Social Class and Anorexia Nervosa In the quiet therapy room of the Hall-Brook Outpatient Behavioral Center in Norwalk,

Connecticut, eight young women sat down to discuss their weekly progress. They looked similar to a tee - well-dressed, frail, only three looked a little over a hundred pounds, all eight of them white. These women were just a small sample affected by the growing mental disorder called Anorexia Nervosa. As outlined by Barbara Fadem in Behavioral Science, Anorexia Nervosa has many physical and psychological characteristics. Some of the physical characteristics include extreme weight loss (15% or more of normal body weight), amenorrhea, mild anemia, and presence of lanugo - downy body hair on the trunk. The psychological characteristics of the disorder include refusal to eat despite normal appetite, an overwhelming fear of being obese, abnormal behavior dealing with food (e.g., simulating eating), excessive exercising, and interfamily conflicts. Yet more and more definitions now also include the phrase Eating disorders are more common in women and in higher socioeconomic groups and are much more common in the United States than in other developed countries (Fadem 2000). While looking at the patients sitting in the therapy room, one could not help but wonder why these characteristics that could potentially affect any chosen individual, affected the eight girls in the room. Even more importantly, why was there a social class bias of those affected by the eating disorder aimed towards caucasian females of middle and upper classes living in the United States? One must look at the attributes associated with the middle and upper classes and those of the American culture to gain a better understanding of why the individuals of these classes have a higher incidence rate of developing an eating disorder. These attributes mainly consist of a strive for high education, high prestige, and mass media exposure.

The pursuit of higher education is one of the things associated with middle and upper classes. These individuals are brought up valuing knowledge from the day they are born. Their parents, understanding the importance of a bachelor's degree, spent hours reading to them, researching school districts and making it clear to them that they simply must graduate from college (Leonhardt 2005). The standards set by the middle and upper-middle class parents are often demanding, and the students follow in their footsteps as told. They tend to share an upper-middle-class upbringing. Students like these remain in college because they can hardly imagine doing otherwise (Leonhardt 2005). While interviewing the girls in the room, I found out that most of them attended four year universities, one was in graduate school, and one had already graduated. My suspicions were true, and after a few questions, all of the girls admitted to feeling pressures to succeed based on their social status, even when their parents did not express such expectations verbally. Most of the girls also described themselves as perfectionists, which they said started to show first and foremost in their academic careers. In one research, the scientists assessed the relationships between external pressures to excel, competitiveness, eating disorder characteristics, and body dissatisfaction. Within the general sample, external pressures and competitiveness were both positively correlated with eating disorder characteristics and body dissatisfaction (Peden 2008). Competitiveness and the desire to excel are some of the underlying values of the members of middle and upper social classes, and it is no surprise that there is a correlation between the socioeconomic status of the girls in the clinic and their illness. The pursuit and value of high prestige among the middle and upper classes may also be connected to the development of anorexia nervosa amongst the members of these classes. In the present day society, there is a constant pursuit of perfection in looks and body image. With the

cosmetic surgery business being at its highest, and our society placing such emphasis on attractiveness, it is no wonder that such problems as eating disorders arise. Being thin apparently symbolizes certain cherished notions, such as social acceptance, self-discipline, self-control, sexual liberation, assertiveness, competitiveness, and class. Dieting in Western culture has become a cultural preoccupation and it may even be argued that eating disorders are simply extensions of normal and socially acceptable models of behavior (Shuriquie 1999) The middle and upper classes of the American society view thinness as prestigious - there is a certain image that has to be reached and maintained to keep one on a class-appropriate pedestal. As Professor Henslin phrased in his book Sociology: A Down to Earth Approach (9th edition), You cant be thin enough. While talking to the girls in the group, most confessed that their fear of gaining weight came from perfectionism - they wanted to be the best, the skinniest, the prettiest. When I asked about their thoughts on the mass media today, all eight girls reported that they constantly compare themselves to runway models and underweight celebrities. A few girls admitted to having participated in online communities labeled as pro-anorexia or thinspiration communities, which are websites and forums of girls encouraging eating disorders and giving each other tips to drop more weight. Mass Media plays a huge role as a determinant of whats valuable or desirable in the American society. Inversely, it also tells us whats undesirable. The changes in our societies perception of obesity are apparent - it has become a negative stereotype. Although both, anorexia and obesity, are the unhealthy extremes, they are treated very differently in society.

Interestingly, anorectics are provided with psychotherapy and highly sympathetic attention by "experts"; those who are obese in this country, conversely, are treated with disgust at the obese person's lack of willpower. Why? U.S. anorectics are overwhelmingly middle-class and upper-middle-class European-American young women, while obese persons cross the class gamut. (Throop 2005) As one can see, the relationship between middle and upper social class and anorexia is highly correlational, but neither is the cause of another. Although anorexia nervosa affects members of all classes, genders, societies, and races, a high prevalence is seen in caucasian women of the middle and upper class who reside in the United States. That, of course, in no surprise. With the high educational and prestige expectations, along with the information we receive from the mass media, its surprising that more people dont acquire the illness.

Works Cited Fadem, Barbara. Behavioral Science. 3rd ed. Maryland: Lippincott Williams & Wilkins, 2000. Henslin, James. Sociology: A Down to Earth Approach. 9th ed. Boston, MA: Allyn and Bacon, 2008. Leonhardt, David. Class Matters: The College Dropout Boom. New York Times 24 May 2005. http://www.nytimes.com/2005/05/24/national/class/EDUCATION-FINAL.html? pagewanted=1 Peden, Jamie, et el. The Effects of External Pressures and Competitiveness on Characteristics of Eating Disorders and Body Dissatisfaction. Journal Of Sport & Social Issues 32.4 (2008): 415-429 Shuriquie, N. Eating disorders: a transcultural perspective. Eastern Mediterranean Heath Journal 5.2 (1999): 354-360 Throop, Elizabeth. The Moral Ambiguity of Anorexia: Class, Culture, and Privilege. Journal of Social Science and Medicine 58.9 (2004): 15-75