Understanding Eating Disorders
Dr. Vicki Harvey

Imagine a world where an ordinary daily activity, performed three times daily, is to blow up purple balloons. Blowing up these balloons is very pleasurable, but it's also a necessity to live. Everybody does it, looks forward to it, and has been doing it all their lives. Everybody but you. You used to be like everyone else. But in the past couple of years, you feel strange about purple balloons. You don't know how many is enough. Furthermore, you are terrified of them. You think if you blow up even one balloon you may become horribly ugly or fat. Or the balloons might even poison you. Everyone will notice, and your life will be ruined.

You look at others and think, They need balloons, but I’m different. Since balloons are potentially dangerous, I’ll blow up as few as possible. Then I’ll be OK.

The problem is, you can never get your balloon blowing regulated normally. Some days you hardly blow at all; other days you blow so many you are sick and disgusted with yourself. Soon this mess with the balloons is all you can think about. It is consuming your waking hours. Should I or shouldn’t I? Is it good, or bad? Am I ugly, or pretty? You long to be free. You hardly know yourself any longer. You have no feeling, no life inside. You have nothing to look forward to when you wake up. Just the torment and the mocking of purple balloons.

This preposterous fantasy is an attempt to help you enter the hellish world of eating disorders. People suffering from bulimia (repeated binge eating followed by self-induced vomiting or purging) and anorexia (self starvation) struggle with severe problems of body image, balanced eating, discipline and self loathing. People suffering from anorexia have deliberately restricted their food intake to the point that they are at least 15 percent below ideal body weight.

Both anorexia and bulimia primarily inflict teenage girls and young women, although the incidence of occurrence among young men is on the rise. The problem has reached epidemic proportions in our society. There are more than five million diagnosable anorexics and bulimics in the United States. One percent of teenage girls in the U.S. develop anorexia and at least one thousand die each year. Up to 5 percent of college women in the U.S. are bulimic. In addition to people actually suffering from anorexia and bulimia, another 20 million Americans demonstrate eating-disordered thinking that could quickly switch to an active disorder.

"In addition to people actually suffering from anorexia and bulimia,
another 20 million Americans demonstrate eating-disordered thinking that could quickly switch to an active disorder."

The most frightening aspect of this problem is how distorted the person’s thinking is about his or her body and the impact of even the smallest amount of food upon it. Girls are convinced if they eat more than lettuce, for example, they will gain more weight than they can exercise off. Many teenage girls with eating disorders complain that they are fat, even when others see them as little more than skin and bones.

Jennifer, 1 for example, is a 17-year-old bulimic. Until a year ago, she was a straight A student, active in the school drama club, track, and student council. She was president of her church youth group and tutored underprivileged children on Saturday mornings. Jennifer is the only child of a physician father and a mother who is CEO of the local chamber of commerce.

About eighteen months ago Jennifer and a good friend, Rachel, began hanging out at each others' homes looking at fashion magazines and comparing their bodies with the models they saw there. About the same time, Jennifer tried out for the cheerleading squad and was not chosen. She was not used to losing and was devastated. Always slender and attractive, Jennifer began to imagine she had not been selected because she was too fat. She began dieting, but quickly decided she was not getting the results she wanted.

Once she tried throwing up after dinner. It felt weird but also instantly cleansing. Her stomach felt flat, and she liked the accompanying empty feeling. She began doing this regularly and soon her entire day was filled with thoughts of how to get enough food for a binge, and then how she could get rid of it without anyone being the wiser. It was not unusual for her to throw up six times a day.

Jennifer's grades began to plunge. She dropped out of most of her activities because they interfered with her schedule for bingeing and purging. Finally, a school counselor contacted Jennifer's mom who confronted Jennifer. At first she denied anything was wrong. But when her mom persisted, Jennifer admitted she was feeling out of control with her obsession. She agreed to go for counseling and began to see a physician for the problem.

After a few months she began to find the emotional roots of her problems. Being the darling only child of two driven, successful parents put her under a lot of pressure. She felt she could never live up to their expectations. Deep down she wondered if they truly loved her. And she sensed her parents' underlying unhappiness which they were trying to mask with their own extreme work ethic.

Jennifer felt responsible somehow, for their pain, and unconsciously tried to solve their problems and earn their love by pleasing them every way she could. This was at the expense of her own childish innocence and vitality. She grew up too quickly and now felt angry as well as empty and lost inside. The immediate feeling she received by stuffing herself with food followed by the "magic solution" of purging was a powerful, but sadly temporary antidote to these feelings.

It took many months of learning how to accept herself as she was, and to admit her neediness and discover alternative means of fulfillment and good feelings in life, before Jennifer could move beyond her addiction to food to embrace a more healthy identity. She will always have to be alert to her tendency to seek solace in food and thinness, but now she has tools with which to recognize and combat the problem. Her grades are at a B level, and she is learning that she doesn't have to be perfect in order to love herself.

If you know someone whom you suspect has an eating disorder, don’t minimize or ignore the problem. Talk directly and honestly about your concerns, but avoid being critical or judgmental. At first, they will probably deny anything is wrong. People with bulimia and anorexia are very secretive about this part of their lives. People who are scrupulously honest in every other area become unbelievably devious about this!

If they don’t open up, make it clear that you are concerned and also emotionally available. Ask how you can be supportive. Don't push, but make it obvious you care and want to listen to whatever they want to share. Women with eating disorders often have the erroneous perception that they don't matter to anyone. Make sure they have a trusted friend in you, whether you are their parent, relative, or church youth leader.

If they talk about their fears of being fat, don't argue with them. And don't get into discussions about what they are doing to their bodies. All the facts in the world do not matter because their perception of themselves distorts reality. Remember that an eating disorder is a symptom that a person feels terribly about him or herself and has little control over her life. They think nothing they do is good enough, so they resort to the idea that if they could at least get really thin, then they’d be a success at something.

Gently persist with the idea that they must talk to a professional. People do not grow out of eating disorders on their own. They are complex and deep rooted and involve deeply painful feelings.

"Remember that an eating disorder is a symptom that a person feels terribly about him or herself and has little control over her life. "

While it is best if the person seeks help without coercion, there are times when you have to take more drastic action. If a child is under eighteen, and you, a parent, are concerned about weight loss, dehydration, or symptoms of physical jeopardy, contact your physician and a therapist experienced with eating disorders for help.

Above all, become a living example to this troubled person through your own life. Avoid diets and preoccupation with thinness and food. Be physically active and enthusiastic about life. Try to evaluate your tendency to affirm others' worth based on performance. Begin demonstrating that it is the person, not their accomplishments, that is important to you. Admit that you get angry, frustrated, afraid, and needy. Talk about your own feelings and emotional and spiritual needs and model how to take responsibility for them. Seek professional help yourself when necessary.

The proliferation of eating disorders is just one more sign of our unbalanced society. As individuals and families, we can reject many of the values portrayed by the media and the culture. Within our own circles return to lives anchored in the meaning of the person as God sees us—complex and unique souls deeply loved and cherished for the spirit within—not for a skinny model look.

1. Jennifer is a fictional composite of traits, family, and environmental factors typical of the eating disordered client.

NOTE: For more information on eating disorders, see the home page of the American Anorexia Bulimia Association, Inc. at www.aabainc.org.

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