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.

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The UK is dangerously close to breaking apart - there's one way to fix it

We must rethink our whole constitutional settlement. 

When the then-Labour leader John Smith set up a report on social justice for what would be the incoming government in 1997, he said we must stop wasting our most precious resource – "the extraordinary skills and talents of ordinary people".

It is one of our party’s greatest tragedies that he never had the chance to see that vision put into practice. 

At the time, it was clear that while our values of equality, solidarity and tolerance endured, the solutions we needed were not the same as those when Labour was last in power in the 1970s, and neither were they to be found in the policies of opposition from the 1980s. 

The Commission on Social Justice described a UK transformed by three revolutions:

  • an economic revolution brought about by increasing globalisation, innovation and a changing labour market
  • a social revolution that had seen the role of women in society transformed, the traditional family model change, inequality ingrained and relationships between people in our communities strained
  • a political revolution that challenged the centralisation of power, demanded more individual control and accepted a different role for government in society.

Two decades on, these three revolutions could equally be applied to the UK, and Scotland, today. 

Our economy, society and our politics have been transformed even further, but there is absolutely no consensus – no agreement – about the direction our country should take. 

What that has led to, in my view, is a society more dangerously divided than at any point in our recent history. 

The public reject the status quo but there is no settled will about the direction we should take. 

And instead of grappling with the complex messages that people are sending us, and trying to find the solutions in the shades of grey, politicians of all parties are attached to solutions that are black or white, dividing us further. 

Anyone in Labour, or any party, who claims that we can sit on the margins and wait for politics to “settle down” will rightly be consigned to history. 

The future shape of the UK, how we govern ourselves and how our economy and society should develop, is now the single biggest political question we face. 

Politics driven by nationalism and identity, which were for so long mostly confined to Scotland, have now taken their place firmly in the mainstream of all UK politics. 

Continuing to pull our country in these directions risks breaking the United Kingdom once and for all. 

I believe we need to reaffirm our belief in the UK for the 21st century. 

Over time, political power has become concentrated in too few hands. Power and wealth hoarded in one corner of our United Kingdom has not worked for the vast majority of people. 

That is why the time has come for the rest of the UK to follow where Scotland led in the 1980s and 1990s and establish a People’s Constitutional Convention to re-establish the UK for a new age. 

The convention should bring together groups to deliberate on the future of our country and propose a way forward that strengthens the UK and establishes a new political settlement for the whole of our country. 

After more than 300 years, it is time for a new Act of Union to safeguard our family of nations for generations to come.

This would mean a radical reshaping of our country along federal lines where every component part of the United Kingdom – Scotland, Wales, Northern Ireland and the English regions – take more responsibility for what happens in their own communities, but where we still maintain the protection of being part of a greater whole as the UK. 

The United Kingdom provides the redistribution of wealth that defines our entire Labour movement, and it provides the protection for public finance in Scotland that comes from being part of something larger, something good, and something worth fighting for. 

Kezia Dugdale is the leader of the Scottish Labour party.