Eating Disorders

Also from Rob Henderson, some research showing that intrasexual competition is the main driver of eating disorders.

The stressor that had the biggest effect on women’s disordered eating—the strongest predictor of developing an eating disorder—wasn’t men or attention from men. It was the presence of attractive women, of perceived romantic rivals. (source here and here).

I worked with lots of women with eating disorders, but was often kept at arm's length by other staff. We had a fair balance of male and female psychiatrists, but the MD's who handled direct medical were much more likely to be male.  Those males were involved of necessity, but in the other departments the bias toward women practitioners was overt.  Nurses and social workers are usually women anyway, but even in that context men would get elbowed out.  Female social workers would quickly volunteer - or insert themselves - if an eating-disorders client fell by luck-of-the-draw to me. Male nurses and psychologists would quietly note this to each other, but we all knew it just wasn't worth challenging.  Female clinicians get very energised about this and will elbow you out. For years I vaguely reasoned that I didn't know much in this area anyway, and these women by their energy gave off that they had paid a lot of attention to the disorders and knew a lot. It took a long time for me to notice that success was hard to come by in this frustrating area, and battles royale involved lots of angry people all quite sure that their approach was better.  

Not only was each school's adherents sure that they had the best theory, they were also convinced that the other camp's ideas were the worst and most damaging plans possible. So I wasn't too unhappy to be left out of those discussions. It often reduced to which female nurse could exert the most dominance, regardless of official hierarchy.

There was always some idea that one origin of the various disorders was that the idea that women should be thin had gotten blown out of proportion, and that the patient was not fully rational about this.  She had read too many girl's magazines or watched too many movies.  It was patriarchal expectations of men who wanted subordinate women.  It was her overbearing mother. It was the woman's need for control over her environment in other areas, such as sex, and was a red flag for having been sexually abused. I never heard anyone comment that perhaps it was because one or all of her sister's were pretty, though that would seem to be a thing people would notice.

I have written about intrasexual competition before, in late 2022, with the surprising revelation that we have long overlooked how much time women and men spent with only their own sex over thousands of years.  Lazily or unconsciously, we assume that our experiences over the last hundred or so years has been the norm for millennia. Not so. The idea that this is derived from a disordered version of genetic structures, perhaps set off by culture but not originating there, responding to other environmental cues such as who you live with and go to school with is intriguing to me.  So far it seems to be a strong association, but teasing out causation is going to be tricky.