Concocting a name for something that catches on can be a powerful force. For example, anti-white racist hate became ever more prevalent in our society in recent decades, but people who were concerned about it didn’t have an acceptable name for what they were inchoately sensing. I suggested calling anti-white racist hate “anti-white racist hate,” but, apparently, that was too on the nose for most of its victims. Eventually, Chris Rufo came up with the idea of calling it by the extremely polite term “critical race theory,” which proved a huge success among polite white people.

Teenage girls are exceptionally vulnerable to social contagion, such as the current transgender craze or bulimia nervosa, which become a Thing after it was first named in 1979. Fortunately, bulimics have never succeeded in establishing themselves as an

From The Cut:

JULY 31, 2017
The Strange, Contagious History of Bulimia
By Lee Daniel Kravetz

In 1972, a woman checked into London’s Royal Free Hospital to be treated for anorexia. “I found her symptoms to be unique,” Gerald Russell, the British psychologist who treated her, tells me. “They didn’t match the diagnostic criteria for anorexia at all.” Unlike his emaciated patients with sallow skin and big eyes, Russell’s new patient was of average weight. Her face was full. Her cheeks were pink as the skin of an onion. She was the first of roughly thirty instances of this unusual condition that crossed the threshold of his clinic over the next seven years, each person presenting with perplexing purging behaviors secondary to binge eating. Russell wasn’t dealing with anorexia nervosa, he realized, but something as yet undefined by psychology or medicine.

In fact, he had stumbled upon a condition that science had yet to see in large numbers or identify at any time in the long history of eating disorders.

Wikipedia lists a number of cases recorded in the first half of the 20th Century. But they didn’t have a name for it.

And when I was a child, the concept of vomiting to make room for more eating was associated with decadent Ancient Rome.

Still, giving something a name that catches on makes it easier to think about, and the easier it is to think about, the easier it is to do.

Psychological Medicine published Russell’s ensuing paper on these unusual cases; in it, he described the key features of this novel mental illness he was now referring to as bulimia nervosa. Many in the scientific community objected to Russell’s conclusions, pointing to the limited and problematic sample size he’d used. At the time, however, there were simply too few cases for Russell to draw from. The pool in the 1970s was just too small.

As bulimia gained further diagnostic legitimacy in 1980 with its inclusion in the third edition of the Diagnostic and Statistical Manual of Mental Disorders, Russell ruefully tracked its unexpectedly swift spread across Europe and North America, where it infiltrated college campuses, affecting 15 percent of female students in sororities, all-women dormitories, and female collegiate sports teams. … In the UK, one out of every one hundred women was now developing the disorder.

“It makes you wonder if maybe bulimia wasn’t a new eating disorder, that it was always there and people just didn’t notice it or talk about it before your paper came out,” I offer.

Russell demurs politely. If the hidden afflicted numbered as overwhelmingly high as they now seem, surely the condition would have made itself known well before he — or anyone, for that matter — identified it. “You might suggest it required somebody to come along and put two and two together before people felt safe talking about bulimia, but I don’t believe that.

“Until then,” he continued, “the disorder was extremely rare. But after 1980, it became widespread in a very short period of time. Once it was described, and I take full responsibility for that with my paper, there was a common language for it. And knowledge spreads very quickly.”

With this knowledge, Russell’s discovery took on characteristics of a pandemic that was set to claim 30 million people, but neither he nor anyone could do a thing at that point to stop it. He was confronted, he says, by a problem of entropy, a gradual decline into disorder with devastating implications for social contagions: once they are out, they are virtually impossible to rein it back in again.

… Following the debut of bulimia nervosa in the DSM-III, the University of Chicago put out a press release publicizing its own rather novel data on a kind of sequela of anorexia. Mademoiselle and Better Homes and Gardens, among other popular women’s magazines, took the press release and described the effects of a new “binge-purge syndrome” making inroads into American culture. With Russell’s data proliferating among diagnosticians, and the term itself entering the lexicon through trendy magazines with wide distributions, cases of bulimia rose steeply. …

To answer that, Russell refers to an exceptional case that transpired in the Republic of Fiji. By the mid-1990s, he says, bulimia was rampant across industrialized parts of the world, but not so much in developing countries. The Harvard Medical School associate professor Anne E. Becker figured that cultural context likely accounted for this barrier to transmission. To test her theory, she sought out a place completely isolated from Western influence. In all of Fiji’s history, the republic had yet to report a single case of someone suffering from an eating disorder. That all changed in 1995.

“What happened in 1995?” I ask Russell.

Melrose Place, he says. Xena: Warrior Princess. Beverly Hills, 90210. “That was the year the first television arrived to the island republic.”

After just three years of exposure to American television shows, 11 percent of Fiji’s adolescent girls admitted to Becker that they had purged their food at least once to lose weight. In that time, the risk of developing an eating disorder jumped from 13 percent to 29 percent. More than 80 percent revealed that television influenced them or their friends to be more conscious about body shape or weight. By 2007, 45 percent of girls from the main island reported purging their food.

… Bulimia is so contagious that support groups and in-treatment facilities designed to help patients are also primary spreading agents.

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