Clothes are designed and displayed for thin bodies in spite of the fact that few women could wear them successfully. Although at highest risk are those whose entire sense of self is based on outside approval and physical appearance, few women are immune to these influences. One interesting anthropologic study reported that during times and in cultures in which women are financially dependent and marital ties are stronger, the standard is toward being curvaceous, possibly reflecting some cultural or economic desire for greater reproduction. During historical periods or in cultures where female independence has been possible, however, the standard of female attractiveness tends toward thinness. Once a person has achieved emaciation, a sense of accomplishment and status can be primary motivators for perpetuating anorexia.
Weight loss brings a feeling of triumph over helplessness.
This false sense of accomplishment is often reinforced by the envy of their heavier friends who may perceive the anorexic patients as being emotionally stronger and more sexually attractive than they are. The cultural attitude toward physical activity is a fitting companion to the disordered attitude regarding eating. Americans are encouraged to admire physical activity only as an intense competitive effort that few can attain, leaving most people in their armchairs as spectators. Anorexia postpones puberty, allowing young female athletes to retain a muscular boyish shape without the normal accumulation of fatty tissues in breasts and hips that may blunt their competitive edge. Coaches and teachers compound the problem by encouraging calorie counting and loss of body fat and by over-controlling the athletes' lives.