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"When I deal with a family and with mothers," Kogel told me, "because I don't like mother-blaming and because I am a mother, I try to see the fullness of the mother—as a three-dimensional person with her own insecurities, anxieties, and strengths." Yet to understand is not always to exculpate. For one of Kogel's clients' mothers, "appearance was everything. She just shamed her daughter at every moment. She said, 'You're fat; you're ugly.' The daughter has recently looked at pictures of herself as a child and she was actually adorable. There were no gross deformities. But the mother took all the badness inside herself and projected it onto her daughter."

Because of my own experience, I have a hard time attributing eating disorders to a cultural conspiracy—an idea that is easy to discredit through caricature, as Elizabeth Kaye did in Esquire. Kaye quotes Naomi Wolf's description of the alleged fashion cabal in The Beauty Myth: "It has grown stronger to take over the work of social coercion. . . . It is seeking right now to undo . . . all the good things that feminism did for women." Then Kaye adds, "This is the language of a science-fiction writer describing the Blob."

Yet because there are profits to be made off women with negative body images, people do fan the members of negativity. In 1992, columnist Ann Landers, a citadel of nonparanoid thinking, published some words of caution for "those who are borderline nutty on the subject of weight loss." They included statistics showing that the diet industry had expanded to $33 billion a year and that women spent $300 million each year on plastic surgery. By age thirteen, 53 percent of American high-school girls were unhappy with their bodies. And even I began to half-believe the conspiracy theorists in January 1993, when Columbia Pictures announced that it had winnowed about thirty pounds off the woman in its logo, transforming her into a torch-bearing skeleton.

Sadly, in the eating disorder wars, the conspiracy camp is about as likely to shake hands with the family pathology crowd as Queen Elizabeth is to host a fund-raiser for the IRA. Which is too bad, because the "cause" of an eating disorder seems to vary between individuals, and involves some combination of cultural and familial issues.

One of the most sensitive dramatizations of an eating disorder and its conflicting causes is Todd Haynes's 1987 movie Superstar, a forty-three-minute documentary written with Cynthia Schneider that uses mutilated fashion dolls to enact the death of seventies pop singer Karen Carpenter from anorexia nervosa. Although the concept sounds like a campy bad joke, the movie is profoundly affecting. "In Superstar, Haynes vindicates Karen from the junkyard of popular culture, forcing us to rethink her achievements," Joel Siegel wrote in Washington's City Paper when the film came out. "I had ignorantly dismissed anorexia as a uniquely capitalistic affliction, a self-induced neurosis that ironically compels the over-privileged to mimic the physical deprivations of the starving poor. Haynes and Schneider convincingly argue that anorexia is a manifestation of a specifically female oppression, a terrifyingly logical response to the demands imposed upon women by a sexist culture."

In Art Forum, artist Barbara Kruger observed: "It is this small film's triumph that it can so economically sketch, with both laughter and chilling acuity, the conflation of patriotism, familial control and bodily self-revulsion that drove Karen Carpenter and so many like her to strive for perfection and end up simply doing away with themselves." The only people, it seems, who didn't like Superstar were Karen's family and executives at A&M Records. They denied Haynes permission to use her songs and sent cease-and-desist letters so threatening that Haynes withdrew the film from circulation.

By dramatizing the story with Barbie-like dolls, Haynes recalls Beauvoir's thoughts on how society pressures women to be "live dolls," who slowly