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During the last two decades, psychiatric researchers have published evidence of eating disorders in regions around the world, despite previous conceptions of eating disorders as "culture-bound syndromes." This paper explores the pressures or processes encouraging this spread of diagnoses and their implications for our understanding of state mental-health policy making today. It argues that the increased willingness to diagnose eating disorders results from global-level instances of assemblage, that is, conglomerations or ensembles of scientific expertise, state policy, international institutions, and practices that frame interventions of a governmental or "improving" kind in a discourse that presumes a particular type of problem and entails a particular set of solutions. Specifically, the paper argues that elements of a mental health assemblage are emerging at the global level, centered around the production of a core transnational mental disorder diagnostic code and its related research agenda, such that a broad array of actors in an increasingly broad array of world regions find it medically, politically, and economically expedient to diagnose and treat persons as suffering from eating disorders (as defined by the code). Thus eating disorders are diagnosed where once they were not. Cases include several recent instantiations of the eating-disorders research agenda in non-western, less developed states. The likely effects of these assemblages include the limitation of political agency to elites who can manage the medical, political, and economic dynamics of shifting diagnostic criteria, and the reduction of non-elites' agency to mere rejection of the "rationalization" of rule, for example by rejecting a diagnosis of mental disorder, to accepting it and thereby rendering themselves "citizen-subjects" of governance, or to embracing it and attempting resistance within that diagnosis. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Epidemiological evidence indicates that eating disorders are spreading around the world. In a likely related development, researchers in many different regions are adopting a core diagnostic model or code, even though the code's diagnostic criteria are culture-laden. This paper explores the connection between these two phenomena. It traces the history of the eating disorders diagnostic code and finds a common source for the code, namely, inter-state cooperation on diseases during the first half of the 20th Century. It finds that a transnational eating disorders research agenda has emerged that is based largely on this code, and specifically, on two mental-disorder diagnostic manuals. The paper then examines the application of this eating disorders research agenda in non-western cultural contexts. In these contexts, researchers and clinicians encounter cultural biases in the diagnostic code yet reinforce it and the overall agenda by suggesting reform rather than replacement of the code and agenda. They suggest, for example, "translational" research initiatives that translate research findings into clinically applicable treatments. Notably, most translational research programs include not only state officials and state and university scientists, but also transnational capital and their own scientists. The paper thus finds that the eating disorders research agenda is transnational at many levels -- from the codification of diagnostic criteria to treatment implementation. At the same time, the agenda is failing, because eating problems are not waning, and are in some cases getting more severe. Ultimately, analysis of the eating disorders research agenda suggests that we need a more self-reflective research agenda under which subjects acquire agency rather than lose it to researchers and especially to clinicians. Analyzing eating disorders as a deterritorialized scientific research agenda enables us to see the historical and global-cultural dynamics to the phenomenon of increasing rates of eating problems. The approach also incorporates both the diagnostic process and the person with eating problems within its analytical framework, unlike the behavioral psychiatric models on which most diagnosticians and clinicians rely. Thus, the paper ultimately suggests that the global study of eating disorders holds political and cultural implications for the persons who fall under its globalizing diagnostic purview. [ABSTRACT FROM AUTHOR]

Literature on governance recently has come under critique in both sociology and international relations, with governmentality proposed as an alternative. The argument is that governmentality reflects more aptly the power and "rationalities" involved in governing processes. This article argues that while the governmentality approach does access better the content and "mentalities" of governing processes, including global-level processes, it needs to acknowledge and theorize the gradations of eligibility for objectifying (achieving and enacting) government. Some types of "civil society" members and nonstate actors are better positioned to achieve the status of simultaneous object and subject of government-others, largely, remain subjects, depending on their positions within professional hierarchies and locations within inter-state power dynamics. Some nonstate actors are positioned better to define governmentality's content, and even manage the terms under which they themselves, as well as others, are produced as citizen-subjects. In our examinations of the mechanisms of power in governing processes, we need to consider nonstate actors' positions in global social contexts. The paper examines the global governance of mental health as a heuristic case-study, with special attention to processes of diagnosing eating disorders such as anorexia nervosa and bulimia nervosa, in which the standard diagnostic code is spreading globally even though its recommended treatments are not working. The case illustrates that within governmentality processes, some actors remain decidedly more subjects than objects. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

Since the 1970s, psychiatric researchers and practitioners as well as state mental-health and psychiatric agencies have increasingly applied global-level psychiatric diagnostic criteria to local persons. These criteria, outlined in the International Clas ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]