This post is Part 1 of a series.

Amongst the central myths of anorexia is the idea that it involves not liking food and not experiencing hunger. In broad-brush terms, folk perceptions of anorexia involve a rather idealized sense of a life to which food is irrelevant.

There’s obvious appeal in the idea that stopping eating creates simplicity: Food is complicated in every culture, and a common human energy-saving response to complication is to withdraw, or try to. Even for those who know first-hand that the experience of self-starvation is far from simply “life with food subtracted,” there can be seduction in it. As a teenager sliding into anorexia, I heard some line about a friend of a friend “wasting away,” and despite all I was already learning about the realities of self-starvation, there was such romance in that little phrase: hazy images of Victorian garrets, dusty white lace, femininely expiring (an equally sexist counterpart, I suppose, to the images of a woman “letting herself go” that I explored in a blog series last year—also involving dusty sunshine, oddly enough).

I suppose it sometimes happens that total starvation (eating nothing at all) means descending into some sort of minimally conscious ketogenic state that makes dying a relatively gentle process. But all we know about the realities of starving to death—for example, from testimony of famines like that of the Warsaw ghetto during World War II (Sinnreich, 2023)—belies those gauzy attic images. The process typically involves tissue wastage, oedema, digestive pain and incontinence, depression and anger, immune dysfunction, and ultimately organ failure. And as far as I can make out, even if ghrelin secretion is reduced by ketosis, reducing prototypical hunger experiences, the process tends to involve some form of preoccupation or obsession with food.

Certainly, for all of us who stay alive by eating something, however little, there is no get-out clause from foody complexity. And in the vast majority of individuals with an eating disorder, food plays a more significant role in that landscape than it does for most people without one. Rumination about food in anorexia has been found to correlate with levels of leptin (ghrelin’s counterpart: a hormone modulating sensations of satiety) and to reduce with........

© Psychology Today