The Psychology of Eating: From Healthy to Disordered Behavior

Eating Disorders 219

in Western questionnaires to assess disordered eating, in other cultures they
could relate to religious fasting.
In summary, anorexia is stereotypically regarded as a problem for young
white women from the higher classes. The evidence for this suggests that
the age and gender profile is fairly accurate. Data on social class and
ethnicity remain unclear.

What do anorexics do?

All anorexics restrict their food intake. Most are extremely knowledgeable
about the nutritional content of food, and count every calorie. When they do
eat, they tend to eat small meals predominantly made up of fruit and vege-
tables. They eat very slowly, sometimes cutting the food into small pieces. They
avoid all fatty foods and often drink coffee and fizzy drinks, chew gum, or
smoke to minimize their hunger (e.g., Reiff, 1992). The diet of anorexics is
often repetitive and ritualized and they eat from a very limited repertoire. Many
anorexics cook elaborate meals for others and often buy and read magazines
and books containing recipes and pictures of food. Some anorexics refuse
to swallow their food and chew it and then spit it out. Others will binge on
large quantities of food and then purge by using laxatives or diuretics or
making themselves sick. One study showed that 26.4 percent of a population
of outpatients with AN had misused laxatives in the month prior to assess-
ment (Bryant-Waugh et al., 2006). Anorexics are also often very physically
active and can show excessive exercise (Mond and Calogero, 2009). Some also
fidget when sitting, or march backwards and forwards as a means to burn
up calories. Some sufferers of anorexia also hoard food. Good descriptions
of what anorexics actually do can be found in literature from survivors of
anorexia and the semiautobiographical novels. For example, one woman
described how “I was eating fruit and dry crispbreads, lettuce and celery
and a very little lean meat. My diet was unvaried. Every day had to be the
same. I panicked if the shop did not have exactly the brand of crispbread
I wanted, I panicked if I could not eat, ritually, at the same time” (Lawrence,
1984, p. 124). Shute’s novel Life-size(1992) described in detail an anorexic’s
eating: “peas were good because you could eat them one by one, spearing
each on a single tine. Brussels sprouts were good, because you could unwrap
them leaf by leaf and make them last forever. Corn could be nibbled, a few
kernels at a time...Potatoes were evil. I would never eat one, no matter what”
(p. 125). Shute also provided insights into the other main aspect of anorexia,
namely, feeling fat. She wrote, “I knew I still had much to lose. There was