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Roots and Recovery: Anthropologists Study Anorexia from all Angles

How do sufferers of anorexia recover? Richard A. O’Connor and Penny Van Esterik seek answers to this question, first by identifying root causes of the disease and then by sharing the stories of those who have made a full recovery.  From Virtue to Vice: Negotiating Anorexia, the book that resulted from their research, does not look at the affliction of anorexia from behind a glass, in fact, O’Connor’s connection to the work is deeply personal. He explains in his own words below.




Every book has a back story. Mine is no big secret. When my daughter Amorn became anorexic it turned our family upside down. Carolyn [my wife] and I desperately wanted answers. We got a great counselor but nothing worked. The explanations we got made no sense. That wasn’t our daughter. Of course we worried we were in denial—that we just didn’t want to face the truth—and that silenced me at the time. I understood clinicians have to put people in categories and few fit perfectly. So I settled into accepting my daughter was an exception, an outlier. What mattered most was working with her caregivers for recovery.


While Amorn was sick I began to meet other parents and hear from friends who knew anorexia first-hand. It was great to have their support but I kept hearing how the standard explanation didn’t fit their loved ones either. Now I’m an anthropologist, and we often find one culture comes up with a plausible but wrong explanation of another culture. In Thailand, where I did my research, if you hang out with Americans you’ll get a consistent—but mistaken—explanation of Thai culture. Its consistency comes from how Americans see the world, not how Thai are. I began to worry that something like that had happened to anorexia. The very thought horrified me. I knew the people treating our daughter were dedicated and able professionals but that kept them close to what the research said. At the time I’d been an active researcher for nearly 30 years. I knew research could go down the wrong path for a generation or more.


I was dubious for yet another reason. I got my professional start as an anthropologist doing fieldwork in a Buddhist temple in Bangkok. So I knew the story of the Buddha and how he had almost starved himself to death before he discovered the Middle Way. You don’t usually hear about that episode, but when temple murals depict the Buddha’s life you see his emaciated body, every rib showing. And that’s not just Buddhism—all monastic orders have to guard against self-starvation. A monk or nun gets into self-denial and, once that ascetic practice takes on a life of its own, they can starve themselves to death.


It didn’t take long to find articles that argued anorexia was out-of-control asceticism. But those were all by scholars in history, anthropology or religion. With one exception, it wasn’t in the clinical literature and medicine would have none of this. Even though medicine could not explain anorexia, nothing published took moral or religious explanations seriously. It might be genetic, or a psychological trauma, or the media’s influence, but it could not be virtuous self-denial taken too far. To me, as an anthropologist, you simply couldn’t say that. It ignored how, in our culture, the good person is self-denying. Nor is it accidental that achieving requires the disciplined self-denial that leads into anorexia.


It has been nearly a decade since those realizations finally sunk in. I soon learned medicine wasn’t prepared to hear from outsiders. Realizing I had a huge project that was also inescapably political I got my friend Penny to help. At the beginning I was mad at the politics—why wouldn’t they listen?—although I eventually came to understand that clinicians were eager for answers but the research had not served them well. The real problem was that anorexia, by its very nature, didn’t fit the way research divided reality to control the variable. In effect, research was forcing a large and unwieldy round peg [anorexia] to fit into a small and tidy square hole. That was backwards.


In the end science must adapt itself anorexia, not the other way around. That’s what our book does.





Richard A. O’Connor is Biehl Professor of International Studies and Anthropology at The University of the South. He has held postdoctoral awards nationally (Fulbright, SSRC-ACLS, NEH) and abroad (Kyoto University and Institute of Southeast Asian Studies).


Penny Van Esterik is a retired Professor of Anthropology from York University where she taught nutritional anthropology, advocacy anthropology and feminist theory. Past books include Beyond the Breast-Bottle Controversy, Materializing Thailand, and Food and Culture: A Reader (edited with Carole Counihan).


Series: Volume 4, Food, Nutrition, and Culture