Historically Speaking: Anorexia’s Ancient Roots And Present Toll

The deadly affliction, once called self-starvation, has become much more common during the confinement of the pandemic.

The Wall Street Journal

February 18, 2022

Two years ago, when countries suspended the routines of daily life in an attempt to halt the spread of Covid-19, the mental health of children plunged precipitously.

Two years ago, when countries suspended the routines of daily life in an attempt to halt the spread of Covid-19, the mental health of children took a plunge. One worrying piece of evidence for this was an extraordinary spike in hospitalizations for anorexia and other eating disorders among adolescents, especially girls between the ages of 12 and 18, and not just in the U.S. but around the world. U.S. hospitalizations for eating disorders doubled between March and May 2020. England’s National Health Service recorded a 46% increase in eating disorder referrals by 2021 compared with 2019. Perth Children’s hospital in Australia saw a 104% increase in hospitalizations and in Canada, the rate tripled.

Anorexia nervosa has a higher death rate than any other mental illness. According to the National Eating Disorders Association, 75% of its sufferers are female. And while the affliction might seem relatively new, it has ancient antecedents.

As early as the sixth century B.C., adherents of Jainism in India regarded “santhara,” fasting to death, as a purifying religious ritual, particularly for men. Emperor Chandragupta, founder of the Mauryan dynasty, died in this way in 297 B.C. St. Jerome, who lived in the fourth and fifth centuries A.D., portrayed extreme asceticism as an expression of Christian piety. In 384, one of his disciples, a young Roman woman named Blaesilla, died of starvation. Perhaps because she fits the contemporary stereotype of the middle-class, female anorexic, Blaesilla rather than Chandragupta is commonly cited as the first known case.

The label given to spiritual and ascetic self-starvation is anorexia mirabilis, or “holy anorexia,” to differentiate it from the modern diagnosis of anorexia nervosa. There were two major outbreaks in history. The first began around 1300 and was concentrated among nuns and deeply religious women, some of whom were later elevated to sainthood. The second took off during the 19th century. So-called “fasting girls” or “miraculous maids” in Europe and America won acclaim for appearing to survive without food. Some were exposed as fakes; others, tragically, were allowed to waste away.

But, confusingly, there are other historical examples of anorexic-like behavior that didn’t involve religion or women. The first medical description of anorexia, written by Dr. Richard Morton in 1689, concerned two patients—an adolescent boy and a young woman—who simply wouldn’t eat. Unable to find a physical cause, Morton called the condition “nervous consumption.”

A subject under study in the Minnesota Starvation Experiment, 1945. WALLACE KIRKLAND/THE LIFE PICTURE COLLECTION/SHUTTERSTOCK

Almost two centuries passed before French and English doctors accepted Morton’s suspicion that the malady had a psychological component. In 1873, Queen Victoria’s physician, Sir William Gull, coined the term “Anorexia Nervosa.”

Naming the disease was a huge step forward. But its treatment was guided by an ever-changing understanding of anorexia’s causes, which has spanned the gamut from the biological to the psychosexual, from bad parenting to societal misogyny.

The first breakthrough in anorexia treatment, however, came from an experiment involving men. The Minnesota Starvation Experiment, a World War II –era study on how to treat starving prisoners, found that the 36 male volunteers exhibited many of the same behaviors as anorexics, including food obsessions, excessive chewing, bingeing and purging. The study showed that the malnourished brain reacts in predictable ways regardless of race, class or gender.

Recent research now suggests that a genetic predisposition could count for as many as 60% of the risk factors behind the disease. If this knowledge leads to new specialized treatments, it will do so at a desperate time: At the start of the year, the Lancet medical journal called on governments to take action before mass anorexia cases become mass deaths. The lockdown is over. Now save the children.

A shorter version appeared in The Wall Street Journal

Historically Speaking: ‘Sesame Street’ Wasn’t the First to Make Learning Fun

The show turns 50 this month, but the idea that education can be entertaining goes back to ancient Greece.

The Wall Street Journal, November 21, 2019

“Sesame Street,” which first went on the air 50 years ago this month, is one of the most successful and cost-effective tools ever created for preparing preschool tots for the classroom. Now showing in 70 languages in more than 150 countries around the world, “Sesame Street” is that rare thing in a child’s life: truly educational entertainment.

The Muppets of ‘Sesame Street’ in the 1993-94 season. PHOTO: EVERETT COLLECTION

Historically, those two words have rarely appeared together. In the 4th century B.C., Plato and Aristotle both agreed that children can learn through play. In “The Republic,” Plato went so far as to advise, “Do not use compulsion, but let early education be a sort of amusement.” Unfortunately, his advice failed to catch on.

In Europe during the Middle Ages, play and learning were almost diametrically opposed. Monks were in charge of boys’ education, which largely consisted of Latin grammar and religious teaching. (Girls learned domestic skills at home.) The invention of the printing press in 1440 helped spread literacy among young readers, but the works written for them weren’t exactly entertaining. A book like “A token for children: Being an exact account of the conversion, holy and exemplary lives, and joyful deaths of several young children,” by the 17th-centrury English Puritan James Janeway, surely didn’t follow Plato’s injunction to be amusing as well as instructional.

Social attitudes toward children’s entertainment changed considerably, however, in the wake of the English philosopher John Locke’s 1693 treatise “Some Thoughts Concerning Education.” Locke followed Plato’s line on education, writing, “I always have had a fancy that learning might be made a play and recreation to children.” The publisher John Newbery heeded Locke’s advice; in 1744, he published “A Little Pretty Pocket-Book Intended for the Instruction and Amusement of Little Master Tommy and Pretty Miss Polly,” which was sold along with a ball for boys and a pincushion for girls. In the introduction, Newbery promised parents and guardians that the book would not only make their children “strong, healthy, virtuous, wise” but also “happy.”

When it came to early children’s television in the U.S., however, “play and recreation” usually squeezed out educational content. Many popular shows existed primarily to sell toys and products: “Howdy Doody,” the pioneering puppet show that ran on NBC from 1947 to 1960, was sponsored by RCA to pitch color televisions. Parents became so indignant over the exploitation of their children by the TV industry that, in 1968, grass-roots activists started the nonprofit Action for Children’s Television, which petitioned the Federal Communications Commission to ban advertising on children’s programming.

This cultural mood led to the birth of “Sesame Street.” The show’s co-creators, Joan Ganz Cooney and Lloyd Morrisett, were particularly devoted to using TV to combat educational inequality in minority communities. They spent three years working with teachers, child psychologists and Jim Henson’s Muppets to get the right mix of education and entertainment. The pilot episode, broadcast on public television stations on Nov. 10, 1969, introduced the world to Big Bird, Bert and Ernie, Oscar the Grouch, and their cast of multiethnic friends and neighbors. “You’re gonna love it,” says one of the show’s human characters, Gordon, to his wife Sally in the first show’s opening lines. And we have.

The Sunday Times: RV There Yet?

Writer and historian Amanda Foreman took her family on an epic motorhome adventure. Would it drive them all round the bend?

Crossing Devils Garden, Utah
Crossing Devils Garden, UtahANGELA HAYS

Imagining yourself behind the wheel of an RV and actually driving one are two completely different things. I discovered this shortly after we hit the road in our 30ft rental for a 1,500-mile odyssey from Denver, Colorado, to Las Vegas, Nevada. As soon as I pressed down on the accelerator, other faculties such as breathing and thinking stopped functioning. My husband, Jonathan, took over, and remained in the driving seat for the rest of the trip, while I quietly buried my pride beneath a pile of flip-flops and rain jackets.

Did I mention there were seven of us — including five children? Masochistic, perhaps, but my motivation in initiating this most ambitious of family holidays was sound. Last year, I wrote in The Sunday Times about the poisonous effect social media can have on families, and on girls’ self-esteem in particular. With four daughters — Helena, 16, Halcyon, 13, and 11-year-old twins Xanthe and Hero (15-year-old Theo completes the gang) — this is particularly pertinent to us.

We’re the Foremans: Amanda and family in their RV
We’re the Foremans: Amanda and family in their RVANGELA HAYS

The latest research offers hope, though. The best antidote to the rapacious demands of the internet, experts say, is its reverse — the power of lived experience. And so we decided to put that theory to the test by taking to the road.

Everything was new and exciting at first. Look, a herd of cattle blocking the road! Oh, we blew the electrics! It was when we left the cool mountain ranges of Colorado and descended into Utah, a dip that sent the thermometer climbing into the 30s, that reality took over.

We were heading for Moab and its two national and one state parks. Some of the best scenery in the totemic road-trip movie Thelma and Louise is here. I kept repeating this fact until Helena reminded me that they’d never seen the film and couldn’t care less. The atmosphere of the RV, already thick with sweat and hormones, was beginning to grow heavy. Knees and elbows were making contact where they shouldn’t.

Our first hike was through the Arches National Park, so named after the formations that stake the desert like a thousand oversized Durdle Doors. Our trail took us to Devils Garden, with its giant phallic pillars. Another led to Landscape Arch, the longest natural arch in the world. A peculiar tension emanates from it, as though at any second something will snap and the whole thing will collapse. I recognised the feeling.

Arches National Park lives up to its name
Arches National Park lives up to its nameALAMY

Three children claimed to be on the edge of survival by day’s end (heat, thirst, sand in shoe, etc). A night’s camping at Devils Garden did it for the rest.

The evening had started well. We ate under the starriest sky I’d ever seen. The intense blackness around us served to highlight the strange symphony of sounds wafting from the brush. After dinner, we sat in companionable silence, listening to the music of the desert. If we could have stayed that way until morning, the night would have been perfect. But shutting down an RV for the night requires concentration — not the futzing and farting about of a family of camping novices. By the time we had secured the awning, washed and put everything away, cleared the only escape route of detritus, converted the “dinette” into a quasi-bed large enough for a small person, or in our case reluctant twins, turned the banquette into a sofa bed (tricky with the seatbelt fittings running down the middle) and stashed the teenagers into the bunk above the driver’s seat, mercury had started rising in the worst way.

I lay on my side in the back alcove, feeling the grit between my toes and the sweat between my eyes, waiting for the inevitable blow-up. There was a yell, a thwack, and the RV started shaking on its plastic levellers. My husband and I leapt out of bed and turned on the lights. The children froze, the twins in mid-wrestle. Each returned sulkily to his or her place.

Once peace was restored, Jonathan and I listened for signs of a round two: was that it, or merely the first skirmish in a battle to the death? “It depends,” I said, “on whether we kill them first.”

“Where do we go from here?” Evita sang over the sound system as we headed to our next stop the following day. There were three more destinations to see before we arrived at the Grand Canyon. “This isn’t where we intended to be,” she warbled.

“Don’t listen to her,” my husband told the children, “she’s being a wuss.”

I was beginning to fear the wuss factor would end up trumping the wow factor. Your basic renters’ RV is essentially a tin can on wheels with a lavatory attached. By midweek we had wrecked the place. Only the desperate and foolhardy dared face the loo. Every spare inch of the RV was occupied by wet and drying clothes, creating a steam-room effect without the refreshing scent of eucalyptus.

On the prowl: a puma roams through Moab, Utah
On the prowl: a puma roams through Moab, UtahGETTY

A gentle rain accompanied our arrival at Bryce Canyon. Despite the name, it’s not a canyon at all, but a series of natural stone amphitheatres created by millions of years of frost-thaw cycles. Each one is filled with densely packed pillars and spires called “hoodoos”, which turn crimson and ginger in the sun. Our goal, as we set off from Ruby’s Campground, was to see the sun set over Bryce’s most famous amphitheatre, the hauntingly named Silent City. There was a whiff of mutiny in the damp air. Nothing obvious, but if I had suggested going back to the RV, no one would have complained.

We trudged through the pines towards Inspiration Point (by God, did we need some) in a long, straggly line. Glimpses of Silent City flashed through breaks in the trees. The hoodoos seemed not alive exactly, but immobile. I looked back and saw that the stragglers had stopped. They, too, were staring at the rocks.

At the Point, we waited in vain for a break in the clouds. Our son suddenly shouted: “It’s a peregrine falcon, I’m sure of it.” His sisters clustered around, taking photographs as the bird swooped and then banked hard into the air. “They do this to impress their mates,” Theo informed us.

Back at camp, we broke out the chocolate Oreos in celebration of Theo’s surprise expertise in all things avian. The rain also cleared in time for us to light the barbecue and go full-on carnivore. There wasn’t a peep from anyone that night.

Gorgeous: the Virgin River flows through Zion National Park
Gorgeous: the Virgin River flows through Zion National ParkALAMY

The next morning, we reached Zion National Park right on schedule, a first for us. This day was a hike through the Virgin River to the Narrows, where the orange-brown walls of the canyon rise 1,000ft, but the gorge is only 30ft across. The water was cold, the rocks slippery, providing ample opportunities for a whinge. None came. I noticed a subtle change as we waded upriver: the children were the ones out in front. That wasn’t all. Over the next few days, blisters that would have been incapacitating at the beginning of the trip were now displayed with pride.

The news that we were camping on the rustic side of the Grand Canyon, at the North Rim, didn’t faze anyone at all. The South Rim, which overlooks the Colorado River, gets 10 times more visitors and has two dozen main viewing points. The North is higher, colder, smaller, with just three principal viewpoints, and is so quiet that you can hear the trees rustling in the early-morning breeze. It means you have one of the great natural wonders of the world all to yourself. We could picnic among the most spectacular scenery without another person in sight.

If there was a wuss among the group, it was me. We had trekked to Cape Royal, where a wooded trail leads to a dramatic plateau that offers one of the widest panoramas of the canyon. The children were naturally drawn to the ledge, carelessly dangling their legs over the side. I was torn between wanting to capture the moment for ever and shouting at them to get back. Jonathan intervened. “It’s all right,” he said. “They are free.”

There wasn’t an ounce of regret when we dropped off the camper in Las Vegas. I doubt we will ever rent an RV again. Yet we ended the week feeling truly content. Without being sappy about it, to experience nature in its untrammelled state is to feel insignificant and uplifted in equal measure.

We came, we saw, and were conquered, happily.

Amanda’s guide to a stress-free US motorhome holiday
Do book your campground berths at least six months in advance. I’m not exaggerating.
Do find out what your RV comes with. Usually, it’s practically nothing.
Do check the depot for “left behinds”. We picked up a barbecue that way, and donated it back at the end.
Do bring physical maps with you — there isn’t much coverage out in the sticks. Praise be.
Do have a games bag with amusements that don’t need charging, such as playing cards, colouring books and chess.
Do take the desert heat seriously. Load up on hats, sunscreen, insulated water bottles and handheld fans.
Do make a list of chores. There should be no passengers on your trip, only crew members.
Don’t overpack.
Don’t attempt more than four hours’ driving a day. It’s not much fun for the people stuck in the back.
Don’t assume that you’ll be allowed to use your generator past 8pm. Plan your meals ahead of time.
Don’t leave out any food overnight. Nature is not your friend. Nature wants to swarm over your leftovers and/or eat you.
Don’t forget to check your water levels every day. Remember how disgusting it is when you flush the loo on a plane and nothing happens when the trap opens? Now multiply that by five.
Don’t expect kids to be as rhapsodic about the scenery as you are.

Hiring a six-berth RV sleeping six for 10 days in November, picking up in Denver and dropping off in Las Vegas, starts at £830, including one-way fee, with Road Bear (roadbearrv.com). A 10-day fly-drive package from Denver in October costs £1,225pp for a family of six, including RV hire (bon-voyage.co.uk). A World on Fire by Amanda Foreman is published by Penguin

Family ties
Have you successfully bonded as a family on holiday? Or had a disaster? Tell us and you could win a £250 holiday voucher; see Letters for details. Email travel@sunday-times.co.uk

https://www.thetimes.co.uk/article/how-to-survive-an-rv-motohome-road-trip-through-utah-colorado-denver-las-vegas-nevada-america-with-the-family-q2j9hvnlg

The Times: Children wouldn’t die on a beach if women were in charge

Photo: Richard Pohle

Photo: Richard Pohle

Religion and men are at the root of the world’s problems, the presenter of a new BBC series tells Alice Thomson.

If we had a more matriarchal society and women were in charge the refugee crisis would not have happened in the way it has, according to the historian Dr Amanda Foreman. “Women looked at that picture of the little dead refugee boy still in his shoes and thought: ‘Not in my name’. It’s not in the female make-up to stand there idly by while women and children die like flies on the beach. Angela Merkel is the one who can’t stomach it but most male politicians think purely in terms of politics.”

Women’s power, or lack of it, is on her mind right now, not least because she is presenting the BBC’s four-part series, The Ascent of Women, which began this week. The mother of four girls, Helena, Halcyon, Xanthe and Hero, and one boy, Theodore, she has been determined to prove that the female of the species has not been an irrelevance, “just there to hang out the washing”.

She has had an astonishing career since coming to Oxford to study Georgiana, Duchess of Devonshire, then an obscure socialite, for her PhD. “All the crusty men thought I was this mad, ditzy girl writing about this trivial woman,” she recalls. But the thesis became a bestselling and award-winning biography, which in turn became a film starring Keira Knightley. It was followed by an equally impressive and weighty book on Britain’s involvement in the American Civil War.

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