It's arrogant to say anorexia is a personal choice rather than a mental illness

A response to Rachel Cusk's New Statesman article "The anorexic statement".

In November 2010, almost exactly two years ago today, a 28-year-old French model called Isabelle Caro died from complications arising from anorexia. A few years before, in 2007, she had risen to increased prominence after appearing in an advertising campaign to raise awareness of eating disorders within her field. Stick-thin, with vertebrae clearly on show, she stared straight out of the billboards that lined Italian cities and were later (controversially) banned. The image was undoubtedly shocking; some even found it outright traumatic. Its accompanying message - "No Anorexia" - made a clear statement about the fashion industry when it was pushed out to the Italian public during fashion week.

If you’re looking for an "anorexic statement", then Caro’s is as close as you can get. She suffered from the disease from early adolescence, and she spoke about being in its grips as a personal struggle. She talked publicly of how she wished to be rid of the crushing mental illness, right up until the two months before her death. The "No Anorexia" campaign was about drawing attention to the downright ugliness of a body destroyed by an anorexic life, the ironic lack of glamour in an illness that pervaded industries priding themselves on allure and desirability. And these reasons are why, for many, Rachel Cusk’s recent article on anorexia in this magazine hurt so much.

Does every woman’s body make a statement? Cusk thinks it does. She claims that the anorexic state "returns the woman to the universality of a child", a pre-pubescent state wherein she doesn’t have to think about menstruation or lactation or childbirth or sex. She paints the sufferer of anorexia as a narcissistic martyr of the modern age, obsessed with her image, privileged enough to impose an illness upon herself, sitting "screaming about a spoonful of peas" while other people just get on with the practicalities. Needless to say, sufferers and former sufferers of the disease, as well as their loved ones, didn’t take kindly to this reductive and convenient analysis.

Why is such an analysis convenient? Precisely because mental illness is infuriatingly inconvenient in its individuality and nuance. Treatments and causes are varied and often inexplicable. Personalities are, by their nature, all very different. By positing an "anorexic type", Cusk makes the problem of anorexia wonderfully simple: it’s just a "sickness of the modern age" manifested in a certain type of defective personality. If they’d stop indulging themselves for one pea-eating second, or experienced some real type of hardship, then they’d snap out of it once and for all, right? If Isabelle Caro had really sat down and thought about it, then she could have saved herself the massive setback of dying during her anti-anorexia campaign.

Even aside from all of this offensive hypothesising, it’s strange enough that Cusk maintains throughout her article the idea that women speak with their bodies, but men don’t. She talks about periods and childbirth as physical states to escape from as if men are beings wholly removed from such concerns (because blood is a problem, but semen is supposedly totally cool.) And feminists have fought for a long time to remove the basic assumption that women are "naturally decorative", "speaking" through their bodies alone, expressing their complaints about society by getting thinner and a little bit childlike, while men are naturally intellectual, objective, and altogether more adult. We suppose that the last fifty years of feminist thought have passed Cusk by, as well as the fact that male sufferers of anorexia exist, unfortunately, in substantial numbers. 

Indeed, Cusk appears to have done little research about the illness, instead relying on verbose rhetoric. At one point in her dense treatise, she implies that anorexics of craving visibility. The "anorexic statement", as she so coldly calls it, seeks attention. And yet, so many sufferers speak of wanting to disappear. This does not compute. Cusk speaks with the authoritative and detached voice of a scientist, but she is no scientist. Her overwrought prose serves to raise her essay up to the status of literature, concealing her crass generalisations beneath "sophisticated prose". And yet, it is lacking in any of the perception or insight associated with that term. Her continual use of "the anorexic" throughout the essay makes her seem emotionless and removed, and she seems to forget that this is a disease that affects real people, not simply medical cases whose motives must be dissected and speculated upon in florid prose.

Anorexia is a complex, awful, terrifying disease, the causes for which are a constant topic for research by medical professionals. Its causes do not fit neatly into a single tick-box, and thus lumping all its sufferers together into one group is supremely unhelpful. As a commenter who had reached recovery noted beneath the original article, "no book or article that I read has ever explained how I got there". To presume a statement on the part of another belies supreme arrogance. Cusk has projected that "statement" onto women and girls who are suffering from a life-threatening illness, women and girls whose friends and family may be reading Cusk’s words in between hospital visits. That she should imply that mental illness is a choice is verging on the unforgiveable as far as anyone who’s ever suffered one is concerned.

At one point in the piece, Rachel Cusk refers to the male gaze. She blames what she calls "the preponderance of male values", and yet there she is, judging these women’s bodies, projecting her agenda, her pseudo-psychoanalysis onto them. In other words, it is not their bodies speaking. It is not their story. Isobel Caro’s "anorexic statement" was just that because she, the sufferer made it, and no one else. In light of this, we should be aware that the only statement that Cusk is making in her article is applies to herself.

The advertising campaign featuring French actress and anorexia sufferer Isabelle Caro. Photograph: Getty Images

Rhiannon Lucy Cosslett and Holly Baxter are co-founders and editors of online magazine, The Vagenda.

Paul McMillan
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"We're an easy target": how a Tory manifesto pledge will tear families apart

Under current rules, bringing your foreign spouse to the UK is a luxury reserved for those earning £18,600 a year or more. The Tories want to make it even more exclusive. 

Carolyn Matthew met her partner, George, in South Africa sixteen years ago. She settled down with him, had kids, and lived like a normal family until last year, when they made the fateful decision to move to her hometown in Scotland. Matthew, 55, had elderly parents, and after 30 years away from home she wanted to be close to them. 

But Carolyn nor George - despite consulting a South African immigration lawyer – did not anticipate one huge stumbling block. That is the rule, introduced in 2012, that a British citizen must earn £18,600 a year before a foreign spouse may join them in the UK. 

“It is very dispiriting,” Carolyn said to me on the telephone from Bo’ness, a small town on the Firth of Forth, near Falkirk. “In two weeks, George has got to go back to South Africa.” Carolyn, who worked in corporate complaints, has struggled to find the same kind of work in her hometown. Jobs at the biggest local employer tend to be minimum wage. George, on the other hand, is an engineer – yet cannot work because of his holiday visa. 

To its critics, the minimum income threshold seems nonsensical. It splits up families – including children from parents – and discriminates against those likely to earn lower wages, such as women, ethnic minorities and anyone living outside London and the South East. The Migration Observatory has calculated that roughly half Britain’s working population would not meet the requirement. 

Yet the Conservative party not only wishes to maintain the policy, but hike the threshold. The manifesto stated:  “We will increase the earnings thresholds for people wishing to sponsor migrants for family visas.” 

Initially, the threshold was justified as a means of preventing foreign spouses from relying on the state. But tellingly, the Tory manifesto pledge comes under the heading of “Controlling Immigration”. 

Carolyn points out that because George cannot work while he is visiting her, she must support the two of them for months at a time without turning to state aid. “I don’t claim benefits,” she told me. “That is the last thing I want to do.” If both of them could work “life would be easy”. She believes that if the minimum income threshold is raised any further "it is going to make it a nightmare for everyone".

Stuart McDonald, the SNP MP for Cumbernauld, Kilsyth and Kirkintilloch East, co-sponsored a Westminster Hall debate on the subject earlier this year. While the Tory manifesto pledge is vague, McDonald warns that one option is the highest income threshold suggested in 2012 - £25,700, or more than the median yearly wage in the East Midlands. 

He described the current scheme as “just about the most draconian family visa rules in the world”, and believes a hike could affect more than half of British citizens. 

"Theresa May is forcing people to choose between their families and their homes in the UK - a choice which most people will think utterly unfair and unacceptable,” he said.  

For those a pay rise away from the current threshold, a hike will be demoralising. For Paul McMillan, 25, it is a sign that it’s time to emigrate.

McMillan, a graduate, met his American girlfriend Megan while travelling in 2012 (the couple are pictured above). He could find a job that will allow him to meet the minimum income threshold – if he were not now studying for a medical degree.  Like Matthew, McMillan’s partner has no intention of claiming benefits – in fact, he expects her visa would specifically ban her from doing so. 

Fed up with the hostile attitude to immigrants, and confident of his options elsewhere, McMillan is already planning a career abroad. “I am going to take off in four years,” he told me. 

As for why the Tories want to raise the minimum income threshold, he thinks it’s obvious – to force down immigration numbers. “None of this is about the amount of money we need to earn,” he said. “We’re an easy target for the government.”

Julia Rampen is the digital news editor of the New Statesman (previously editor of The Staggers, The New Statesman's online rolling politics blog). She has also been deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines. 

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