The X-ray study for this picture comes from a girl with anorexia nervosa. The subject of anorexia has been widely discussed and there is a well formed philosophy around this condition. General opinion is that the anorectic is a person with seemingly contradictory beliefs. They believe they are too thin, they also believe they are too fat. There is a view that anorexia is a self-destructive act; the sufferer has a self-imposed death wish arising from a complex perception of body image.
A contrary philosophy has, however been put forward, arising from the link between food and pleasure. This opposite view is based on the consideration that it is a condition not just of the body, but also of the mind.
The reason people pay so much attention to eating is that it is a pleasure. Like addiction this pleasure drives a person to want to eat more. It could be claimed similarly; 1, pleasure derived from food is self-defeating because eating does not completely satisfy, and from each meal less pleasure is derived and 2, pleasure obtained is illusory because it depends on the body being in a disordered state – in hunger – and in need of repair.
Hunger is a physical condition and the enjoyment derived from eating and drinking (and also from sex) is a base pleasure that employs none of the higher faculties enjoyed by humans; cognition, abstract reasoning, and judgement.
Arising from the opinion that eating is merely a base (animal) need, voluntary starvation can be interpreted as an opposite, possibly even a superior, (human) act. Extreme dieting could be explained as reaching for the very core of the human nature and starvation construed neither as mental illness nor “eating disorder”. On the contrary, in this way of thinking anorexia is a symptom of ordinary mortality, a viewpoint taken more seriously than usual; taken to its logical conclusion.
I do not adhere to this philosophy myself. It is however an interesting contrary point of view. It does not undermine the position that when a person with anorexia dies, that death is entirely avoidable. It does not take away from the distress of loved ones who find the death literally unbearable.
The picture includes quite prominently the image of the girl with two contrasting patterns arising from within her pulling in opposite directions.