This paper explores the ways in which young women ‘manage’ the complexities of the presentation of an anorexic identity, the stigma attached to it, and the relationships that are developed with fellow sufferers. A range of ethnographic data and ‘voices’ are drawn upon, including a small qualitative study within a leading centre in the UK for the treatment of eating disorders. The paper begins by outlining the ways in which for many young women, anorexia is a stigmatised identity which in various contexts comes to be perceived as an irrational and self-inflicted condition. It was reported by the young women in our study that many of their peers, families and teachers made sense of their eating disorder through a medicalised discourse which focused on visual aspects of weight gain/loss and often stigmatised the condition, reducing it to a position of pathology or irrationality. It is argued that these experiences form a type of ‘discursive constraint’ (Ronai 1994) which many of the young women attempt to resist by engaging with alternative contexts and relationships through which they can construct more positive self-representations of anorexia or anorexic identities. As is revealed through the various data sources, as these young women negotiate the various discourses which offer them alternative subjectivities, they come to manage anorexia as both an illness and an identity.