed) bodies that dominate the fashion industry.

The narrative is a plausible one, and it fits a familiar template: Big business uses mass media to destroy consumers’ health by creating harmful desires. Yet there are large parts of it that don’t hold up.

In the first place, anorexia is not in any way an artifact of our modern, weight-obsessed society. Thomas Hobbes wrote about it in the 1680s. A 1987 study showed that anorexia in the United States increased throughout the 19th century and peaked around 1900, when chorus girls were voluptuous and the boyish flapper look was still two decades away. A similar historical trajectory has been found for eating disorders in France. Some interplay of genetic and environmental factors may be at work in these cases, or they may have resulted from the common pattern in medicine of certain diagnoses’ rising and falling in popularity. But it’s clear that none of these outbreaks can be attributed to the late-20th- and early-21st-century emphasis on skinniness.

There are plenty of other examples. The medical historian I. S. L. Loudon has identified chlorosis, the 19th-century “virgin’s disease,” with anorexia and shown that diagnoses of it reached “epidemic proportions” in Victorian England before disappearing completely between 1900 and 1920. A pair of Dutch historians has traced the practice of severe self-starvation all the way back to the early Christians and described the various explanations that were offered for it over the centuries (holiness, witchcraft, demonic possession, miracles, various nervous or emotional disturbances) before a newly scientific medical profession defined it as an illness in the mid-19th century.

All these statistics must be taken as rough indications only. Eating-disorder rates, like those for most psychiatric illnesses, are notoriously slippery, since the conditions are so hard to pin down. Journalists sometimes say that anorexia rates have been increasing for decades, as Americans’ lives have become more media-saturated; one source reports that anorexia in young adult females has tripled over the past 40 years. This is a case of the common phenomenon in which growing awareness of a condition leads to increased diagnosis of it, even when there is no real increase in its prevalence. Researchers who have carefully studied the data conclude that there has been no significant change in the rate of anorexia in America since at least the mid-20th century.

Moreover, while it’s tempting to blame America’s appearance-obsessed culture for the plight of its self-starving daughters, anorexia is a global phenomenon. A 2001 article reviewed the extensive literature on eating disorders among residents of Europe, Asia, Africa, the Middle East, and Australia. In some regions, the reported rates of anorexia were several times that of the United States (though, as above, such figures must be taken with caution). In a case of political correctness attacking itself, one researcher says those who attribute anorexia to media sexism are being ethnocentric: “The biomedical definition of anorexia nervosa emphasizes fat-phobia. . . . However, evidence exists that suggests anorexia nervosa can exist without the Western fear of fatness and that this culturally biased view of anorexia nervosa may obscure health care professionals’ understanding of a patient’s own cultural reasons for self-starvation.”