This has essentially been all over the internet, but if you haven't seen it, here's the lowdown: France passed a bill this past week that would make it illeval to "incite" anorexia. A father in the Around the Dinner Table Forum (who is from France, and whose daughter is being treated for anorexia) summarized it as such:
France could become the first country to jail anyone who "incites" excessive dieting or promotes anorexia. The legislature next week will take up a bill calling for up to 3 years in prison and a 45,000 euros ($71,000) fine for those convicted of inciting people "to deprive themselves of food in order to lose weight in an excessive way" or to openly promote anorexia. Under the proposed law, publishers of magazines, internet sites and blogs could be prosecuted. The bill was unveiled today by conservative representative Valerie Boyer, who called anorexia "a real public health problem, with an estimated 30,000 to 40,000 new cases in France each year.
So before I get into my thoughts on the bill itself, I would first like to give France a little pat on the back for treating eating disorders as a real public health problem. This is not something we have done in America. You are far, far more likely to die from anorexia than obesity, yet our priorities seem to have been screwed up about that. The CDC does absolutely NO RESEARCH on eating disorders the last I checked. They will measure symptoms as part of larger surveys, but there is no real work being done on eating disorders by the group that has the best resources to look at epidemiology.
But now, the reality. My first thought was this: can you really incite anorexia? Of course there are cultural aspects to the disorder; I would never say anything to the contrary. The saying is that genes load the gun the environment pulls the trigger. Our culture's bizarre fascination with thinness, weight, and dieting is quite the trigger. Maybe it's just a translation issue, but I find the idea of inciting what is fundamentally a biological disorder quite bizarre.
That being said, you have to start somewhere. And we can't change our DNA, but we can start at the cultural level. An article from the Toronto Star says this:
"Most eating disorders start by dieting, so what if we lived in a world where dieting wasn't normative?" said Leora Pinhas, psychiatric director of the eating disorders program at the Hospital For Sick Children.
The bill targets pro-anorexia websites rather than standard here-are-some-really-messed-up-ways-to-lose-weight. There is such a thing as the Feast and Famine diet that has been published in book form. The aura of legitimacy around this diet is much stronger than around those on a standard pro-anorexia website, yet this doctor is basically promoting a form of non-purging bulimia. Yet I don't think the latter would be critisized by France.
I'm thinking of the talk I heard by Dr. Cynthia Bulik at the EDC Lobby Day right now. We know that most eating disorders start with a diet, whether it be specifically to lose weight, or to eat healthier, exercise more, etc. But what we don't know is where people get their information. How many visit pro-anorexia websites?* How many visit standard diet sites? What are the goals of the initial weight loss (if it's intentional)? This would certainly enable us to target better prevention methods.
Another essential problem with the bill is that our entire culture is essentially pro-anorexia. When all of my former coworkers went on their bizarre group diet, their motivational posters were basically identical to the rhetoric of pro-anorexia sites. Those sites have simply co-opted the information that is already out there, and in typical anorexic fashion, taken it to the extreme. So where do you draw the line? I don't think dieting is harmless, and shouldn't be promoted as such. We take smoking seriously. Why not dieting? And the whole "it's too engrained in our culture" line won't work: smoking was almost as common once as dieting is now. Yes, people still smoke, and I'm sure people will still diet, but views have significantly changed.
Lastly is the always fun issue of free speech. Like in the above, where do you draw the line? In some blogs, people are very honest about their struggles. Which is kind of the point. But do you say something is pro-anorexia if a person is merely struggling and being honest? What if the information is the same ("I haven't eaten for X days") but the context is different? What then? Or what about things like the feast and famine diet? Or the Super Skinny Me BBC documentary? The "Thin" documentary? Books like Wasted? All of which had plenty of "tips."
A father, C, on the Around the Dinner Table forum (who I had the great fortune of meeting at Lobby Day) is a lawyer and said this:
Which is just about the smartest solution to the problem yet. And I basically cheered when I read the last line.
*I'd also be quite hesitant to ask this because if sufferers hadn't found them, I certainly wouldn't want them to go looking. I suppose you could ask more open-ended questions about where on the internet you have found information on eating disorders, how often do you visit, what information you found there, etc. And limiting the people asked to those who had recovered would greatly bias the results: the proportions of recovered sufferers who visited pro-eating disorder sites might not be the same as those who didn't. Which would be fascinating data in and of itself.