Anorexia has a long history – but are we any closer to understanding it?

In 1992, a few weeks after her 14th birthday, Hadley Freeman stopped eating. Nothing very dramatic caused this. A skinnier classmate at her all-girls school in London told her: ‘I wish I was normal like you.’ But the comment triggered a change that was dramatic in the extreme. Within weeks, Freeman was monitoring every crumb that entered her mouth, opening the fridge just to smell the food, making her house quake as she did star jumps over and over again. Within months her weight had plummeted and she was sent by her frantic parents to a doctor. She was diagnosed with anorexia nervosa and lived in various psychiatric wards for the next two and a half years.

She is now a journalist, formerly at the Guardian, currently at the Sunday Times. Her previous book, House of Glass, recounted her Jewish family’s experience of the 20th century, and was brilliant. Good Girls looks inwards – or, as she admits in the introduction, at her own belly button – and it’s excellent too, if in a different way. Reading it will leave you amazed that Freeman has made such a success of her life. She came horribly close to losing it. When she was at her illest, a GP told her mother to prepare for her death. At some points she was so thin that her spine would bleed as she did sit-ups, and so bald that a woman in the street asked her if she had cancer.

The book gracefully interweaves sections on the science of anorexia with Freeman’s account of getting ill, as well as stories from other women she met in hospital and has since tracked down. This is grounded in a history of the disease, which turns out to be quite a long one. It’s tempting to think of anorexia as a modern phenomenon, related in some misty way to fads such as social media and heroin chic. But anorexia has been around for hundreds, if not thousands, of years. The first recorded anorexic, Freeman recounts, was a princess now known as Saint Wilgefortis, whose father decided to marry her off to a foreign king sometime between 700 and 1000 AD. Determined to remain a virgin, she stopped eating. Her suitor was put off, so her irritated father had her crucified. After her death she became the subject of veneration: people would leave her wistful offerings of oats.

Treatment has become more humane since Freeman got ill in the early 1990s, but we aren’t much closer to understanding anorexia, or to sending it packing when it sets in. Rates have remained more or less steady for years. It’s still an overwhelmingly female affliction, and it’s still impossible to predict who will succumb or who will make a recovery. Freeman herself has been given all sorts of nutty reasons for her illness: that she developed it because she was born by caesarean; because her parents were too strict; because they were too indulgent; because she was Jewish and inherited trauma from the Holocaust. If anything, she writes, her anorexia was an attempt to stop time. Newly 14, she was becoming a woman. She didn’t want ‘a bum or a tum or a chin’; she wasn’t ready for male attention (not long before she got ill a boy had disturbed her by putting his hand on her bottom). She learned that by not eating she could erase herself, freeze her ripening body in bud.

Her book is at its most enjoyable – if enjoyable is quite the word – when she relates her time on the psychiatric wards. Many of her fellow anorexics were gentle creatures – the ‘good girls’ of the book’s title – some of whom died. A few were conniving monsters. Tara, a 27-year-old, delighted in finding out how much other patients weighed and gloating if she was lighter than them. Caroline, a devout Christian, would flick her food towards the plates of fellow patients, then watch with relish as they were made to eat what she had sent their way.

A lot of the hospital stories are depressing, and the book isn’t exactly a picnic. I kept trying to read it over lunch and found for some reason it kept killing my appetite; but it’s absolutely worth reading, whether you have an interest in anorexia or not. There’s a solid redemption narrative to cling to. The teenage Freeman eventually realises she doesn’t want to be in a ward forever and gets – slowly, slowly – better. And it’s engaging, intelligent and occasionally funny, written with the author’s characteristic clarity. You’ll be left glad that she at least climbed out of the wolf’s mouth and recovered fully enough to be able to tell us what it was like.