When Thin Isn't Thin Enough
Two thousand years ago, an unknown Greek artist created the world's first supermodel: the Venus de Milo. Though sculpted from stone, her features were hardly chiseled. Her hips were round and ample, her midriff full--proof that the ancients saw nothing wrong with a little bit of marbling.
Today's society worships a much different goddess. The 100 percent fat-free magazine model comes with a neck like a swan's and legs that flow right into next month's issue. And the message she delivers is anything but subtle: the thinner, the better.
For many women, today's standard of beauty is a minor annoyance. But for millions of others, the fight against fat becomes an obsession that ages them prematurely by depriving their bodies of basic nutrients, weakening their hearts and other organs and hurting their physical appearance.
"It's no wonder to me that we see so many women with anorexia nervosa and bulimia," says Vivian Meehan, president and founder of the National Association of Anorexia Nervosa and Associated Disorders. "In our country, people who are fat are shamed. Instead of looking healthy and normal, women are trying to look like something 99 percent of them can't possibly be."
A Heavy Price to Pay
An estimated seven million American women suffer from eating disorders. Meehan says a high percentage of them are too embarrassed to seek treatment or don't even realize they have problems.
Eating disorders usually start in the teenage years, but many women suffer with them well into adult life. Meehan says she routinely sees women in their thirties and forties--even in their seventies--with anorexia or bulimia. The disorders can also begin in adult women who never showed symptoms in their younger years.
Women with anorexia, Meehan says, are often starving, convincing themselves they're fat when they may be 25 percent or more under their ideal weight. Women with bulimia, on the other hand, may eat enormous quantities of food during secret binges, then purge the food through vomiting, laxatives and diuretics or excessive exercise.
"Both disorders have serious consequences," says Janet David, Ph.D., director of community outreach at the Center for the Study of Anorexia and Bulimia in New York City. "Women are simply not giving their bodies what they need to survive."
Dr. David cites a number of potential health and aging problems, including:
* Loss of calcium. If you don't eat enough calcium, or if you purge it before your body can absorb it, you're at risk for early onset of osteoporosis. The brittle bone disease, which usually attacks after menopause, weakens bones and leads to frequent bone fractures.
* Intestinal problems. Depriving your body of food may hurt its ability to digest food. That can cause problems during recovery from anorexia or bulimia, when women who have starved themselves find it difficult to gain weight.
* Heart and kidney trouble. Again, malnutrition weakens your organs, sometimes leading to irregular heartbeat and permanent damage to heart tissue and kidneys.
* Cosmetic problems. These include hair loss, broken nails, dry skin and rashes around the mouth. Women with bulimia sometimes develop ulcers on the backs of their hands caused by stomach bile that touches them when they force themselves to vomit.
* Loss of tooth enamel. Caused by stomach bile that touches teeth while vomiting, this can progress to tooth loss and degeneration of jawbone.
* Amenorrhea. When your body weight drops too far, menstruation stops. Some younger women with anorexia have never had periods.
* Emaciation--and even death. Statistics show that as many as 10 percent of people with anorexia literally starve themselves to death.
* Hypothermia. Without enough fat in your body, you're at risk of losing body heat dangerously fast.
Do You Have Anorexia?
If you think you might have anorexia nervosa, answer these questions from the American Psychiatric Association: 1. Is your body weight 15 percent or more below normal? (A five-foot-five woman with a light build should weigh at least 127 pounds. Fifteen percent less than that is 108 pounds.) 2. Do you have an intense fear of gaining weight or becoming fat even though you already weigh less than normal? 3. Have you missed at least three consecutive periods? If this sounds like you, experts say it's time to see a doctor. |
Breaking the Grip
Anorexia and bulimia are both classified as psychological disorders. Diagnosis can be tricky, Dr. David says, since doctors are not always trained to look for signs of eating disorders.
Even when doctors diagnose anorexia or bulimia, recovery can take months or even years, Meehan says. Some women overcome the disorders without ever seeing doctors or psychologists, though no one knows how many women have beaten anorexia or bulimia by themselves. "It's tough to estimate," Meehan says. "The people who overcome it on their own don't come in for treatment."
Women who seek help can expect to attend a number of therapy sessions with psychologists or psychiatrists in one-on-one, family and group settings. Treatment for anorexia can sometimes require inpatient hospital stays to help women stabilize their bodies and gain weight.
Underlying psychological problems may come to light during therapy, Meehan says. Researchers believe that as many as 50 percent of women with anorexia and 75 percent of women with bulimia suffer from clinical depression. For some women, doctors prescribe antidepressant drugs such as fluoxetine (Prozac), according to Robert L. Spitzer, M.D., professor of psychiatry at Columbia University's New York State Psychiatric Institute in New York City.
Dr. David says many of her patients come from dysfunctional families, with histories of alcoholism and physical or sexual abuse.
A Tale of Victory
For many women with bulimia and anorexia, stringent eating habits offer feelings of control over otherwise chaotic lives. "When I was 16, I discovered that I could eat all I wanted, purge it and emerge the victor," says Sara, now 40 years old. "Bulimia was an escape for me, a way to forget everything else that was going on."
Sara beat her eating disorder after a decade-long struggle. She now runs a successful health and fitness club in New York City. But it troubles her to see women in the club, many her age or older, battling anorexia nervosa or bulimia, seeking the same control that she once craved.
Even after years of therapy, Sara must still fight off cravings and old habits. "The grip is very powerful," she says. "You really have to want to overcome it."
She also admits that the stigma of an eating disorder can be difficult to overcome. She asked that her name not be used in this book, for fear that knowledge of her disorder would harm her reputation and business.
Do You Have Bulimia?
These are the key signs of bulimia, according to the American Psychiatric Association: * Rapid binge eating--consumption of a large amount of food in a discrete period of time * A feeling of loss of control during binges * A minimum of two binges per week for at least three months * Attempts to purge food through self-induced vomiting, use of laxatives or diuretics or strict dieting or fasting, or attempts to prevent weight gain through excessive vigorous exercise If you meet most or all of these criteria, experts recommend that you see a doctor. |
Taking the First Steps
While recovering from anorexia and bulimia can require outside help, experts say it's often up to women to begin their own healing process. Specialists offer these guidelines.
Practice good nutrition. Women shouldn't view food as a foe, says Dori Winchell, Ph.D., a psychologist in private practice in Encinitas, California. "Eating a balanced, proper diet won't make you fat. It will make you healthy," she says. "If you eat right and exercise sensibly, you will become the most attractive person you possibly can be."
Seek strength in numbers. For many people with eating disorders, support and self-help groups can offer needed comfort. "You're not the only person out there with an eating disorder," Dr. Winchell says. "Other people have struggled with the same problems, and sometimes it helps to share experiences."
Dr. Winchell and others suggest finding a local chapter of Overeaters Anonymous, a 12-step group patterned after Alcoholics Anonymous. You'll probably meet people with similar problems who may offer support any time you're having trouble coping. Many areas also have support groups specifically for women with anorexia or bulimia.
While these groups may not be for you, Dr. Winchell says you may at least find a friend or two with whom you can talk.
Be honest. Dr. David says the majority of women with eating disorders deny that they have problems--sometimes for years. "Anorexic women look at themselves in the mirror and say 'I'm so fat' when they are in fact terribly emaciated," she says. "You have to be true to yourself, to examine your feelings and really look in that mirror, if you're going to help yourself."
If you feel you might have an eating disorder, Dr. David advises you to see a doctor immediately.
"These are serious disorders," she says. "Your long-term health can be at stake."
