The dangerous cult of thinness

Both anorexics and bulimics overvalue body thinness. At the same time, they have an exaggerated fear of fatness.

By: Russell Marx, M.D.
   Everywhere you look, the ideal of thinness, especially for women, is promoted as the ultimate goal.
   Many people have been persuaded into accepting an artificial, impractical, even unhealthy image of the human form. But society’s ideals are at war with the natural design of our bodies. The war takes place on a vulnerable battleground: our minds.
   People who are especially susceptible to social pressure — hose who have never developed a healthy sense of self-esteem — will go to extreme lengths to avoid ostracism and rejection. They will sabotage their own bodies for the sake of an artificial, unnatural concept.
   When the social pressure to be thin meets an everyday temptation — the abundance of tasty food — it can produce an extreme reaction in the form of an eating disorder.
Anorexia and Bulimia:

"Spectrum Disorders"
   Anorexia and bulimia are considered "spectrum" disorders. Like
the spectrum of light in a rainbow, anorexia and bulimia appear in a range of
intensities. Anorexia is characterized by starvation; bulimia is notorious for
its cycle of bingeing and purging.
   While there are distinctions between the two conditions, there are certain common denominators. Both anorexics and bulimics overvalue body thinness. At the same time, they have an exaggerated fear of fatness.
   Patients who start off with anorexia find it difficult to maintain constant starvation, so they eat. They then often adopt such measures as self-induced vomiting to keep their weight down.
   Conversely, patients who begin by bingeing and purging may eventually try starvation as their only means of restricting food intake.
   This passage from one kind of eating strategy to another affects the treatment they require. Both anorexia and bulimia involve an obsession with food. As the disease progresses, thoughts of food come to dominate every aspect of their lives, at the expense of family, friends, careers and health.
   Anorexia and bulimia are life-threatening conditions that must be treated aggressively and thoroughly.


Who is Most at Risk?
   People who are at special risk of an eating disorder include
those who:

  • Have low self-esteem;

   

  • Are overly sensitive to the opinions of others;

   

  • Carry the concept of self-control to extremes;

   

  • Have difficulty separating from their families, and/or
  • Work in occupations that require a high level of body-awareness, such as modeling,

dancing or acting.
   When people with these characteristics suffer stress —
for example, the death of a relative, a move to a new school or city, or a personal
loss such as the breakup of a romance — an eating disorder is sometimes
the result.
   While most anorexics and bulimics are women, about five to
10 percent are male.
   Family problems can contribute to the onset and severity of
an eating disorder but they don’t cause it. Research has shown that children
with eating disorders come from many types of families, including healthy, functional
families.
   Contrary to a common misconception, dieting does not necessarily
lead to eating disorders. Many patients did diet before their disorder arose,
but others who diet never develop an eating abnormality.
   Why eating disorders arise in some people and not in others
is the $64-thousand-dollar question. There may be a biological factor, a psychological
push, family dynamics or socio-cultural pressures.
   Many eating disorders are triggered in adolescence during
the development of self-identity. These pressures can merge and result in a
desire to create an identity based on the ability to control food and eating.
But defining self-worth through abnormal eating is a dangerously unhealthy preoccupation.
The Warning Signs of Eating Disorders:
   Family and friends who think something is wrong should be
on the lookout for warning signs of an eating disorder. These red flags can
include:   

  • Severe weight loss;
  • Preoccupation with being thin and/or an intense fear of being overweight;
  • Severe diets or odd behaviors about food;
  • Signs and symptoms of depression;
  • Loss of menstrual periods;
  • Hyperactivity, compulsive exercising;
  • Distorted body image;
  • Unexplained medical problems including hair loss, slow pulse, intolerance
    to cold;
  • edema (swelling of the ankles);
  • low body temperature;
  • Dental damage (due to vomiting);
  • Weakness, and/or
  • Sleep disturbance.

The Medical Dangers of Eating Disorders:
   Your body needs food to function. Poor eating damages the
body in many different ways, and some of these medical complications can be
fatal.
   A slowed heart rate is a common effect of starvation. Fatal
cardiac failure can occur if weight is regained too rapidly. Starvation also
reduces the ability of bone marrow to produce blood cells, resulting in anemia.
   As the starving body "turns down the thermostat" to conserve
energy, the thyroid reduces its functions, slowing down the metabolism. Another
major problem is osteoporosis, a decrease in bone mass that can make the body
vulnerable to fractures.
Steps to Recovery: Diagnosis and Treatment
   If you have an eating disorder or if you are the parent of
an anorexic or bulimic child, don’t condemn yourself: you are not to blame.
   Start by educating yourself: read, learn as much as you can,
and seek professional help. The critical moment in the process of helping a
patient with an eating disorder get better begins with a diagnosis —
giving a name to the medical condition. The aim of any therapy is to help the
patient return to a normal life.
   The Eating Disorders Program at University Medical Center
at Princeton offers comprehensive services for the treatment of eating disorders,
including acute inpatient and partial hospital programs. There services are
directed at men, women, girls and boys as young as the age of 8.
   Eating disorders cause stress on family members as well, and
that’s why there is counseling available for family members and tutoring for
school-aged children and adolescents.
   To learn more about the Eating Disorders Program at the University
Medical Center at Princeton, call (609) 497.4490. To find a physician with Princeton
HealthCare System, call (888) 742-7496 or visit www.princetonhcs.org.