Anorexia Nervosa: When Critique Loses Sight of Care

"Anorexia nervosa is often portrayed as an illness that has existed for centuries, does not respond well to treatment, and is surrounded by confusing and competing theories. Many people are told that little has changed despite decades of research and clinical work. This message appears in academic writing, the media, and everyday conversations. Over time, it shapes how professionals approach care, how families understand the illness, and how people with anorexia nervosa view their chances of recovery."

"A recent article, Anorexia Nervosa: 150 Years of Critical Theory, reflects this way of thinking. Written by international experts, the paper reviews how anorexia nervosa has been understood over the past 150 years. It questions whether today's theories and treatments truly work and suggests that the field may be stuck. The article is thoughtful and wide-ranging. However, it also raises an important concern: when criticism becomes too far removed from real-world care, it can overlook what is actually helping people with anorexia nervosa today."

"One of the article's strengths is its focus on history. The authors trace self-starvation from ancient religious asceticism through Victorian hysteria, psychoanalytic formulations, cognitive-behavioural models, feminist critiques, evolutionary accounts, and contemporary biopsychosocial and metabo- psychiatric theories. This reconstruction makes a significant contribution by demonstrating that anorexia nervosa has never been understood through a linear or cumulative explanatory framework, but rather through paradigms that are often in competition and deeply shaped by broader epistemological, cultural, and ideological shifts."

Anorexia nervosa has been explained in many different ways across history and cultures. Self-starvation has been linked to ancient religious asceticism, Victorian hysteria, psychoanalytic and cognitive-behavioural models, feminist critiques, evolutionary accounts, and contemporary biopsychosocial and metabo-psychiatric theories. Prevailing explanations are not linear or cumulative but competing paradigms shaped by epistemological, cultural, and ideological shifts. Many portrayals present anorexia as longstanding, treatment-resistant, and surrounded by confusing theories, influencing clinicians, families, and patients. Critique of treatment remains important, yet excessive theoretical skepticism can overlook real-world therapeutic advances. Some intensive treatments help people even without a fully settled theoretical framework.

Read at Psychology Today