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University of California Press

About the Book

When Rebecca Lester was eleven years old—and again when she was eighteen—she almost died from anorexia nervosa. Now both a tenured professor in anthropology and a licensed social worker, she turns her ethnographic and clinical gaze to the world of eating disorders—their history, diagnosis, lived realities, treatment, and place in the American cultural imagination.
 
Famished, the culmination of over two decades of anthropological and clinical work, as well as a lifetime of lived experience, presents a profound rethinking of eating disorders and how to treat them. Through a mix of rich cultural analysis, detailed therapeutic accounts, and raw autobiographical reflections, Famished helps make sense of why people develop eating disorders, what the process of recovery is like, and why treatments so often fail. It’s also an unsparing condemnation of the tension between profit and care in American healthcare, demonstrating how a system set up to treat a disease may, in fact, perpetuate it. Fierce and vulnerable, critical and hopeful, Famished will forever change the way you understand eating disorders and the people who suffer with them.


 

About the Author

Rebecca J. Lester is Professor of Anthropology at Washington University in St. Louis and a licensed clinical social worker. She is the author of numerous academic articles and the award-winning book Jesus in Our Wombs.

 

Table of Contents

Prologue
Preface

SECTION ONE • PROVOCATIONS
1 • Introduction
Roller-Skating
2 • Rethinking Eating Disorders
Little Debbie
3 • Eating Disorders as Technologies of Presence
For the Ladies

SECTION TWO • FRAMEWORKS
4 • Identifying the Problem: When Is an Eating Disorder
(Not) an Eating Disorder?
Spinning
5 • A Hell That Saves You: Cedar Grove’s
Staff and Programs
Lettuce Sandwich
6 • Fixing Time: Chronicity, Recovery, and Trajectories
of Care at Cedar Grove
Liquidated
7 • Loosening the Ties That Bind: Unmooring
Mortifications
8 • Me, Myself, and Ed: Recalibrating
Calculated Risks
9 • “Fat” Is Not a Feeling: Developing New Ways of Presencing
Looking for the Exit

SECTION FOUR• RECURSIONS
10 • Running on Empty: Relationships of Care in a Culture of Deprivation
Breaking
11 • Capitalizing on Care: Precarity, Vulnerability, and Failed Subjects
Spark
12 • Conclusions: Where Do We Go from Here?
Afterword

Acknowledgments
Notes
Works Cited
Index

Reviews

"A refreshing perspective on the realities and challenges one faces when living with an eating disorder.... Recommended."
CHOICE
"Impressive and exhaustive.... Those who treat, study, or are afflicted with an eating disorder in the family will find excellent resources here."
Truthdig
“This is psychological anthropology at its best.”
Anthropology News

“Lester offers one of the most compassionate, realistic, nuanced examinations of the complexity of ED care and patients I have read. Her book presents a much-needed discourse exemplifying how the American treatment landscape fails patients and perpetuates illness.” 

Affilia: Journal of Women and Social Work
“Beautifully written, sharply observant, and deeply researched, Rebecca J. Lester’s Famished is a work of rare nuance and depth on a subject that is still scarcely understood. A voice of both reason and compassion, Lester proposes viable solutions to the public health crisis of eating disorders, solutions we cannot afford to ignore.”––Marya Hornbacher, author of Wasted: A Memoir of Anorexia and Bulimia and Madness: A Bipolar Life

“Disordered eating is the norm in the contemporary United States: eating disorders are an extreme kick in the stomach of life. Lester sifts through perspectives from ethnography, epidemiology, psychoanalysis, gender studies, and memoir to get at how wearing it is to attempt caring and curing. This is a strangely optimistic book about luck and will among experts and patients in an eating disorder clinic, as they succeed and fail to find ways to forge less impossible lives.”––Lauren Berlant, author of Cruel Optimism

Famished provides a uniquely comprehensive examination of eating disorders in America. Writing from multiple perspectives—as former patient, trained cultural anthropologist, and practicing clinician—she offers both insight and a valuable critique of current approaches to therapy for these notoriously persistent syndromes. This book is an essential resource for anyone engaged in treating and caring for those who suffer from eating disorders.”––Aimee Liu, author of Gaining: The Truth about Life after Eating Disorders and Solitaire

“Combining her perspectives as a licensed therapist, anthropologist, and former patient, Lester contributes valuable insights on how our society withholds care while trying to treat those whose illness tells them they are unworthy of care.”––Pamela K. Keel, author of Eating Disorders

“This gem of a book offers a compelling and unique account of eating disorders. Lester takes us on a journey exploring the felt experience of what it is like to have an eating disorder, summarizes the key research, and shares her findings regarding the (disappointing) state of healthcare for individuals and their families or loved ones who need and deserve support. Lester’s multiple levels of experience and careful and caring analysis shed new light on the personal and social challenges arising from eating disorders.”––Ruth Striegel Weissman, Professor of Psychology and Walter A. Crowell University Professor of the Social Sciences, Emerita, Wesleyan University
 

Awards

  • Victor Turner Prize (Third Prize) 2020 2020, Society for Humanistic Anthropology
  • Eileen Basker Memorial Prize Honorable Mention 2021 2021, Society for Medical Anthropology