France says: illegal to "incite" anorexia

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:

While the First Amendment probably protects pro-dieting and pro-ed speech from government censorship, it does NOT protect that kind of speech from civil liability. The tobacco industry, for example, was nailed for huge money damages for failing to disclose the dangers of smoking and for evil practices like marketing cigarettes to children. Those practices violated general tort law and consumer protection statutes and were found by the courts not to be protected by the Constitutional right to free speech. It would be interesting to look at the marketing practices of the diet industry for examples of where it crosses the line. Like failing to warn of the dangers of dieting.


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.

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6 comments:

Laura Collins said...

I am so conflicted over this whole thing! I'm pro-free speech, pro-anti-pro-ana, don't think EDs are a choice, don't think EDs can be incited, want us all to end dieting forever, worry about recovering people steeping in bad messages, don't believe the Internet can be regulated, don't think it is all about looks, worry about the images.... sometimes the enemies of our enemies are not our friends, and our friends are friends with the enemies... AAAGGGGHHHH!

!

IrishUp said...

Hmm - I'm gonna throw this out there, see if it sticks.
I happen to disagree with Laura, insofar as I believe that the strong "pro-ana" undercurrent in Western-American creates a climate where more of the people who are at baseline predisposed to EDs will actually wind up realizing that risk with full-blown disease. Additionally, more people will/do develop disordered eating patterns, which is no more good for them than it is for those already at risk. Using Carries lung-cancer analogy, that disease is a relatively uncommon cancer outside the setting of environmental exposures. Not everyone who smokes gets the cancer (not even most smokers). But if you've got the genetic predisposition, you're risk of developing the cancer goes up the more time you spend around cigarette smoke regardless of whether it's you doing the smoking.
So, when I look at pro-ana sites from an epidemiological stand-point, they are more symptoms of the disease that, like second-hand smoke, pose increased dangers to susceptible people. I'd rather go after industries (professional modeling, rowing, jockies, wrestling) that promote unhealthy eating and excercise as conditions of employment. If that doesn't meet the criteria for inciting, I don't know what does.
As a matter of public health policy, why not model a fairly effective campaign such as quitting smoking? Get pro-ED out of the workplace. The NAACP is taking a step in the right direction, how bout the Olympic Committee taking heed from that? No profession should require you to injure yourself as a lifestyle! Make it illegal to market self-loathing to minors. PSAs advocating loving the body you're born with, and framing self-flagellation as uncool.
Sorry if this is rambling a bit, but I haven't gotten the ideas to quite coalesce yet. The gist is, I think if you could address contributors better at a public health level, much of this phenomenon would eventually go away on it's own. Not all, but much of it. The way smoking rooms in hotels have gone.

Laura Collins said...

Irish,

I don't disagree on the danger and horror of pro-ana sites. I'm with you on that completely. And on the toxic environment that all of us have created around ourselves and poisons our children.

But the people creating the pro-ana stuff - the ones they are prosecuting - are ILL, and criminalizing their behaviors - what will it do? If the penalty for putting up a pro-ana site was mandatory TREATMENT, now that I could get behind.

If the penalties were for fashion magazines or diet sellers or books about dieting or anything that was people who weren't ill but were aiding and abetting illness behaviors - sign me up.

I get lots of correspondence from pro-ana people. They're gravely ill, and completely lacking in insight into their behaviors or the consequences. Nothing we do to them will make them stop, except recovery.

carrie said...

My thoughts on the pro-ana movement are this:

It's a symptom of the disease. It's also part of the nature of the extreme loneliness and isolation demanded by the eating disorder- and this is an "acceptable" outlet.

However, as much as it is a symptom of anorexia, it is also a symptom of our culture at large. The language on those sites has essentially been co-opted from traditional diet talk- a lot more extreme, perhaps, but not really all that different from what you would find on a standard diet site.

I support free speech on the internet, and from that standpoint, I don't think they can or should be shut down by law. I think ISPs have the right (even obligation) to say they won't host them, but an actual law prohibiting them is different.

Then there's the issue of criminalizing someone for a symptom of an illness. Yes, it's more complex than that, but the fact is that AN is anosgosnic. I think someone could rightfully plea insanity should they be charged.

Lastly, I still don't know that you can "incite" anorexia. You can contribute to it, help maintain it, help hide it, but not incite. I didn't make a huge deal out of the semantics in the post because I don't know the exact French word, nor if it translates exactly as "incites". So.

Anyway, just my thoughts.

And Irishup? My love for you has only been slightly diminished by the fact that I've had the anniversary song in my head for almost two days now. :)

Jeanne said...

I'm not sure how I feel about this whole thing either.

I do like laura's ideas though - if the law targeted the industry/companies rather those suffering from the illness (like the cigarette analogy), I'd back it whole-heartedly.

And my thought was exactly what carrie said - if a pro-ana blogger was arrested, s/he could plead insanity. And hopefully get the treatment s/he needs to survive.

But then, if the blogger doesn't want help, would the treatment even be meaningful? How long would s/he need to stay? ...

I'm right with laura's first comment - AAAGGGGHHHHH!

carrie said...

Jeanne,

I think much of the ED treatment community has placed far too much importance on wanting to get well. Treatment can and does work even if the patient doesn't want to get better. The wanting usually comes with weight restoration and normalizing of eating habits, as well as eating a wide variety of foods, especially proteins and fats.

There is the matter of presuading the person to agree to this. I never wanted to get better. I had reached the point where I was just sick and tired of being sick and tired.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote



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