By Stephanie Allmon
WACO, Texas -- When most people see a cupboard full of food, they
see just that -- food.
But when people with eating disorders see the same cupboard,
they may see opportunities for control, for a meaningful
relationship or for a way to feel loved.
More than 5 million people suffer from eating disorders in
America, and anorexia nervosa (starving oneself) and bulimia
nervosa (bingeing and purging) are the most common. Both can lead
to long-term health problems and even death, experts say.
Looking into eating disorders from the outside, it's easy to ask
why anyone would starve herself to death. It's easy to think it's
ludicrous to consume and then vomit entire meals. It's easy to
think that eating disorders are about food.
It's more difficult to understand that they are not.
``It's a combination of a lot of environmental and psychological
factors,'' said Julie Clark-Sly, psychologist and co-clinical
director for the Orem, Utah-based Center for Change, a treatment
center for women with eating disorders. ``In treatment, therapists
focus on food and eating, and that never works. It has to focus on
emotional issues, and it's challenging.''
People develop eating disorders for different reasons, Clark-Sly
said, but many are either consciously or unconsciously unhappy with
some of the most important relationships in their lives -- with
themselves, with their family and with God.
Almost a year after ending treatment for bulimia and anorexia,
19-year-old Amanda Meador of Waco says she still has trouble loving
herself and feeling worthy of love from others.
Although she can't pinpoint the exact causes of her disorder or
when exactly it started, Meador said she hated herself for as long
as she can remember. As a child, classmates and swim team members
teased her about her size. In high school, she felt like she had to
compete with other girls with pretty hair or fashionable clothes.
When she was 17, she started starving herself and making herself
throw up after meals.
``I didn't like myself,'' Meador said. An eating disorder ``is
about wanting to be somebody that you're longing to be.''
She felt good about herself when people complimented how she
looked, but then she couldn't stop. She liked being in control.
Carol Weston, a columnist for Girl's Life magazine, said
adolescents naturally want to find ways to control their lives.
``Some girls who don't feel like they have control of their
lives will say, `If I stop eating, my life will change and I'll be
in control,''' she said. ``Preteens can't have full control of
their lives because they're not autonomous. Controlling what they
eat or digest is a very primitive but powerful, as well as
wrong-headed, approach to having control,''
Young women are bombarded with magazine and television images of
sexy and slim women, which give them unrealistic standards for
their body, Weston said.
Clark-Sly said she is starting to see children as young as 10
and 11 years old struggling with eating disorders. This indicates a
need for parents to encourage their children to develop healthy
self-esteem at a young age, she said. But parents are not to blame
if their children develop eating disorders, she said.
Dawn Montaner, Amanda Meador's mother, said she knows first-hand
how parents are put between a rock and a hard place when it comes
to helping them develop healthy self-images. Montaner said she
wanted Amanda to be happy, so she encouraged her to lose weight if
it made her feel better about herself. They even went on diets
together. But Montaner never dreamed her daughter would develop an
eating disorder.
``Nobody gives you a rule book,'' Montaner said. ``It's like,
you're damned if you do and you're damned if you don't.''
Wortman said parents need to remember that much of children's
self-esteem is based on their confidence and how much they are
supported and loved by their primary family members.
``If people get the idea that they will be loved more if they
lose weight, they're sunk,'' she said.
Clinical psychologist and motivational coach Randi Wortman, who
on Wednesday and Thursday will moderate national teleconferences
about how to encourage girls to feel better about themselves, said
parents should not emphasize their own weight and shape.
``If you're overemphasizing body shape and sizes, your children
will do the same and only take it further,'' she said. Emphasize
eating nutritiously and exercising as healthy lifestyles instead,
she said.
Perhaps most important is a daughter's relationship with her
father, Clark-Sly said, because girls pick up signals about how the
male population will perceive her from her dad.
``If a father's very critical, it's obviously going to have an
impact on his daughter,'' she said. ``Men are either going to be a
role model or a mirror or window of society.''
Meador said she was never close with her father, before or after
her parents' divorce when she was 13 years old. He wasn't a bad
person, she said, he was just busy so she never felt like she could
get his attention.
Meador is focusing her attention on a new relationship now, one
with her fiance.
``He does not care what I look like. He loves me for who I am,''
she said. ``It's hard because I don't even love me sometimes for
who I am. He knows how to love.''
In some cases, eating disorder patients view God the same way
they view their parents. Clark-Sly and her colleagues at the Center
for Change studied spirituality in their own patients and published
their findings in the Journal of Treatment and Prevention in 1997.
In the report, they say that eating disorder patients often
struggle with a negative image of God.
``Eating disorder patients tend to perceive God much as they
perceive their parents,'' they wrote. ``When patients experience
their parents as rejecting, critical, controlling, angry,
devaluating or shaming, they often project the same characteristics
onto God.''
Clark-Sly said she believes a spiritual healing is essential for
any addiction because people lose a sense of connection with God
and then lose their own well-being and sense of purpose.
``I think at the fundamental level, even with people who don't
believe, the ones who have had the most effective (treatment) are
those who find a spiritual base for themselves and spiritual value
in more than a worldly dimension,'' she said.
Clark-Sly described eating disorders as a vicious circle in
which sufferers want help and need help, but they feel they must
push people away. And when they finally want help, it's expensive
and hard to find. Few insurance companies cover eating disorder
treatments, which can cost hundreds of thousands of dollars.
Because of their personal experiences, Montaner and Meador have
taken on the task of educating others and of trying to get better
treatment for eating disorder sufferers in Texas.
Montaner organized efforts to recognize National Eating
Disorders Awareness Week this week in Waco, and Meador will tell
her story at a public forum on Feb. 21 at the Providence Pavilion
Auditorium at Providence Medical Center. The forum will be from 7
to 8:30 p.m.
Wortman said she wishes society would change its message that
``thin'' equals ``good.'' But she said that's as unrealistic as
trying to achieve a supermodel's body.
``We need to educate our children about the genetic basis for
the natural diversity of human shapes and sizes,'' she said. ``More
importantly, (we need to teach them) it's what's inside, who they
are as a person, that they're loved and valued and contribute to
society in so many ways; that body shape is irrelevant.''
