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Inside Anorexia

Inside Anorexia

The Experiences of Girls and their Families

Christine Halse, Anne Honey and Desiree Boughtwood

Paperback: £13.99 / $21.95

2007, 234mm x 156mm / 9.25in x 6in, 208pp
ISBN: 978-1-84310-597-8, BIC 2: MMZD JFFH

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Introduction

Teenage girls have the highest incidence of anorexia nervosa of any group in society but anorexia is a perplexing problem for everyone involved. People with anorexia often do not acknowledge their condition and resist treatment; distressed parents and carers are torn between meeting their child's demands and following the advice of medical experts; and clinicians and health professionals often wrestle with the challenge of how best to manage this complex and potentially life-threatening problem.

Inside Anorexia is designed for people encountering anorexia for the first time or those who want factual information and an insight into the lived experience of girls suffering from anorexia and that of their families. The book has been written to meet the needs of people diagnosed with anorexia, their parents and families, and the increasing number of professionals from health, education, and social services who are encountering and dealing with teenage girls with anorexia and their families in professional practice.

Inside Anorexia brings together the stories of teenage girls with anorexia, their parents and families to provide an insight into the real-life experiences of those living with anorexia. These family biographies are combined with up-to-date information and research about anorexia from a variety of disciplines including health, medicine, psychology, and feminist and cultural studies. This information is based on critical analyses of the latest research as well as findings from the authors' own research, much of which has been published in more extended forms in international health, medical, and social science journals including The European Eating Disorders Review, Eating Disorders: The Journal of Treatment and Prevention, Qualitative Health Research, Child: Care, Health and Development, Gender and Education, and The Journal of Community and Applied Social Psychology.

The family biographies presented in Inside Anorexia are a small sample of the interviews collected as part of a large-scale study called Multiple Perspectives of Eating Disorders in Girls, based in Sydney, Australia. The study involved in-depth life history interviews with adolescent girls diagnosed with anorexia and separate interviews with one or both of their parents and sometimes with other family members. At the time of interview, all girls were between the ages of 14 and 21 years, with an average age of 16 years and 3 months. All girls were being treated for anorexia in a hospital or on an outpatient basis and had been diagnosed between two weeks and seven years earlier. Reflecting the diversity of Australian society, families in the study represented a wide range of social and economic groups in terms of family income, place of residence, parental education, and occupation. Those who were interviewed came from a range of ethnicities including first and second generation migrant families where all or some family members came from China, India, or Italy. However, the bulk of interviewees were of Anglo-Australian descent. At the time of interview, none of the girls regarded themselves as "recovered," and their families and clinicians agreed with this view.

Each family member whose story is presented in Inside Anorexia was interviewed by one of the authors, sometimes on several occasions, and their individual stories have been woven into what we call "family biographies." The eight stories in this collection were chosen because they illustrate the diverse issues, experiences, and emotions of girls, parents, and families who are dealing with anorexia. These are tales of distress, resilience, courage, and hope.

Working with teenage girls with anorexia and their families at a time when they are highly stressed and vulnerable imposes significant ethical responsibilities on researchers. The ethical issues of working with girls with anorexia and their families are complex, and making sure that our research practice was sensitive to the circumstances of girls and their families has been an issue of concern that we have written about elsewhere.1 As part of this broader ethical agenda we have kept in touch with the girls and families from the Multiple Perspectives of Eating Disorders in Girls project through an annual newsletter, and the girls and their parents whose family biographies appear in this book were invited to read a draft of their story. Several girls or their families have since contacted us and postscripts on their current circumstances follow their stories. We are humbly appreciative of the generosity and encouragement of the girls, their parents, and other family members. Without their support, this book would not have been possible. (All girls and their family members are identified by pseudonyms.)

This book has three unusual features. First, its organization is atypical. In most books on anorexia or other eating disorders the stories of people diagnosed with anorexia and their families are buried in a larger body of factual information. In such books, the stories serve as examples or case studies that are designed to illustrate general patterns. Inside Anorexia reverses this usual structure. In this book, the family biographies are the centerpiece and framework for presenting pertinent issues and information about anorexia. The purpose of this unusual approach is to make the important point-increasingly recognized in clinical and professional health practice-that the unique experiences and circumstances of individuals are the starting point for any discussion of anorexia amongst teenage girls and their families. This structure allows the book to be used by different readers in different ways: as a source of insight into the experiences of girls and their families; as a starting point for factual information on different perspectives of anorexia that direct the reader to influential research in the area; and as a collection of detailed case studies that can be used by health professionals, people with anorexia, and their families as a basis for discussion, debate, and analysis.

The second distinguishing feature of this book is its focus. While most books address the experience of anorexia from the perspective of recovered adult women looking back on their experiences, this book focuses on teenage girls who are currently suffering with anorexia and the experiences of their parents and families. In this way, Inside Anorexia offers an insight into the actual experience of anorexia at the time of the experience from the perspective of the family members who are touched whenever anorexia strikes a teenage daughter or sister in their family.

The third noteworthy feature of Inside Anorexia is its multidisciplinary orientation. Books about anorexia are generally based in a single discipline or even a strand within a discipline. In contrast, the information in Inside Anorexia draws on a range of disciplines, including health, medicine and psychology, feminist and cultural studies as well as original research findings from our own larger research project on the Multiple Perspectives of Eating Disorders in Girls. The aim of presenting a multidisciplinary approach in a single book is to give readers an overview of the different disciplinary perspectives on anorexia and guidance to further reading so they can avoid at the onset the burden of having to consult multiple references to get an insight into the perspectives of different experts on various aspects of anorexia.

A note on language: different disciplines have different views about the language that is best for accurately yet sensitively describing people diagnosed with anorexia nervosa. After much discussion and consultation, we have used the phrases "people diagnosed with anorexia" and, far less frequently, "people with anorexia." Our decision was driven by the recognition that language both describes and constructs the identity of what is being spoken about. At the same time, this choice recognizes that all of the girls whose stories are reported in Inside Anorexia were diagnosed with anorexia but some of them rejected this diagnosis or accepted their diagnosis but were reluctant to have a life without anorexia. Regardless of language, it should be noted that all the girls and parents described their experience of anorexia as causing distress.