Mind over matter - unto death?
December 31st, 2006
Anorexia in Brazil show power of mental disturbance to wreck health
Similar mind-body phenomenon likely helps kill in HIV∫AIDS, but gay liberation may extinguish it
Anyone who has visited Brazil might be surprised to hear that there is an anorexia epidemic in that body-worshipping country of hot flesh and vibrant samba rhythms. Half of Rio seems to spend its life at the beach, and its sensual culture, rich array of exotic foods, and sea and rain forest environment would seem to rule out the unnatural insanity of self-starvation.
But the fashion industry is taking action after Ana Carolina Reston, a 5′ 8″ beauty and model, died at age 21 weighing 80 lbs, and three other young women starved themselves to death in the last two months following the same strange ritual of self destruction, where distorted body image and fear of weight gain translates into skeletal physique and death, the victim all the while convinced that she is overweight .
In the latest incident, Beatriz Cristina Ferraz Bastos, a 23-year-old student and office worker, died on Christmas Eve, weighing just 75 pounds. On her home page at Orkut, a popular Web site for young Brazilians, she described herself as —thin—? after having been —110 pounds overweight—? as a teenager, and included before and after photographs to prove her point.
The first death, in mid-November, was that of Ana Carolina Reston, a 21-year-old model, and it was initially regarded as an aberration. At the time of her death, Ms. Reston stood 5 feet 8 inches tall but weighed just over 80 pounds and was undergoing medical treatment after having collapsed at a fashion shoot in Japan.
A few days later, though, a 21-year-old fashion student also died of anorexia. At the beginning of this month, her death was followed by that of a 23-year-old manicurist, and a full-fledged media frenzy was on, with articles and television programs speculating that Brazil—s obsession with physical beauty was getting out of hand….
At the same time, though, more than 11 million families, mostly in the impoverished northeast region of the country, benefit from a government program that pays a small monthly stipend to those who do not have enough to eat. According to the national statistical office, at least 8 percent of Brazil—s 185 million people are underweight, a vast majority because they are too poor to afford a proper diet.
All four of the deaths from anorexia, in contrast, have occurred in the state of São Paulo, the country—s most populous, prosperous and modern. It is also the center of Brazil—s booming fashion industry, which has come under pressure to take steps to protect working models and discourage ordinary girls from starving themselves in order to conform to designers— and booking agents— idea of feminine beauty.
Concern over dangerously thin models has also led to action in Spain and Italy where fashion show organizers have restricted models to a weight at or above a floor. Madrid imposed a height to weight ratio in September, and guidelines have been announced for the New York fall fashion show starting in four weeks. Working out what the rules should be is proving difficult, however.
The New York Times
January 6, 2007
Health Guidelines Suggested for Models
By Eric Wilson
The fashion industry sells modish trapeze dresses and $800 platform ankle boots. But it also sells women an ideal of beauty embodied by the models who walk the runways and appear in fashion magazines.
And since the fall, American designers have been under increasing pressure to respond to a wave of dangerously thin models who have set the aesthetic standards of global fashion.
Now the industry has decided to issue guidelines to designers, aimed at promoting healthier behavior among its highly paid clothes hangers.
The guidelines, which fall short of modeling restrictions announced in recent months by fashion show organizers in Madrid and Milan, were introduced yesterday at a meeting of the Council of Fashion Designers of America in Manhattan. But the group—s recommendations, which will be sent to designers next week in anticipation of the fall fashion shows that begin in New York on Feb. 2, seem unlikely to satisfy many critics of fashion—s embrace of ultra-thinness.
According to participants at the meeting, the recommendations are likely to include scheduling fashion-show fittings with younger models during daylight hours, rather than late at night, to help them get more sleep; urging designers to identify models with eating disorders; and introducing more nutritious backstage catering, where a diet of Champagne and cigarettes is the norm.
There are no plans to require models to achieve an objective measure of health like a height-to-weight ratio, which was imposed by Madrid in September, a move that brought much public attention to the issue. It was further highlighted by the death of Ana Carolina Reston, a 21-year-old Brazilian model, from complications of anorexia in November.
More than two-thirds of respondents to a questionnaire on Elle magazine—s Web site last month said they wished that American designers would follow the recent examples of fashion show organizers in Milan and Madrid in banning overly skinny models.
But the American designers rejected that option as unworkable.
—It is important as a fashion industry to show our interest and see what we can do because we are in a business of image,—? said Diane von Furstenberg, the president of the designers— council, the industry trade group. —But I feel like we should promote health as a part of beauty rather than setting rules.—?
The group that tackled the issue also included Anna Wintour, the influential editor of Vogue; several members of her staff; health professionals including a nutritionist, a psychiatrist and a physical trainer; a representative of a modeling agency; and a producer of fashion shows.
Designers and fashion magazine editors, who hire models, and executives for agencies that represent the young women, are skeptical that the profession can be regulated or monitored.
—It—s nothing that we don—t do already,—? said David Bonnouvrier, the chief executive of DNA Model Management, speaking of the guidelines. His colleague Louis Chabat, an agent at DNA, attended the fashion council meeting yesterday.
—I hope it will be successful,—? Mr. Bonnouvrier said. —It is a serious enough issue that people will pay attention, but we cannot dictate the designers— choices. There will be a conscious effort for a while to address this, but whether that will last is another issue.—?
Madrid—s banning of models who have a body mass index less than 18, a normal body standard according to the guidelines of the World Health Organization, did not initially draw much support among the organizers of shows in the major fashion capitals, until last month, when the Italian group issued what it described as a manifesto.
The new rules in Italy are meant to be applied at fashion shows in Rome this month, although they are not binding and in many cases not entirely understood.
The Chamber of Fashion, based in Milan, is asking that models hold a license issued by a committee of city officials and a panel of doctors, nutritionists, psychologists and other experts. But when proposing that models, who must be 16 to work there, also achieve a minimum body mass index of 18.5, the organizers added that geographical and ethnic considerations should also be considered, which industry professionals found confusing.
—Can you think of another job you would have to talk to a nutritionist, a psychology expert and a doctor to get certified?—? asked Roberta Myers, the editor of Elle. —Maybe the C.I.A.?—? Ms. Myers did not attend the American council meeting, but said she supported the idea of guidelines and educational programs because they would raise consciousness of the issue.
—I see this as a good-faith effort on all of our parts,—? she said.
Abigail Walch, Vogue—s health editor, who attended the fashion industry meeting, said the group conceived its recommendations independently of Milan and Madrid.
Vogue identified several experts to help educate models on health and fitness. They include a nutritionist, Joy Bauer; a fitness trainer, David Kirsch; and Dr. Susan Ice, a psychiatrist at the Renfrew Center in Philadelphia, which treats eating disorders.
—You cannot say one factor contributes to eating disorders or that one factor resolves them,—? Ms. Walch said. —We should have different avenues for dealing with this issue. We realize there are problems and we want to do everything possible to have resources available to these young girls.—?
Restricting models because they do not meet the specific height and weight standards of Madrid, which requires them to have a body mass index higher than 18, would not solve the problem, she said.
—We see models who are thin and getting thinner,—? said Ms. Bauer, who contributes nutrition advice to —The Today Show—? and Yahoo in addition to her Manhattan and Westchester County practices. Some models who have been referred to Ms. Bauer—s offices are genetically thin, some come seeking healthy ways to lose five pounds, and some have genuine eating disorders.
—I get this pressure,—? Ms. Bauer said. —The reality is that your entire career is somewhat based on being thin. It—s a tricky thing.—?
Ms. Bauer said a goal of the fashion industry recommendations was to encourage healthy behavior among models, but also to educate designers on how to recognize disorders. Ms. Bauer, Mr. Kirsch and Dr. Ice will appear on a panel discussion of the issue during Fashion Week in New York.
She said that the body mass index would not give a fair indication of the healthfulness of models because of their height and age.
—It—s not so much about whether they can be 18 or higher and still look fabulous,—? she said. —I—m not for mandating certain B.M.I.—s because I don—t think that is fair.—?
Patrick O—Connell, a spokesman for Ms. Wintour, said: —The feeling is that it is not realistic to dictate or impose rules on a huge fashion industry. However, we do believe raising awareness and consciousness will go the furthest toward increasing people—s sensitivities to the problem.—?
Is fear and shame fatal in HIV∫AIDS?
That such a deadly phenomenon has reached Brazil proves how powerfully the misguided mind can take over health in any culture, and suggests how likely it is that the phenomenon is central to HIV∫AIDS, where the shame and guilt some gays feel at their rejection by the mainstream, and even by their families, is often spoken of as leading to similar unconscious self-destruction, and was powerfully evoked by recent comments here. The point is not that it happens. The ability of the mind to control the body is a given. The issue is the extent to which the roots of gay death in the US from AIDS are or were in the culture.
The topic was raised recently in the Andrew Sullivan sideswipes Harpers thread by Michael Geiger, a leader of the chapter of Health Education Aids Liaison or HEAL in San Diego, who wrote:
what about the extremely toxic emotions that are concurrent with the belief that one has HIV and will sicken and die? Do you Mark, believe that emotions can be toxic, even to the point of death?
Certainly most people given the diagnosis of HIV or AIDS hold or have held on to such a belief, and those taking the drugs hold to the belief that the drugs will keep them alive, otherwise they would not be taking them.
(It is) my own, and as far as I can see, scientifically “unprovable”, belief, that belief itself plays the major defining role.
My evidence: As the overwhelming “belief” of HIV causing AIDS progressed after the 1984 Gallo’s pronouncement, so did the death rate in those who “believed” they had it or “believed” they would get it, and they certainly mostly “believed” they would die from it. As the common belief shifted in 1995 to a belief that one could “live” with HIV, this too became the reality for the masses.
Mark, Is there some reason that “belief” itself should not be strongly considered, and probably investigated, albeit currently scientifically difficult to do, as a, if not even perhaps the, leading causative factor of progression to AIDS, and should it not be a major scientific pursuit or personal investigation as well?
The problem with that time line is that the rise in death rate also reflected the arrival of immunity damaging, high dose (up to 1800 mg) daily AZT as the main prescription for a major immune deficiency disorder already owed to high (recreational) drug intake.
But “Wilyretrovirus” offered an impressive personal anecdote:
I knew a gay couple who were in absolutely normal health. When one of them was told the word “positive” by the clinician, he physically collapsed on the spot, sobbing hysterically, curling up into the fetal position. He had been fine the entire time I’d known him, but within a couple weeks after having the rattle shaken at him (the “test” “result”), he became very ill. There was nothing I could do to help him. I felt so powerless.His lover though, was fine until he started taking AZT. Their attitudes were quite different from each other, and it showed in the time it took for them to sicken and die. The friend who collapsed died within a year, his lover would hang on for another year.
“MacDonald” added this post emphasizing the group fantasy reinforcing individual fear and recommending the early seminal paper in the Journal of Psychohistory Summer 1984, on AIDS as a cultural hysteria by the prescient Caspar Schmidt:
The positive HIV test is a shaman’s rattle, but to get past the truism that any diagnosis can produce illness, I suggest that in this case it’s the whole culture of hysteria created around HIV/AIDS that’s the rattle and we all, media, politicians, activists, risk groups, docs, general population to a greater or lesser extent the witch hunters (I prefer witch hunters to shamans, since a shaman’s function is quite different)
This view is in line with Casper Schmidt’s The Group-Fantasy Origins of AIDS
Here is Schmidt’s introdution:
I propose an alternative hypothesis for the etiology of AIDS, based on the second of these two mechanisms of contagion in man. This will posit a psychosocial origin of epidemic AIDS, which will lie on the cusp between immunology, pathology and psychology (the latter including the psychology of both individuals and groups). I will do so in twin papers meant to be read in tandem: this one, which will deal mostly with the group psychology, and a second paper for the medical press. In the medical paper, which is entitled, “The Pathogenesis of Epidemic AIDS”, I account for the “biological” end of the disorder. It will trace the physiological effects of the group-psychological factors outlined in this paper on the individual patient, with the resultant epidemic of severe, mostly masked, reactive depression in the at-risk groups, of which the immune deficiency is one facet. It will outline the pathway and the mechanism by which the cell-mediated immunity may be suppressed, and will provide an animal model for AIDS, as I discuss below.
Even if you find Schmidt’s analysis somewhat overwrought as we do - fantasy replacing fantasy, as it were - there is no denying that fear of AIDS - AFRAIDS as some label it - has to be a most powerful superstition in its own right, given the effective invisibility of the “cunning” agent at every turn (even to the scientists who warn us with such certainty of its as yet unexplained and unproven action), and its supposed ability to strike otherwise healthy victims down without warning at any point over a period of 24 years (ie double the average 12 years latency period).
In fact, when one contemplates the attributes of the Virus one has to say that it is the most fearful virus ever conceived of, though luckily for some as yet unexplained reason no threat to white heterosexuals in the USA, though deadly if you are gay or if you are black, African and living in dire poverty or starving, in which latter case you are likely to be rated as suffering from AIDS by any visiting American celebrity or medical worker who catches sight of you if you have so much as a sniffle or are undernourished.
Yet obviously the individual fantasy is fed by group fantasy on every level. Thus “MacDonald” added the witty analogy that
In fact, in an exact parallel to the modern Christian missionaries, the AIDS church has largely given up on improving its numbers at home and now chooses to concentrate on Africa for new converts.
The thread is worth reading to the end of that section, since as several wise commentators point out its boundaries are cultural rather than scientific, and extend far beyond science, perhaps even starting there. Like Schmidt they also point out that by its nature this kind of deeply rooted group fantasy will resist with hostility those who try to pop the bubble, treating them as outcasts rather than saviors.
The ruling AIDS paradox is that those most in need of enlightenment in the US may try to kill the messenger. But it also seems that with gay liberation, as gays more and more take their rightful place in society, free of prejudice and other-induced guilt and shame, they may finally free themselves of HIV∫AIDS think too.
If this is true then gay liberation may be one route to the liberation of true science in HIV∫AIDS.
UPDATE (Jan 14 Sun)
Two more Brazilian beauties die
In In the Land of Bold Beauty, a Trusted Mirror Cracks, an update for the Week in Review, Larry Rohter notes that two more women died from anorexia in the last two weeks, and speculates why Brazil’s female body image is narrowing.
The death that followed Ms. Reston—s was of a 21-year-old fashion student. There was also a 23-year-old student and office worker who had a home page on the Web and gave English lessons….Even the famous —girl from Ipanema,—? immortalized in the bossa nova song written in 1962, illustrated the cultural differences that prevailed then: only in the English lyrics is she —tall and tan and young and lovely.—? In the original Portuguese version, the emphasis is on —the sweet swing—? of her hips and backside as she walks, a sway described as —more than a poem, the most beautiful thing I have ever seen.—?
Today, in sharp contrast, the epitome of beauty is Gisele Bündchen, the top model whose enormous international success has inspired the thousands of Brazilian girls who dream of emulating her to enroll in modeling schools and competitions. But very little about Ms. Bündchen—s body —” tall and blond, rangy yet busty —” connects her to her homeland and its traditional self-image….
According to the survey, the percentage of the population taking appetite-suppressants more than doubled between 2001 and 2005, making Brazil the world champion in the consumption of diet pills.
—The reasons are purely aesthetic, not medical, especially for women,—? who account for at least 80 percent of the market, said Dr. Elisaldo de Araújo Carlini, a professor at the Federal University of São Paulo who is the author of the study. —They want to get thin no matter what, all because of images from north of the Equator. It is a cruel cultural imposition on the Brazilian woman.—?
Women in countries around the world are subject to such pressures, of course. But Brazilians argue that the situation here is more extreme: this is, after all, a tropical country in which, much more than the United States, Europe or Japan, people live their lives outdoors, often, for comfort—s sake, in skimpy clothes showcasing the body—s glories or defects.
A result is a culture of vanity that seems to know no boundaries. This summer, the newest rage, according to local news reports, is liposuction on the toes, and there have also been accounts of a boom in plastic surgery among women 80 and older.
Men are not immune. President Luiz Inácio Lula da Silva is reported to have recently had cosmetic work done on his teeth, and even the chief of an Indian tribe in the Amazon had plastic surgery because, as he guilelessly put it, —I was finding myself ugly and I wanted to be good-looking again.—?…
—This abrupt shift is a feminine decision that reflects changing roles—? as women move out of the home and into the workplace, she said. —Men are still resisting and clearly prefer the rounder, fleshier type. But women want to be free and powerful, and one way to reject submission is to adopt these international standards that have nothing to do with Brazilian society.—?
The bottom line (speaking metaphorically here) seems to be that cultural forces can take a perfectly reasonable individual response based on vanity and magnify it into a killer.
The New York Times
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January 14, 2007
In the Land of Bold Beauty, a Trusted Mirror Cracks
By LARRY ROHTER
RIO DE JANEIRO
AS king of carnival, the corpulent Rei Momo is supposed to embody all the jollity, carnality and excess associated with that most Brazilian of bacchanals. So when the event—s reigning monarch has gastric bypass surgery, sheds 150 pounds and starts an exercise program, you begin to wonder what—s going on.
And when six young women die of anorexia in quick succession —” two in the last two weeks —” the wonder turns to bewilderment. Brazil may well be the most body-conscious society in the world, but that body has always been Brazil—s confident own —” not a North American or European one.
For women here that has meant having a little more flesh, distributed differently to emphasize the bottom over the top, the contours of a guitar rather than an hourglass, and most certainly not a twig. Anorexia, though long associated with wealthier industrialized countries, was an affliction all but unheard-of here.
But that was before the incursions of the Barbie aesthetic, celebrity models, satellite television and medical makeovers made it clear just how far some imported notions of beauty, desirability and health have encroached on Brazilian ideals once considered inviolate.
By — —upgrading— to international standards of beauty,—? said Mary del Priore, a historian and co-author of —The History of Private Life in Brazil,—? the country is abandoning its traditional belief that —plumpness is a sign of beauty and thinness is to be dreaded.—? The contradictory result, she added, is that —today it—s the rich in Brazil who are thin and the poor who are fat.—?
A generation ago, the ideal type here was Martha Rocha, a Miss Brazil from the mid-1950s. She finished second in the Miss Universe competition supposedly because her body was a bit too generous in the hips, buttocks and thighs, but since those characteristics were so highly valued here, as suggested by cartoons and the popularity of the semi-pornographic drawings of Carlos Zéfiro that circulated, it was the rest of the world whose taste was questioned.
Even the famous —girl from Ipanema,—? immortalized in the bossa nova song written in 1962, illustrated the cultural differences that prevailed then: only in the English lyrics is she —tall and tan and young and lovely.—? In the original Portuguese version, the emphasis is on —the sweet swing—? of her hips and backside as she walks, a sway described as —more than a poem, the most beautiful thing I have ever seen.—?
Today, in sharp contrast, the epitome of beauty is Gisele Bündchen, the top model whose enormous international success has inspired the thousands of Brazilian girls who dream of emulating her to enroll in modeling schools and competitions. But very little about Ms. Bündchen—s body —” tall and blond, rangy yet busty —” connects her to her homeland and its traditional self-image.
—Hers is a globalized beauty that has nothing to do with the Brazilian biotype,—? said Joana de Vilhena Novaes, author of —The Intolerable Weight of Ugliness: On Women and Their Bodies—? and a psychologist here. —She has very little in the way of hips, thighs or fanny. She—s a Barbie,—? one whose parents are of German descent.
Dr. Novaes and others have noted that during the 1960s and 70s, Brazilian girls played with a locally made doll named Susi, who, reflecting the national aesthetic, was darker and fleshier than her counterparts abroad. But in the 1970s, Barbie arrived, and by the mid-1980s, production of Susi dolls had ceased, though it has resumed in recent years in a sort of backlash.
Yet until recently no one here would ever have talked with admiration about having an hourglass figure like Barbie—s, let alone the coat-hanger physiques of the international runways. Instead, the ideal was what is known as —um corpo de violão,—? or —guitar-shaped body—?; that is, like Susi—s, thicker in the waist, hips and fanny.
One indication of how rapidly values are changing can be gleaned from a government study released in November, just after the first in the cluster of anorexia deaths, that of Ana Carolina Reston, a 21-year-old model. According to the survey, the percentage of the population taking appetite-suppressants more than doubled between 2001 and 2005, making Brazil the world champion in the consumption of diet pills.
—The reasons are purely aesthetic, not medical, especially for women,—? who account for at least 80 percent of the market, said Dr. Elisaldo de Araújo Carlini, a professor at the Federal University of São Paulo who is the author of the study. —They want to get thin no matter what, all because of images from north of the Equator. It is a cruel cultural imposition on the Brazilian woman.—?
Women in countries around the world are subject to such pressures, of course. But Brazilians argue that the situation here is more extreme: this is, after all, a tropical country in which, much more than the United States, Europe or Japan, people live their lives outdoors, often, for comfort—s sake, in skimpy clothes showcasing the body—s glories or defects.
A result is a culture of vanity that seems to know no boundaries. This summer, the newest rage, according to local news reports, is liposuction on the toes, and there have also been accounts of a boom in plastic surgery among women 80 and older.
Men are not immune. President Luiz Inácio Lula da Silva is reported to have recently had cosmetic work done on his teeth, and even the chief of an Indian tribe in the Amazon had plastic surgery because, as he guilelessly put it, —I was finding myself ugly and I wanted to be good-looking again.—?
But most of the complaints about the tyranny of the culture of beauty here come from women. Each year follows the same pattern: Enrollment at gyms, here called —academies,—? declines as cool weather arrives and then rises in the final quarter of the year, as women try to prepare their bodies to look good on the beaches during the Southern Hemisphere summer vacation season, which runs from just before Christmas until carnival, about two months later.
But Brazilian eating habits don—t make the process easy. If the emblematic American meal consists of fried chicken, corn on the cob and apple pie, its Brazilian equivalent is more like this: rice and beans, potatoes, pasta, bread, salad and a slice of meat sprinkled with farofa, or ground and toasted yucca flour.
The Brazilian diet is much higher in carbohydrates and lower in protein than is recommended, said Claudia Carahyba, a nutritionist in São Paulo whose clients include modeling agencies that want to break their girls of such bad habits. —That is especially true of the poor,—? she said. —Since protein costs more, they trade that for more carbohydrates like yucca, which are cheaper and make you feel full.—?
In fact, the new paradigm has been slower to penetrate poorer regions like the Amazon and the northeast, where hunger is still widespread and the idea of —fartura,—? or cornucopian abundance, is especially valued. There, men in particular are proud to show off wives and children whose bodies are more rounded, as a sign that they are good providers.
—To be fat used to be considered wonderful in Brazil, because it showed that you eat very well, which is important to Brazilians,—? said Roberto da Matta, an anthropologist and newspaper columnist who is a leading social commentator. —That you have three meals a day and eat meat and beans, calmly, at a table with friends and relatives, means that someone is taking good care of you.—?
Experts also agree that Brazilian men, whatever their class or race, have been much slower to accept slenderness as a gauge of feminine beauty. When they are looking for a sexual partner, Brazilian men are consistent and clear in saying that they prefer women who are fleshy in the rear —” —popozuda—? is the wonderfully euphonious slang term used here —” and have pronounced curves.
In the past, that standard was so firmly established that some Brazilian women resorted to breast reduction or buttock augmentation surgery, sometimes even transferring their own tissue from top to bottom.
But as the international standard has taken hold, tastes are changing.
—Those huge breasts you see in the United States, like in Playboy, were always considered ridiculous in Brazil,—? said Ivo Pitanguy, the country—s most renowned plastic surgeon. —But there is now more of a tendency than before to want breasts that are a bit larger —” not to make them huge, mind you, but more proportional as part of a body that is more svelte and more athletic.—?
Though such globalized standards of beauty originated in rich, mostly white neighborhoods, they are gradually being spread to the rest of Brazil and across racial lines by the actresses and models who live here and perform in popular telenovelas. Exercise academies can be found in slum areas, and newspapers noted that the most recent anorexia victim was a dark-skinned teenager from a working-class suburb of Rio who dreamed of becoming a model.
In fact, all six women who died of anorexia lived either in Rio de Janeiro or in São Paulo, the country—s most cosmopolitan states and centers of the Brazilian fashion industry. The death that followed Ms. Reston—s was of a 21-year-old fashion student. There was also a 23-year-old student and office worker who had a home page on the Web and gave English lessons.
Ms. del Priore, the historian, pointed to other fundamental changes, which she said have led to a rebellion against machismo and the patriarchal structure that she believes persists here.
—This abrupt shift is a feminine decision that reflects changing roles—? as women move out of the home and into the workplace, she said. —Men are still resisting and clearly prefer the rounder, fleshier type. But women want to be free and powerful, and one way to reject submission is to adopt these international standards that have nothing to do with Brazilian society.—?
The New York Times
December 30, 2006
Burst of High-Profile Anorexia Deaths Unsettles Brazil
By Larry Rohter
RIO DE JANEIRO, Dec. 29 —” In less than two months, four young women have died in widely publicized cases of anorexia in Brazil, causing a national debate about body image and eating disorders.
The problem is a new one here, and it clearly puzzles and shocks Brazilians. In this country, eliminating hunger among the millions of the poor has traditionally been an important political cause, so the notion that people would voluntarily starve themselves is hard for most Brazilians to comprehend.
In the latest incident, Beatriz Cristina Ferraz Bastos, a 23-year-old student and office worker, died on Christmas Eve, weighing just 75 pounds. On her home page at Orkut, a popular Web site for young Brazilians, she described herself as —thin—? after having been —110 pounds overweight—? as a teenager, and included before and after photographs to prove her point.
The first death, in mid-November, was that of Ana Carolina Reston, a 21-year-old model, and it was initially regarded as an aberration. At the time of her death, Ms. Reston stood 5 feet 8 inches tall but weighed just over 80 pounds and was undergoing medical treatment after having collapsed at a fashion shoot in Japan.
A few days later, though, a 21-year-old fashion student also died of anorexia. At the beginning of this month, her death was followed by that of a 23-year-old manicurist, and a full-fledged media frenzy was on, with articles and television programs speculating that Brazil—s obsession with physical beauty was getting out of hand.
In the clearest sign that the issue has reached public awareness, a popular television soap opera, —Pages of Life,—? includes a character who is a teenage ballerina suffering from bulimia. In addition, a weekly newsmagazine published a cover story last month that featured a photograph of Ms. Reston alongside a headline that read, —Inside the Mind of an Anorexic.—?
At the same time, though, more than 11 million families, mostly in the impoverished northeast region of the country, benefit from a government program that pays a small monthly stipend to those who do not have enough to eat. According to the national statistical office, at least 8 percent of Brazil—s 185 million people are underweight, a vast majority because they are too poor to afford a proper diet.
All four of the deaths from anorexia, in contrast, have occurred in the state of São Paulo, the country—s most populous, prosperous and modern. It is also the center of Brazil—s booming fashion industry, which has come under pressure to take steps to protect working models and discourage ordinary girls from starving themselves in order to conform to designers— and booking agents— idea of feminine beauty.
Gisele Bündchen, a model who in recent years has been among the best known and most successful in the world, is Brazilian. Her fame and wealth are widely admired here and have prompted thousands of other young women to enroll in modeling schools and competitions, whose number has proliferated.
Last month, after Ms. Reston died, Ms. Bündchen agreed to an interview with Folha de São Paulo, a leading daily newspaper. She criticized the international obsession with thinness and urged girls who hoped to emulate her not to fall into that trap.
—Unfortunately, with the competition that exists in our milieu, a lot of girls attach more importance to work and certain notions of beauty than to their health,—? she said. —To go hungry in order to copy a certain standard is a big mistake and is not going to guarantee anyone—s success.—?
The annual São Paulo Fashion Week is scheduled to be held again late next month, and organizers have said they will require proof that all participating models are at least 16 years old and that they have supplied a health certificate. They have also announced a health and anorexia awareness campaign that includes print, broadcast and Internet announcements, the distribution of fliers and talks at schools.
