The drawing on the cover page was created by a young man suffering from anorexia and offers an insight into his perspective of the condition. I recommend delving into the compelling case study, where the piece and its interpretations are described in detail.
Allow me to add some remarks on the drawing and its representation of anorexia expanding beyond the individual perspective to broader implications. Anorexia often involves purging behaviors such as vomiting or the misuse of laxatives. Interestingly, the drawing portrays a contradiction as to purging. While vomiting seems impossible due to the obstruction in the esophagus, the presence of feces underneath the quasi-skeleton could suggest a possible use or abuse of laxatives. Furthermore, the depiction of the gastrointestinal system resembles the primitive gut tube seen during early embryonic development. Additionally, the figure lacks any other internal organs like the heart, lungs, liver, gallbladder, pancreas, kidneys, as well as the reproductive organs thus appearing neutral.
The apple in the drawing has multiple connotations. Aside from representing sin, it also stands for health ("an apple a day keeps the doctor away") and is a symbol for eternal youth and immortality in Nordic symbolism. In the context of anorexia, it may signify a desire to avoid growing up and to suppress maturity and sexuality.
The drawing illustrates the dichotomous nature of anorexia and in my opinion, this is reflected in its black-and-white imagery.
Anorexia is undeniably one of the most severe diseases encountered in psychiatry and psychosomatics. Individuals with anorexia are actively starving themselves to death while being surrounded by abundance; their slow demise being observable in real-time. Known as anorexia since the late 19th century [1], the prevalence has significantly increased since, becoming a global issue predominantly affecting high-income countries. In Australia, for instance, the prevalence among females reached 1.4% in 2019. Females are disproportionately affected compared to males, with numbers ranging from 2-fold to more than 4-fold in some countries like Italy and Spain [2]. Nevertheless, anorexia is not uncommon in male adolescents and young adults and this must be taken seriously.
The young man who allows us to take part in his experience and to contemplate his work of art shows a lot of courage. The drawing certainly has a subliminal effect that goes far beyond words. In this regard, he mimics the efforts of the late French actress and model Isabelle Caro, who tragically succumbed to anorexia at the age of 28. Caro, being fully aware of her illness but unable to fight it, initiated a campaign called "No Anorexia". The campaign featured powerful, greatly enlarged photographs of her emaciated body when she weighed only 25-32 kg at a height of 163 cm. The protruding vertebrae, ribs, pointed bones and jawbones attracted the observers attention while having a repellent effect at the same time. They "adorned" billboards to raise awareness and to question expectations and treatment of models as well as societal ideals regarding beauty and body image in general.
The young man’s endeavor is similar to the one of Isabelle Caro and I sincerely hope that our ideals, especially body ideals, will continue to change so that young people will be less drawn into eating disorders and the suffering they cause; even to the point of losing their lives.
