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    billp's Avatar
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    Anorexia Realis

    For reasons unconnected to my own health I got very interested in Anorexia Nervosa about a year ago. While I was doing that I discovered something interesting: that Anorexia Nervosa is a new disease, really discovered only in the 1860s and made known in the 1870s.

    There are a few clear cut cases before that, like Timothy Dwight: https://en.wikipedia.org/wiki/Histor...Timothy_Dwight

    But, basically Anorexia Nervosa hardly existed. But there was a similar condition in its place, Anorexia Miribalis. Same age group, same sex-bias (many more females than males), same symptoms, same outcome - either they got better or died - but totally different. The motivation was religious - holy fasting. Nothing to do with body image, nor as far as we can tell anything to do with wanting to be thin or to lose weight. They did it out of piety. Different but really the same.

    Now I come across something called Orthorexia Nervosa. This is not a medically recognised condition, but it is put forward as an obsession with eating the right foods. Pure foods, free of chemical additives, unmanufactured, or free of animal products, or raw, or without pesticide, etc. It is the same effects as the other variants, affects the same age-group, has the same bias towards but not exclusive to girls, and has the same risks, and people also become obsessed, malnourished and also sometimes die from it. Like Anorexia Miribalis, it is different from Anorexia Nervosa, but really it is the same.

    I propose these are three manifestations of the same illness (in time order):
    https://en.wikipedia.org/wiki/Anorexia_mirabilis
    https://en.wikipedia.org/wiki/Anorexia_nervosa
    https://en.wikipedia.org/wiki/Orthorexia_nervosa

    I propose that this is really one illness, that should be rightly called Anorexia Realis, an underlying condition currently unknown - neither what it is nor why it happens. In fact, all the explanations so far contradict each other, yet they describe what is clearly the same condition. Like Australia, this condition now has a name before being discovered itself.

    What I want to know is:

    1. What real cause? - As opposed to the fake and contradictory causes currently held.
    2. What other variants are there that we haven't noticed yet? Once you have three of a kind there are bound to be more.

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    I recently read an excellent book called 'Mad, Bad and Sad' about women and mental illnes through history. In the 1800s was the phenomena of hysteria. It was widespread amongst young women and filled the asylums and hospitals. Now it has disppeared, and instead we have anorexia and also (more recently, in the last 15 years, self-harm). These are the illnesses of the young.

    And I agree about the three anorexias being the same. Sort of. I'm tired now but am interestd in this post. Will have a closer look at your links and get back to you. it's very interesting and I think these illneses are a statment about society and the ways in which trauma and body image are dealt with in families and within a culture.

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    billp's Avatar
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    I actually would totally rule out body image. The other two known types (the non-medically recognized Orthorexia and the Mirabilis variant) don't appear to involve body image at all but are clearly the same thing.

    Do you know how they treated Hysteria? NSFW

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    Quote Originally Posted by billp View Post
    Do you know how they treated Hysteria? NSFW
    If that's the treatment I think it is, I would imagine the attractiveness of it increased the rate of complaints of hysteria.

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    The popular perception is that anorexia nervosa and bulimia nervosa are about body image, but that's not entirely accurate. Although body image plays a role, there is also a need to assert some control over something, and for a lot of young women, the thing they most have power over is their body.

    I agree that mirabilis and nervosa are at their root likely the same--exerting power over the body as an attempt to conform to a kind of idealized perfection or purity. But in essence, anorexia, bulimia, and binge eating disorder are all strongly related, as would be ED-NOS (eating disorder not otherwise specified), which is a category used in the DSM for something that's clearly an eating disorder but does not fit all of the diagnostic criteria for one of the named disorders (this is actually where orthorexia nervosa would likely fit under the current standards).

    Sadly, young men also experience eating/body image disorders, but they are not as recognized in boys and men and often don't take the same form. You will see young men overexercising and obsessing over body image and body fat percentage, and some of these guys end up abusing steroids at young ages, for example. Males may be underdiagnosed with EDs because we strongly associate eating disorders with females, but men are as likely as women to be diagnosed with body dysmorphic disorder and more likely to be diagnosed with muscle dysmorphia.
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    billp's Avatar
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    Quote Originally Posted by orielwen View Post
    If that's the treatment I think it is, I would imagine the attractiveness of it increased the rate of complaints of hysteria.
    Oh yes. Especially when carried out vigorously by strapping young doctors - as it often was, allowing them to retain a greater proportion of the fee.

    One of the ways medicine as regressed in the last hundred years. In 1910 the newspaper we full of adverts for, er, vibrating medical equipment needed to, er, cure this, er, complaint. And people think they used to be repressed in the past!

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    It's caused by cultural stupidity.

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    I disagree about the same origins in every case of Orthorexia Nervosa, as that can arise from wanting to avoid foods that cause inflammation, IBS and various autoimmune problems.

    These problems are more common among young women than among any other age group, as they have the strongest immune systems.
    F 5 ft 3. HW: 196 lbs. Primal SW (May 2011): 182 lbs (42% BF)... W June '12: 160 lbs (29% BF) (UK size 12, US size 8). GW: ~24% BF - have ditched the scales til I fit into a pair of UK size 10 bootcut jeans. Currently aligning towards 'The Perfect Health Diet' having swapped some fat for potatoes.

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    Quote Originally Posted by paleo-bunny View Post
    I disagree about the same origins in every case of Orthorexia Nervosa, as that can arise from wanting to avoid foods that cause inflammation, IBS and various autoimmune problems.

    These problems are more common among young women than among any other age group, as they have the strongest immune systems.
    I would argue that eating carefully because of a health condition does not make one orthorexic. As a celiac, I'm extremely careful about my food, but that would not qualify me as orthorexic since there is clear justification for my choices. Orthorexia nervosa would be when it becomes an obsessive tendency rather than rational self-protection. It's a question of degree, just like exercising sensibly as part of a weight loss plan is different from exercising as a purging aspect of bulimia.
    “If I didn't define myself for myself, I would be crunched into other people's fantasies for me and eaten alive.” --Audre Lorde

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    Quote Originally Posted by Owly View Post
    I would argue that eating carefully because of a health condition does not make one orthorexic. As a celiac, I'm extremely careful about my food, but that would not qualify me as orthorexic since there is clear justification for my choices. Orthorexia nervosa would be when it becomes an obsessive tendency rather than rational self-protection. It's a question of degree, just like exercising sensibly as part of a weight loss plan is different from exercising as a purging aspect of bulimia.
    I agree with that. It's a question of definition. I'm often accused of orthorexia by people who don't believe that my food intolerances exist. But in truth I'm not orthorexic and am prepared to compromise as long as certain foods I have to eat only give me mild symptoms. And I'm not underweight or malnourished.
    F 5 ft 3. HW: 196 lbs. Primal SW (May 2011): 182 lbs (42% BF)... W June '12: 160 lbs (29% BF) (UK size 12, US size 8). GW: ~24% BF - have ditched the scales til I fit into a pair of UK size 10 bootcut jeans. Currently aligning towards 'The Perfect Health Diet' having swapped some fat for potatoes.

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