The bulimic self : constructions of bulimia and women's embodied experiences of bulimic practices

Bulimia nervosa disproportionately affects young women and is associated with considerable distress and debilitation. Much of the research on this phenomenon focuses upon the complex and biopsychosocial causes of disordered eating behaviour. On the other hand, rather than examining causes, constructionist approaches to eating disorders find evidence of how these practices reflect broader cultural values and discourses, and thereby challenge the assumption that bulimia is only an individual abnormality or pathology. More specifically, research taking a feminist poststructural approach has explored a multitude of gendered meanings of thinness and disordered eating that might make sense of “extreme” body management behaviours. However, this body of work has typically focused on the meanings of women’s bodies, and of anorexia; consequently, there has been little focus on the actual embodied experiences and meaning of bulimic behaviours. The purpose of this research has been to explore the construction and experience of bulimia, and has used the methods of Q methodology and interviews to do so. Through a feminist poststructural theoretical approach it has examined a range of personal, embodied and cultural meanings of these practices, as well as other important objects, such as food, bodies, and femininity. The Q methodological study used a sample of participants with varying experience and knowledge of eating disorders, and identified different cultural construction of bulimia through factor analysis and qualitative interpretation. These constructions included bulimia as uncontrolled behaviour, as self-medicating with food, and as being the best at being thin. Construction and experiences of bulimia were further elaborated through a thematic decomposition of the interview accounts of women who engage in bulimic behaviours. Three major themes were identified. The first involved the way participants often purposively deployed two alternative constructions of bulimia, one in which bulimia was something they had (a mental illness), and another in which bulimia was something they did (a cycle of behaviours). As such, this thesis explores the reasons for which women might take up, or move between, a position of having or doing bulimia. Second, women constructed their bulimia as a relational problem, as caused by, maintained and even relieved through relationships with others. Drawing upon relational-cultural theory, this thesis examine how this construction might work in conjunction with women’s gendered subjectivity, as well as being rendered problematic through broader cultural values of masculinity and individualism. Third, a range of cultural and embodied constructions of food, including consumption as a means to moral virtue, health, spirituality, love and comfort, were used by these participants to make sense of bulimic behaviours. The contradictions and gendered nature of these constructions are then explored. Finally, drawing together findings from the Q methodological and interview studies, the thesis concludes with the argument that bulimia can be made sense of as both a problem and a solution by women who engage in these behaviours. The implications these findings have for research and practice, including informing treatment, prevention and help seeking are explored, as well as future directions for research into bulimia