People, especially women, love two things that don’t often come together: sumptuous food and svelte bodies. The prevalence of eye-popping imagery in the media barrages us with visions of both, tempting us to covet both, inadvertently causing us to lose both.
Food fuels our lives. But for some, it becomes a tool of self-destruction. It works something like the proverbial “Catch 22”—we see beautiful bodies; then observe our own paunches, sags, and cellulite. In despair, we self-medicate with food. A cycle begins. We get fatter, get sadder, and then get another bowl of Fudge Ripple from the freezer. Most of us settle into less-than- perfect ﬁgures resulting from less-than-perfect eating habits. Some of us, in a desperate attempt to straddle food and ﬁtness, fall into the quagmire of disordered eating.
The two most prevalent types of eating disorders (ED) are anorexia nervosa and bulimia nervosa. Let’s get acquainted with both.
The name of this illness is inaccurate. Anorexia literally means “no appetite,” but in reality sufferers are extremely hungry and tend to obsess over food. Anorexia is characterized by severe, prolonged limiting of food intake and a refusal to maintain normal body weight. With it comes an intense, irrational fear of becoming fat and cognitive distortion regarding one’s own body image. Often anorexics, who are typically underweight, think of themselves as fat. A high rate of adolescent girls develop anorexia, perhaps in an attempt to simplify an increasingly complicated life down to one primary quest—to be thin.
The effects of anorexia can be quite grave. Left untreated, anorexics often become amenorrheic (without periods). The resultant low levels of estrogen can contribute to bone loss, and failure to shed the cells of the uterine lining each month can predispose a woman to female cancers. Malnourishment can open the door to heart problems, as was the case with singer Karen Carpenter, who dropped dead of an anorexia-related heart attack at the age of 32. The skin and hair become dry as the body attempts to economize. Lack of fat “padding” can lead to bone and joint injury. Nervous system challenges arise, including insomnia. The brain may actually shrink, exacerbating cognitive dysfunctions.
Although anorexics often feel a sense of pride about being thin, they can collapse in despair when the condition worsens to the point of health breakdown. Up to 15 percent of anorexics die—the highest fatality rate of any psychiatric illness. Most victims are young females.
Bulimia is Greek for “hunger of an ox.” This time the name matches the illness, for bulimics eat with a seemingly endless appetite. Characteristics include recurrent episodes of binging on high-calorie foods, secretive eating, compulsive dieting, use of diuretics and laxatives, and self-induced vomiting to “purge” excess, unwanted calories. While anorexics are thin, bulimics are typically average or a little overweight. They’re fully aware that their eating patterns are abnormal, but there’s a loss of control as the compulsion takes on a life of its own. Typical post-binge emotions include a sense of self-loathing and shame.
The typical binge averages more than 3,415 calories, but binges as high as 11,500 calories have been reported. Some people force-feed themselves at such levels several times a day. Typical foods of choice include calorie-dense junk foods such as cookies and ice cream, as well as bread—the purchase of which causes food bills to skyrocket.
Bulimia is called the “college girls disease” because it claims as much as one ﬁfth of the college female population.
This eating disorder isn’t often as fatal as anorexia is, but it can cause a heart attack by throwing off the balance of electrolytes that give the chemical signal necessary for the heartbeat. The digestive system of a bulimic is constantly insulted by both binge eating and frequent vomiting. The stomach becomes over- expanded, and the pancreas can become inflamed as it is repeatedly jolted into action. Esophageal inflammation, loss of natural gag reflex, and a predisposition to esophageal cancer can also result from frequent vomiting. The throat becomes strained and the vocal cords compromised from contact with stomach acid.
Bulimics sometimes experience swelling in the parotid glands, giving them a “chipmunk cheek” appearance. Frequent use of laxatives results in the breakdown of the protective mucous lining of the intestine, leaving the bowel vulnerable to diseases of various kinds.
A telltale sign of bulimia are sores that develop on the back of the bulimic’s hands as a result of repeatedly shoving ﬁngers down the throat. Impulse-control weaknesses pave the way for substance abuse, promiscuity, and even shoplifting. In attempting to understand complex issues, we often search for a simple answer. There is no one cause for eating disorders, but rather an interplay of causes that can be summed up into three categories: psychological, biological, and cultural.
Although it’s difficult to ﬁnd a typical family proﬁle for eating disorder patients, there are certain prevailing psychological tendencies in both anorexia and bulimia. These can be inherited either environmentally or genetically. Among them are perfectionism, low self-worth, sexual identity confusions, and depression.
Like so many who resort to escapist behaviors, eating disorder sufferers have trouble perceiving their real value and usefulness. Lacking this spark of personal vision and purpose, they pursue either elusive physical perfection, sensual indulgence, or both. Once the disorder is in place, they often fluctuate between self-loathing and self-indulgence. As the isolation that accompanies addictive behavior increases, the sufferer has an even keener sense of worthlessness and despair.
While not all those with eating disorders evolve from a past history of sexual abuse, many who suffer these traumas will resort to disordered eating later in life in an attempt to regain lost control. Childhood abuse generally predisposes an individual to escapist behaviors. More than this, sexual abuse often triggers feelings of abhorrence in a young person toward their bud- ding sexuality. Self-starvation can conveniently “desexualize” a person by lowering vital forces and thus minimizing sex drive. This also reduces the sexual attractiveness of the body.
More and more research is indicating that social connection has a profound effect upon physical and psychological health. Those who don’t reach out to others for help and comfort may face higher stress levels and increased health risks, including EDs.
There exists an intimate and well- documented relationship between the mind and the body. Thoughts can affect health dramatically. The reverse is also true—the body can affect the mind. Since the mind is housed in a physical organ, and that organ is connected to other bodily organs and systems, the condition of the body can powerfully impact thoughts and emotions. Because of this, biological factors can contribute to eating disorders.
For instance, research has linked eating disorders with a family history of depression and other mental health problems such as bipolar dis- order. This suggests a genetic predisposition, especially to bulimia. This genetic factor does not always cause an eating disorder, but can con- tribute when combined with other factors.
Various feminists have spoken out on the exploits of fashion contained in books and magazines that focus upon dieting, eating disorders, and something called “looksism.” Looksism is characterized by two things: an undue emphasis upon the importance of physical appearance, and a distorted ideal of beauty. This phenomenon has factored into the eating disorder issue by placing pressure on women to be “ﬁgure- perfect.” At the same time, it has purveyed a distorted definition of what the perfect ﬁgure is.
When the gangly Twiggy made her debut in a 1965 issue of Vogue, she was ﬁve feet six inches tall and weighed 97 pounds. Suddenly teen girls discovered that they had to be rail thin in order to be fashionable. Such standards change at the whims of the fashion industry. As women try to outdo one another by redeﬁning beauty in their own terms, every- thing from muscle-man athleticism to oversized breasts are idealized. But the rail-thin idea of beauty has been a constant in the catwalk culture simply because clothes hang on the models’ waif-like bodies as they would on a hanger, thus keeping the focus on the clothes. This is why victims of eating disorders are more often young women. Unlike their older, more mature counterparts, teens and college-aged girls strive to follow fashion trends.
In the early 1900s women’s magazines began to extol a thinner and thinner ideal of beauty. As the model female weight has decreased, two things have increased: the weight of real women, and eating disorders. It seems that the more unrealistic and unattainable the perfect body becomes, fewer women actually try to reach it. Of those that do, more and more are resorting to anorexia and bulimia.
Complex Interplay of Forces
Why some women explore these practices and others don’t is due to a complex interplay between psychological, biological, and cultural forces. One woman is surrounded by a looksist society, but her family of origin was nurturing; she’s well-connected socially, maintains a strong faith, and has no genetic tendency toward depression. Another woman is ensconced in the same looks-obsessed society; but she was sexually abused as a child, is disconnected socially, and depression runs in her family. The ﬁrst woman never develops an eating disorder. The second one battles anorexia or bulimia for years.
Thank God there’s more to the ED picture than the odds life has dealt. There’s a mysterious, often unmentioned factor called choice, which is what makes the ultimate difference. Choice is the way an ED sufferer avails him or herself of the grace of God as well as the lifestyle and treatment options available. The sufferer may have the psychological, biological, and cultural odds stacked against him or her, but there’s still hope of recovery. This will be our focus in Drop Dead Beautiful, Part 2.
Singer, speaker, and anorexia nervosa survivor Jennifer Schwirzer is the author of several books including Dying to Be Beautiful. She’s a mother of two and lives with her husband, Michael, in Pennsylvania.
Originally published in Vibrant Life, used with permission.