I recently showed a group of
graduate students what is now an outdated documentary by NOVA, Dying to Be
Thin, narrated by Susan Sarandon. The program depicts the extreme forms of
eating disorders among teens and young women: the anorexic ballet dancer, the
bulimic adolescent trying to maintain a sense of control in a dysfunctional
family, a marathon runner at risk for heart problems, and the recovered woman
suffering in her 50s from osteoporosis. Clichés perhaps, but he program is still
relevant.
At one residential treatment center you see young girls in group therapy talk about how they learned to control their eating from a movie or a TV show about eating disorders – the very programs that try to bring awareness and foster prevention. All one has to do these days is look at an issue of People Magazine and wonder how teens interpret celebrities' plights with weight and body image. My class discussion, however, centered on what to do when a student comes to the health center for an unrelated reason, but discloses one or two eating symptoms or a weird exercise fetish. How do you intervene as a counselor or residential advisor? Or, even more common in the lives of these 20-somethings, what can you do as a friend?
It’s not easy, as most people with disordered eating patterns will vehemently deny they have any problem. Plus, who knows how many live with eating problems that go undetected, unbeknownst to love ones, and suffer silently.
On the books, the prevalence of classic eating disorders remains relatively low – less than 5% in the US – and that may be due to the specific symptoms needed to meet the criteria of a medical diagnosis. The people numbers, however, are staggering with estimates ranging from 10-24 million individuals. Of course, 90% of them are girls and women. What there is no statistical data for are the millions of girls – and boys – who suffer with “sub clinical” eating issues.
The medical establishment has tried to capture this grey zone with the diagnosis of “Eating Disorder not other wise specified” or Ednos. But the diagnosis is only handy if people seek help for their symptoms. Most don’t. For those who do? A mere 10% of people with eating disordered behavior receive treatment and often it is not covered by health insurance.
Now comes a New York Times article by Abby Ellin, who has previously written a book about her story: Teenage Waistland. She recently interviewed national experts on the subject, and concludes:
Perhaps the most difficult part of treating Ednos is that “normal” eating is such an elusive concept. Thinness tends to be the ideal, no matter what lengths people go to get there.
Juxtaposed to the obesity
epidemic that may strangle our health care system in the near future, it really
does leave one pondering just what can be done when there is no
"normal" anymore.
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