The truth about eating disordersWritten by Focus on the Family
Sara is an intelligent, talented girl from a Christian family. She's also a perfectionist. When she was young, she took ballet lessons for five years. In high school, she participated in other sports, as well as modelling and life guarding. These activities constantly drew attention to her body and weight, so they kicked her perfectionism into overdrive. In order to maintain what she felt was an acceptable size, Sara started skipping meals.
Growing up, Tiffany never felt the freedom to be herself. A deep need to please people caused her to become, in her words, "a chameleon melting into whatever anyone wanted me to be." And coming from a family that focused on food and diets, she learned that thin is what people wanted. She began experimenting with dieting in the first grade, and by the time she was a high school senior, Tiffany was caught in the trap of anorexia and bulimia, dropping 54 pounds from her 5-foot, 4-inch frame.
Lucas wrestled throughout high school and college. Although his high school coach never pressured him about his weight class, when he got to college, the rule was "make a particular weight class or don't wrestle." Because of this demand, Lucas once lost 21 pounds in five days. He regularly fasted for days before matches and then binged for days afterward due to the intense hunger that set in.
Shorts and swimsuits were a part of Florida-born Kelly's everyday wardrobe. She wanted a thin body to fit in with the attractive, athletic crowd of friends she hung out with on the beach. Besides that, her church was very legalistic, and her parents quite controlling. She learned that the same dieting habits that helped her stay thin were also a way for her to feel in control of at least part of her life.
What's your story?
Sara, Tiffany, Lucas and Kelly are real people who lived through an eating disorder. Their stories represent thousands of teens who struggle daily with their weight and appearance. Sometimes the demands of a sport or pressure from peers and family feed the disorder. Other times, teens don't know how to react to the physical changes that come with adolescence and they panic, desperately trying to stop this natural, healthy weight gain. Still other teens use food and weight-control to get attention or bring stability to a world that seems to be in chaos. No matter what their roots, eating disorders are dangerous and hurtful to bodies, emotions and relationships. If you or a friend is struggling with an eating disorder, keep reading. You will find help and hope in solid information and in the stories of those who have fought this battle and won.
Eating disorders 101: What are the facts?
- Between 11 and 13 million Americans suffer from eating disorders.1
- 13 per cent of high school girls purge, and 30 to 40 per cent of junior high girls worry about weight.2
- Anorexia nervosa has the highest mortality rate of any psychiatric disorder, as high as 20 percent.3
An eating disorder is an unhealthy way of using food to cope with psychological stress. If you're fighting this food battle, you're probably dealing with one of the following problems:
Anorexia nervosa: You intentionally starve yourself. You have a radically distorted view of your body. Even when your weight drops dangerously low, you still see a fat person in the mirror, so you avoid eating in order to lose weight. You may exercise compulsively. If you notice these characteristics, be careful: Anorexia destroys health. It can cause you to have a slow heart rate, reduced body temperature and low blood pressure. Your digestive system is impaired. If you're a girl, your menstrual cycle is interrupted – or it may stop altogether. Hair falls out. Muscle tissue is lost. Brain function and size can even be reduced. Teenagers with anorexia often get osteoporosis – and never recover. Anemia and other cardiovascular abnormalities also result.
Bulimia nervosa: You overeat (binge) and then take laxatives or force yourself to vomit (purge) to get rid of the excess food. You probably feel extreme guilt after eating, but you also feel that you can't stop binging. Bulimia is just as destructive as anorexia. Complications include tooth decay and gum erosion. Body fluids become imbalanced and can lead to heart attacks. Your salivary glands are enlarged, and your digestive system is impaired. Your esophagus may even tear or rupture. Muscles (including your heart!) weaken. Your body becomes vitamin deficient, and your central nervous system can be disturbed.
“I struggled with dissatisfaction even as the weight rapidly dropped off. My mind constantly spun with thoughts of food. Vital functions of my body starved and shut down: I rarely used the bathroom, my brushes collected large clumps of hair, the loss of my monthly period struck a blow to my womanhood.” – Tiffany
“After years of anorexic eating, I began to develop health problems from lack of nutrition. I was always tired and hungry. I had little energy. My eating disorder shifted to the opposite extreme. I began overeating and then would immediately feel guilt. I would make myself vomit, hoping to reduce the feelings of anxiety. My binge-purge pattern of eating continued into college.” – Sara
It's easy to see that these disorders are disastrous for your health. In addition to destroying your body, eating disorders often cause depression and confusion, harm relationships with family and friends, and produce a sense of separation from God.4 Why? While anorexia and bulimia may have distinct physical symptoms, they're really a matter of emotional and psychological wounds that show up in physical ways.
What are some factors that might lead to an eating disorder?5
- Low self-esteem
- Feelings of inadequacy
- Defining yourself in terms of appearance
- Helplessness and a need for control
- Difficulty in managing emotions
- Social anxiety and problems with social skills
- A tendency toward perfectionism
Although the presence of these issues in your life doesn't guarantee you'll develop an eating disorder, it does place you at a higher risk. There is no foolproof way to guess who will struggle with anorexia or bulimia; people who develop eating disorders come from every race, religion and economic background. However, there are some common warning signs. If you're concerned about yourself or a friend, ask the following questions:6
- Are you frightened of situations where you will have to eat a normal meal?
- Do you have food rituals such as eating food in sequence, not allowing foods to touch each other, eating a very limited variety of foods, cutting food into small pieces or blotting with napkins to remove fat?
- Do you feel good or bad according to how much you eat, how much you weigh or how much you exercise?
- Does weighing too much make you keep to yourself and feel lonely?
- Do you spend most of your time thinking about how much food you have eaten or will be eating during the day?
- Do you use laxatives, vomiting, diet pills, excessive exercise or water pills to help you lose weight or feel in control of your weight?
- Would you eat more than others if you didn't control yourself?
- Do you sometimes feel out of control when eating?
- Do you often eat beyond the point of fullness, to the point of physical discomfort?
- Are you frequently depressed because you feel fat or overweight?
- Do you diet or fast (other than for Biblical purposes) weekly or monthly?
- Do you feel that, if you could lose weight, you could achieve all your other goals?
- Do you restrict your eating, or overeat, when you are stressed or feel unhappy?
The root of the problem
If answering these questions feels like looking in a mirror, it's time to turn a 180. Discovering these signs in your own life can be overwhelming. You may have a sense of sliding down a dangerous slope and not being able to stop. On the other hand, seeing these symptoms in the life of someone close to you may be confusing. What makes your friend act the way he or she does?
Sometimes understanding the source of emotional stress is the best way to begin dealing with an eating disorder. If you're the one struggling, this knowledge can help you look at your pain more objectively and fight it in a way that's healthier than disordered eating. If you're watching a friend battle anorexia or bulimia, understanding where he or she is coming from can help you to respond in a caring, constructive way.
From rapid physical development to the need for love and attention, emotional trauma can come from lots of sources. Let's take a look at some of the primary stresses that contribute to eating disorders.
What's happening to my body?
Between your parents and your health class, you've probably been sufficiently warned about the physical changes that happen during adolescence. And it may seem like a no-brainer, but along with all this growth and change comes a natural increase in weight. Between ages 11 and 16, most girls grow 7 to 9 inches and gain 35 to 50 pounds. And most boys grow 10 to 12 inches and gain 40 to 80 pounds.7 Even though this is perfectly normal, the sudden increase in weight scares some teens into thinking they're "getting fat."
"I had been forewarned that my body would change and mature during adolescence, but I had no idea that weight gain was a normal part of this process. As I began to put on a few pounds, I panicked. I felt overweight and abnormal, like my body was out of control.” – Sara
To complicate things even more, weight gain and height growth are not perfectly synchronized, so almost everyone will go through phases of being chubby or awkwardly skinny at some point during adolescence. Instead of panicking over what you see in the mirror day to day, remember that the best indicators of what your adult body will look like are genetic factors within your family. So relax. Take good care of your body. And be patient. Soon the ups and downs will level off into a more stable adult size and shape.
Truth: A female who diets before the age of 14 is eight times more likely than other girls to develop an eating disorder.8
If your family has a history of being overweight, it is important that you maintain a balance of healthy eating and exercise. But the key word here is balance! Exercising compulsively can be just as unhealthy as anorexia or bulimia. And anytime one area of your life causes you to obsess, it's an indication that something is wrong.
Competing for thinness
Athletes are usually among the most disciplined and fit of all people. Unfortunately, the rigid standards of some sports and the unrealistic expectations of some coaches and parents can drive young athletes to practice unhealthy dieting habits. In fact, a recent study of 562 athletes found that 58 percent of the females and 38 percent of the males were at risk for developing an eating disorder.9 This is especially true in sports where being small or thin is a competitive advantage.
Sports that present the highest risk for developing eating disorders include:10
- distance running
- figure skating
- cross-country skiing
- body building
Truth: Sixty per cent of ballerinas and other athletes whose fields require leanness practice disordered eating and dieting.11
Male athletes may not go through the emotional distress that many females with eating disorders experience. A girl's identity and self-worth often become closely tied to her success at shedding pounds. For guys, a certain weight may be just a goal to meet in order to do well athletically. But even if guys don't get psychologically addicted to losing weight the way girls do, they still need to be careful not to do permanent harm to their bodies thorough unhealthy dieting.
"Most wrestlers suffer from self-inflicted starvation. I've had teammates who lost up to 27 pounds in a short period of time. It was never viewed as an eating disorder, and especially never labelled anorexia. Most view it as a necessary evil and see it as much a part of the sport as practice and weightlifting. . . . The negative symptoms of 'cutting weight' are numerous – stunted growth, muscle deterioration, dizziness and fainting. Many wrestlers become irritable, bitter and angry from depriving their body of food." – Lucas
Whether you're a girl or a guy, being an athlete won't automatically cause you to have an eating disorder. In fact, some team sports actually protect against them. But you will need to be extra cautious so you don't fall into that trap. If you choose to participate in the "risk sports" (gymnastics, figure skating, dancing, synchronized swimming, wrestling), make yourself accountable to a mature, objective person such as a school counsellor, youth leader or school nurse. Ask this trusted adult to give you feedback on your health. Parents, coaches and teammates may be too close to the situation to be your sole source of accountability.
Looking for love
Some teens who fall into an eating disorder have the desperate feeling that no one loves or even notices them. They may feel neglected and abused, and food becomes a way to bring control back to their lives. Sometimes a traumatic experience or loss is at the root of their struggle. Others start losing weight to look good and then discover that the rapid weight loss gets them lots of attention. So the cycle continues: they keep losing weight, even when they know it's unhealthy, just to elicit more attention from parents, doctors or counsellors. Most commonly, teens feel that if they can just reach a certain size and weight, they'll be accepted by those around them.
"Frequently I would compare myself to others, longing to know that I was accepted. I daily battled low self-esteem. Because I believed that my personal worth was determined by my accomplishments and appearance, I tried to develop an identity of significance through external means: academics, leadership, sports, service, etc. I thought that if I met my own high standards, I would be valuable to others." – Sara
"Hunger reflected and expressed my needs. Food became much more than a means for survival or a way to maintain control in my life; it became a symbol for love." – Tiffany
"I had been starting toward anorexia, and two years into it, I was date-raped. That experience validated all the fear I had about not having control over my life, not being respected and not being heard. It was the clincher in my becoming anorexic.” – Kelly
A high-pressure society
"In a society where thinness is equated with success and happiness, nearly every American woman, man and child has suffered at one time or another from issues of weight, body shape and self-image."12
Why do so many teens turn to food-control as a source of stability, attention and acceptance? Why does body image have so much to do with our self-worth? While there's no simple explanation, part of the answer is that we live in a world that places excessive value on looking good, being thin and staying in style.
But wait! Who decides how thin is thin enough? And who sets the standards for what "beautiful" means?
The people who determine society's standards of beauty haven't had some magical revelation of what perfection is. They just happen to control the diet, fitness, fashion and cosmetic industries. The message they're sending is "perfection is possible . . . if you use our products." And sex appeal sells, so TV and movies also profit from promoting the lies that beauty equals success, that perfection is attainable and that thinness leads to happiness.
Of course, they always make sure that perfection is just out of reach – so that we keep on buying their stuff without ever being satisfied. Want proof? Follow the money trail: The diet industry rakes in $33 billion a year from people who believe that "thin is in!"13 And in the mid-1990s, the number of people forking over the cash for cosmetic surgery rose 70 per cent in four years.14 As long as these industries can keep us believing that beauty will be attained with our next purchase, they've got us right where they want us.
Sadly, many people are buying into these lies. That's why 80 per cent of adult women and, even more frightening, 50 percent of 9-year-old girls say they've dieted.15 What happens when the diet doesn't work, or worse, when it does work, but the results still aren't satisfying? These girls are setting themselves up for an eating disorder. They've been given an unrealistic idea of what is beautiful or even normal. They've tried to reach that ideal and failed. And increasingly, they're willing to do destructive things to their bodies in order to achieve that image at all costs.
What is beauty?
What most of these girls don't realize is that standards of physical beauty have a habit of changing as time passes. Before the 20th century, being "portly" or "plump" (in today's words, "fat") was a sign of wealth and having enough to eat, so it was considered desirable and beautiful. Advertisements of that time period promoted products to help people gain weight.
In the 1920s the boyish flapper look was in. The 1950s idealized Marilyn Monroe. By today's standards she would be fat. Twiggy came on the scene in the 1960s, glamorizing the anorexic look for the first time – she was 5 feet, 8 inches and weighed 97 pounds. Elle McPherson personified the strong, lean look desired in the 1980s. Today, top models are 5 feet, 9 inches to 6 feet and weigh 110 to 118 pounds, even though the average woman is 5 feet, 4 inches and weighs 142 pounds.16
"I've always thought Marilyn Monroe looked fabulous, but I'd kill myself if I was that fat." – model/actress Elizabeth Hurley17
"Being a film star is a label and seems to me not to be about whether you are a good actor, but about the size of your breasts, the size of your body, whether you've had a facelift or a nose job. None of that stuff interests me." – actress Kate Winslet18
Since standards of beauty change so rapidly, is it really worth our time, effort and tears to conform to them? No! And it's certainly not worth doing permanent damage to your body to live up to a standard that will probably change within a decade.
"I wouldn't say that society is where my disorder began, but I would say that it affected me as the struggle continued. There were many times that I watched TV and thought, I could never be as skinny as those girls. Looking at magazines, I felt like I was always in competition and never able to win. Even though I was just as skinny or skinnier than those I saw plastered on advertisements, I still felt the pressure. The media play with the mind and increase the competition for any young girl." – Tiffany
Debunking the lies
Our image-driven society wants us to think that everyone should have the same ideal body size and shape, regardless of genetic predisposition. If we believe this myth long enough, we also start thinking that our value as a person is based on how close we come to this ideal. If we're going to change our attitudes about eating, weight and appearance, we've got to start recognizing these ideas as lies.
To do that, it is vital that we develop the skill of independent, critical thinking. Culture slips falsehoods into our lives in subtle ways – a through television, movies, music, magazines and advertisements. Tragically, the false messages are sometimes reinforced by our families and friends. No matter how much you're being bombarded by the lies, don't buy into them.
Instead, learn to pick apart the messages you're receiving from society. For example, talk with your friends about celebrities whose lives are dysfunctional and filled with problems in spite of having the "perfect" body. This may help you realize that looking like a cover girl or poster boy won't solve all your problems.
"No actress, model or singer is perfect. Stars have makeup artists and computers that airbrush us. So if you're anorexic or bulimic, and you're killing yourself to look like one of us, realize we all have flaws. That's what makes us who we are." – TLC's T-Boz19
"Eating disorders are lies that form these nice little structures inside your brain. You have to tear down those structures gently and rebuild them with stuff that's solid – replacing lies with the truth. And it's got to be God's truth." – Kelly
Nothing but the truth
If we're going to start believing the truth about appearance and weight, we've got to go to the ultimate Source. What does our loving heavenly Father have to say about our bodies and real beauty? Check out these Scriptures:
- Genesis 1:27 – You were made in the image of God.
- Psalm 8 – In the whole wonderful universe, He gives you a place of honour.
- Proverbs 31:30 – Outward appearances don't matter as much as what's inside.
- Zephaniah 3:17 – The God of the universe takes delight in YOU!
- Romans 5:8 – God loves you enough to send His Son to die for you.
- 1 Peter 3:3 – How you look is not what really makes you beautiful.
Look especially at Psalm 139. The author of that poem knew that the human body is among God's most miraculous creations. He thanked God for carefully forming our bodies even before birth – for creating us each unique and incredibly special. If God created our bodies, then they are good!
"Part of my healing process was the discovery that who I am is more important than how I look or what I do. I realized my need to place more emphasis on my character than my image." – Sara
Truth: Your body is important because God created it – not because it looks a certain way.
An ounce of prevention
While almost everyone suffers from the influence of our culture's lies, not everyone will respond by developing an eating disorder. If you're not already in that trap, here are some practical ways to avoid it:20
- Examine your attitudes and behaviours regarding weight and appearance.
- Avoid categorizing food as "good" and "bad."
- Recognize food as fuel for your body and eat sensibly.
- Don't avoid activities like swimming or water-skiing just because they call attention to your weight and shape.
- Make a list of all your strengths – creativity, intelligence, compassion, patience, goodness, faithfulness, etc. Don't include physical appearance. Focus on these gifts and talents that God gave you.
- Look at what's wrong with the "thin is best" message rather than what's wrong with your body.
- Be responsible and do not discriminate against anyone because of weight or physical appearance.
- Take part in activities and friendships that enrich your self-image, and refuse to focus on things that emphasize your physical appearance.
- Remember that there is no ideal body shape, size and weight.
- Begin to accept yourself in all circumstances; avoid dieting and stop condemning yourself based on physical size or lack of perfection.
- Most important, surrender your body and heart to God and know that God created you and loves you no matter what you look like.
"The body is like a machine that needs the right mixture of 'gas and oil.' It needs to be properly maintained in order to operate at its full potential. Wrestlers often try to cheat the system and eat improperly in order to get ahead, but the result is a lockdown of the system. A wrestler can best honour God with his body by studying his specific body needs and finding the best source to fulfill those needs, helping the body to operate at its full potential." – Lucas
What if I'm already struggling?
Maybe you're living life brokenhearted – having a hard time seeing yourself as God's treasured creation. Maybe you're tired of deceiving others into believing that everything is all right. Has thinness become your god? Do you feel as though no one can understand your feelings? God wants you to rest in Him. He knows your hurts and your desire for acceptance. Your life is not hidden from the One who loves you and created you. Let Him call you to obedience and renew your strength as you meditate on the following Scripture:
"Why do you say ..., 'My way is hidden from the Lord; my cause is disregarded by my God'? Do you not know? Have you not heard? The Lord is the everlasting God, the Creator of the ends of the earth. He will not grow tired or weary, and his understanding no one can fathom. He gives strength to the weary and increases the power of the weak. Even youths grow tired and weary, and young men stumble and fall; but those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint." Isaiah 40:27-31
Though eating disorders mean serious danger to your life, there is hope. You first have to be willing to admit your struggle and ask for help. Many people who suffer from anorexia or bulimia feel utterly alone and think that telling someone will bring more rejection and disappointment. Thankfully, this is not true, as long as you are wise about whom you confide in. A close friend or adult who is a mature Christian can encourage you, pray for you and hold you accountable for practicing healthy eating habits.
"Being aware that I had a problem was the first step toward getting help. I realized that while I was fighting the illness – and it really is an illness – I kept people at arm's length to a greater and greater degree. I had to realize that I had a need; I had to search out people whom I could trust and allow into my world. And the more I trusted, the more I gave people a chance to know where I was and help me. The more I was able to do that, the healthier I was, and the fuller my life was, and the less need there was for control." – Kelly
Depending on the severity of your situation, different types of assistance may be required, from counselling to hospitalization. In fact, according to eating disorder experts, "eating disorders are complex disorders that require psychological, medical and nutritional treatment. They are best treated by a team of professionals well trained and experienced in treating these difficult problems. Likewise, strong relational support from family and intensive support groups are vital in the recovery process."21
Truth: You can completely recover from an eating disorder – the sooner you get help, the better your chances are for recovery!
"As I faced therapy, the thought of running away and hiding within the safe walls of anorexia encompassed me. I did not know what was beyond those walls." – Tiffany
Though telling someone your secret may be terrifying, there is no better time to get help than now! If you don't know where to turn, you can reach Focus on the Family Canada's counselling service by phoning 1.800.661.9800 weekdays from 8 a.m. to 4 p.m. Pacific Time. When you call, we will arrange for you to speak to a professional Christian counsellor who can guide you to further assistance near you.
Just remember, there is a way out, but you have to take the first step!
"I am no longer in bondage to anorexia and bulimia. Still, I need to surrender my thoughts to God daily, asking to see myself through His eyes as a unique and precious creation." – Sara
"I am a walking miracle. Five years ago I never dreamed that a day could go by and I don't think about food and weight. But now I go every day without a thought of it. For the first time in a long time, I can live a life of normalcy and allow myself the freedom to just eat. More than anything today, I am aware of God's love for me. I am also aware of the responsibility I have for my life. I have quit blaming and have chosen to live and strive for what is ahead." – Tiffany
All scripture quotations are taken from the HOLY BIBLE, NEW INTERNATIONAL VERSION®. NIV®. Copyright ©1973, 1978, 1984 by International Bible Society. Used by permission of Zondervan. All rights reserved.
1."Facts About Eating Disorders: What the Research Shows," Eating Disorders Coalition, eatingdisorderscoalition.org. See also remudaranch.com.
2.Journal of the American Academy of Child and Adolescent Psychiatry.
3."Facts About Eating Disorders: What the Research Shows," Eating Disorders Coalition, eatingdisorderscoalition.org..
4.Marian Eberly and Bonnie Harken, Help and Hope for Eating Disorders (Focus on the Family, 2000), 6-7.
5.Bulleted information courtesy of Remuda Ranch, remudaranch.com.
7.CDC 2000 "Stature-for-Age and Weight-for-Age" report.
8.L.K. George Tsu quoted by Paula Levine, Ph.D., presentation at the 1995 Eating Disorder Awareness and Prevention State Coordinators' Conference.
9.A. Laureate quoted by Marsha Alexander-Meler, R.N., and Carol Tappan, B.A., The Eating Disorder Institute (Methodist Hospital and Health System, 1996).
10.Bulleted information courtesy of Remuda Ranch.
11.Kathryn Zerbe, M.D., The Body Betrayed (American Psychiatric Press, 1993), 138-139.
12.American Anorexia Bulimia Association, Inc: www.aabainc.org.
13.Karen S. Schneider, "Mission Impossible," People, June 3, 1996.
14.American Society of Plastic and Reconstructive Surgeons, Colorado Springs Gazette, November 29, 1998.
15.Karen S. Schneider, "Mission Impossible," People, June 3, 1996.
17.Jump, May 2000.
18.ABC News Online, February 4, 1999.
19.YM, May 2000.
20.Bulleted information courtesy of Remuda Ranch.
21.Eberly and Harken, 19.
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