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..."prevalence studies among females in late adolescence and early adulthood have found rates of 0.5-1.00% for presentations that meet full criteria for anorexia nervosa ... there are limited data concerning the prevalence of this disorder in males" (p. 557). These views are substantiated by epidemiological data that estimate that girls and women account for about 90% of diagnoses of the condition (Andersen Holman, 1997; Robb & Dadson, 2002). Such professional and public views arguably have less to do with incidence of individual pathology than with social practices that surround the condition. Various writers (e.g., MacSween, 1993; Orbach, 1978, 1986; Zerbe, 1993) have argued that, instead of being an individual problem, AN reflects social pressures on women to conform to unrealistic notions of the ideal thin woman. It thus constitutes women's attempts to control body shape in line with men's expectations, and, therefore, should be viewed as part of a complex response to the confusing demands of patriarchal society. Gendered social ideals accordingly are mirrored in individual experience.
More recently, however, writers have argued that the gendered nature of AN arises not from individual experience but from its origins as a recognized disorder. Hepworth and Griffin (1990, 1995; Hepworth, 1999), for example, argued that the representation of AN in women can be traced back to the development of knowledge about the condition within late nineteenth century medical and psychiatric contexts. In the course of this development, knowledge of AN comprised five main discourses, including specifically a "discourse of femininity." Further, Hepworth (1999) described how during earlier historical periods there are examples, such as Catherine of Siena (1347-80), in which self-starvation was seen by religious authorities as a contributor to Sainthood. However, later on through the Middle Ages and the rise of witch-hunts throughout Europe religious interpretation focused on women who starved themselves as being possessed by the devil. Hepworth and Griffin (1990, 1995; Hepworth, 1999) maintained that the development of AN within medical and psychiatric contexts has led to its construction as a disorder with specific feminine symptomatology, and has emphasized the individual and her eating behaviors. In doing so, attention is diverted from the gendered nature of the condition and from the social and cultural processes that present and sustain it as individual pathology.
Moreover, the construction of AN in medical terms has consequences far beyond the context of medicine itself. The authority and power granted to medicine in general and psychiatry in particular result in definitions of AN as a disorder of women being taken up by both by diagnosed individuals and more widely within society. For example, in a study of male and female college students, Benveniste, LeCouter, and Hepworth (1999) found that participants used discourses of sociocultural influences, femininity, and individual psychology in making sense of AN as a condition. The participants deployed these discursive repertoires to separate individual experience from social contexts and to locate understanding, diagnosis, and treatment of AN within the context of medicine. Prevailing medical constructions of AN as a disorder of women were thus reflected in everyday understandings of the condition.
The studies discussed above offer a useful account of how AN...
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