Un articolo di The Cut racconta la storia della bulimia nervosa attraverso gli occhi di Gerald Russell, lo psicologo inglese che trattò il primo caso di bulimia mai registrato. Riconosciuta per la prima volta dagli psichiatri negli anni ’70, la bulimia si diffuse nel mondo a partire dagli anni ’80.

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. The disease moved through the halls of American high schools, where binging, fasting, diet pill use, and other eating disorder symptoms easily clustered. He chased its dispersion across Egypt, where the number of new cases grew to 400,000. In Canada, it swelled to 600,000. In Russia, 800,000. In India, 6 million. In China, 7 million. In the UK, one out of every one hundred women was now developing the disorder.

Secondo Russell, il drastico aumento delle diagnosi in seguito alla decisione di includere la bulimia tra le patologie descritte dal DSM 3 avrebbe innescato una vera e propria “pandemia sociale” alimentata dai media. Inizialmente popolarizzata da diverse riviste molto diffuse tra il pubblico femminile, venne infine adottata in molti casi come una strategia di controllo del peso corporeo. Tra la fine degli anni 80 e l’inizio degli anni ’90, la frequenza dei nuovi casi tra le donne tra i 10 e i 39 anni triplicò.

“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.
Once people realized they were able to eat whatever they wanted and as much as they wanted without a weight consequence, binging and purging became the new strategy for weight management. It was no coincidence that these unhealthy and harmful behaviors took hold at the same time that obesity — which the researchers Nicholas Christakis and James Fowler have found to be as contagious as any eating disorder — doubled in the US.

Le prime terapie efficaci si basarono sul supporto di gruppo: la psicologa statunitense Deborah Brenner-Liss, tra le prime ad adottare questo approccio terapeutico, descrive la sua esperienza.

“Whatever it was we were doing in those living rooms, I suddenly found I was starting to get better,” she reveals. The curious curative nature of these support groups went well beyond talking, relating personal experiences, and offering empathetic understanding. There was something about being in the presence of others who were trying to eat healthfully and also engaging in nourishing activities that began influencing healthy behaviors in her. These tightly knit, highly influential social networks fostered her motivation for positive behavior changes and stoked the stamina in her to stay in the fight.
In other words, she says, members of her support group, by virtue of simply attending the meetings, were catching healthier eating behaviors from each other, along with motivation, resilience, and hope by way of observation and unconscious mirroring.

Though they didn’t know it at the time, members of Brenner-Liss’ support group were combatting the social contagions contributing to bulimia with other social contagions.
Where Russell finds a threat in exposure, Brenner-Liss finds healing and a road to the remission of symptoms. Are media and group exposure vectors for spread, I continue to wonder, or are they vectors for treatment?

“Maybe it’s a little of both,” she offers. The same processes of mirroring and unconscious competition that allow people to encode dangerous thoughts, behaviors, and feelings from others might just be the very same that spread beneficial social contagions.

“Then what tips the scale?”

“Personal susceptibility. Environment. The unknown.” She shrugs her shoulders.