When she turned thirteen, Jessica started receiving messages that she should watch her weight. Her father told her frequently that her mother had been a slim, trim 115-pound bride. And Uncle Bill would always grab her side and say, “I can pinch an inch.”
One day Jessica saw a TV commercial in which a young man almost fell off his bike to get a better look at a slender girl. Many others also gravitated toward her. No mention was made about her personality; people seemed to like her because of her figure.
Soon afterward, Jessica went on a diet. Her goal was to drop from her weight of 130 pounds to 115 pounds. As she lost weight, her friends complimented her and asked about her diet. For a while it appeared that slimness did guarantee happiness.
But as she maintained her new weight, the social reinforcement dropped off. “Maybe I didn’t lose enough weight,” she thought. “If I lost ten more pounds, I could be really happy.”
With much effort, Jessica brought her weight down to 105 pounds. But her life was not magically transformed. She dropped out of her circle of friends because she was consumed with thoughts of how to avoid food. She felt uncomfortable at Church because she thought ward members were talking about how imperfect she was. Her grades plummeted because she was unable to concentrate at school. Dinnertime became a war as her parents tried to get her to eat.
Jessica dieted down to a frightening eighty-five pounds. Her parents and friends told her she looked horrible, but when Jessica looked in the mirror, all she felt she could see was fat. When she started reporting frequent fainting spells and pains in her heart, she was finally hospitalized. The diagnosis: anorexia nervosa.
Susan was a registered nurse and a single mother of three. She blamed her extra weight on the stress and depression she was experiencing. “If I could lose a few pounds,” she reasoned, “I’d be happy, relaxed, and energetic; and I’d be a better mother.”
As Susan tried to diet, she found that she often binged on large quantities of food. One day, she overheard a couple of women say that they lost weight by vomiting after they ate. Soon, Susan tried it herself. What started out as a way to deal with an occasional splurge of overeating became a daily habit.
Susan became obsessed with food and dieting—and increasingly depressed and isolated from her friends and co-workers. She found herself losing her temper with her children and becoming less sensitive to their needs and concerns.
One evening, as she was in the process of vomiting a meal, she heard a knock on the bathroom door. “Mommy, when are you going to stop throwing up and come out and play with me?” her three-year-old son cried. Susan sought professional help the next day. She was diagnosed as having bulimia.
Jessica and Susan (the names have been changed) are two of many who suffer from an epidemic of eating disorders. Ninety-five percent of those with the disorders are women, many between the ages of twelve and thirty. One in 100 females has anorexia nervosa, and almost 15 percent of college females have bulimia.1
Anorectics restrict their caloric intake for long periods, exercise excessively, vomit, and use laxatives to deliberately starve themselves, resulting in the loss of at least 15 percent of their body weight. They have an intense fear of becoming obese.
Bulimia is a cyclic pattern of binge eating and some type of purging: fasting, self-induced vomiting, or use of cathartics or diuretics. Anorexia nervosa and bulimia are often present together.
Serious medical complications have been noted in connection with anorexia nervosa and bulimia. Victims almost always suffer from malnutrition—which causes low blood pressure, circulatory disturbances, irregular heartbeat, and impaired ability to fight disease and infection. During long periods of undernourishment, the body cannibalizes its own muscle tissue; since the heart is a muscle, cardiac arrest often occurs. In addition, malnutrition might adversely affect the brain. (This may explain why many anorectics see themselves as obese even when they are emaciated.)
Another common problem caused by malnutrition is electrolyte disturbance. Electrolytes are substances that help the nerves to function; an electrolyte of special concern is potassium. Low levels of potassium in the blood can lead to a wide range of complications, including muscle weakness, heart problems, kidney failure, urinary infections, and, in rare cases, epileptic seizures. In severe cases, potassium loss can threaten life.
People who frequently vomit often have sore throats, tooth decay, gum disease, and swelling of the cheeks.
Compounding the eating-disorder victim’s problem is the fact that the dietary methods she has adopted may be programming her body to more readily turn calories into fat. Although a person may be eating less than she did before her diet, her body reacts to the shortage of fuel by using calories more efficiently; her metabolic rate slows down, sometimes as much as 40 percent.2 If she resumes her pre-diet caloric intake upon reaching her goal weight, her reduced metabolic rate makes it easier for her to gain weight. Studies suggest that this “yo-yo” dieting (losing weight, then gaining, then repeating the cycle) may lead to “dieting-induced obesity.”3
Most eating disorders start with negative feelings toward self. Often, victims harbor feelings of despair and/or feelings of being flawed and defective. Many factors—including physical, sexual, or emotional abuse—can lead to these negative feelings. (Some victims may be genetically predisposed to depression and might be helped by antidepressants.)
Some eating-disorder victims come from families with poor communication skills and unhealthy styles of relating. Such families may have one or more of the following characteristics:
The perfect family places undue importance on externals such as appearance and achievement. They are often overly concerned about how others perceive them.
In the overprotective family, parents leave their children little room for making decisions and experiencing consequences. Family members are often confused about their own identities.
The chaotic family is usually unstable. Family rules are inconsistent; children often distrust themselves as well as others. Parents may suffer from alcoholism or severe depression, and children are often the victims of physical abuse.4
Individuals who struggle with eating disorders appear to go through addictive cycles similar to those suffered by alcohol and drug abusers.5 The obsession with food and dieting often becomes a way to alleviate inner distress.
In my work, I have asked eating-disorder patients, “What does your avoidance of food and/or your binging and purging do for you?” The most frequent answer is that it “numbs” them, distracting them from real or perceived life problems. By subordinating everything else to the goal of losing weight, victims believe (consciously or unconsciously) that they can bring structure and meaning to a world that they feel otherwise to be beyond their control. Ironically, in the process, some eating-disorder victims totally lose control.
Women learn early and from diverse sources—their family, television, movies, the fashion industry—the message that appearance is of supreme importance and that dedicating oneself to the external being guarantees love, happiness, and respect.
Often, the physical standards that are portrayed are impossible to achieve. For example, only 5 percent of all women are naturally as slender as models. Unfortunately, many women who embrace these standards pressure other women to adopt them as well.
Jane, a recovered eating-disorder victim, writes: “Most women do not know their full power. They accept themselves at 50%, or 20%, or less, of who they really could be. Where does the energy of these women go? Look at the women’s magazines! … Women are programmed to be concerned with external glamour.
“Beauty is one thing, glamour is another. Beauty comes from externalizing inner power. Glamour comes from our need to pretend we are beautiful, a compensation for our own inner fears and weaknesses. …
“But true power comes from within. It is a state of consciousness that commands respect regardless of our looks. A woman who knows she is powerful does not need to prove it. As long as we believe glamour is beauty, we will be taken in by a bunch of lies.”6
Neither anorexia nervosa nor bulimia is mentioned or implied in the scriptures; these disorders have only recently been diagnosed. However, a test one might use to determine if a behavior is condoned by the Lord is to ask: “Does it promote life? Does it help build up the Lord’s kingdom? Will it help lead me back to my Heavenly Father?”
Eating disorders interfere with one’s ability to seek love from or give love to others. As people become more involved with aberrant eating, they turn to food instead of reaching out to a parent, a friend, a spouse, or the Lord. Joan, who was actively bulimic through her entire mission, thinks that she could have served the Lord much better if she hadn’t spent so much time struggling with bulimia.
In addition, placing too much emphasis on worldly goals leaves one little time for developing spirituality. Elder Neal A. Maxwell suggests, “Think for a moment how different it would be if people took on that physical appearance which would reflect distinctly how well they are doing spiritually. … Under such telling circumstances—when the outer person reflected the inner person—whom would we applaud? And who would really deserve our pity?”7
In the Doctrine and Covenants, the Lord chastises James Covill, saying, “Behold, I have bestowed great blessings upon thy head; Nevertheless, thou hast seen great sorrow, for thou hast rejected me many times because of pride and the cares of the world.” (D&C 39:8–9.)
In contrast, in 1 Samuel 16:7 we read, “The Lord seeth not as man seeth; for man looketh on the outward appearance, but the Lord looketh on the heart.” [1 Sam. 16:7]
Eating disorders are far more complex than they appear. Parents, spouses, and friends—in an effort to help—have said, “Just eat,” or “Chew and swallow.” But simplistic suggestions don’t work; eating disorders have emotional roots, and we must address emotional problems in order to solve the disorders.
The following are some ways you can help a family member or friend who is suffering from an eating disorder:
Help her recognize that she has a problem. Her attitudes and behaviors won’t change until she admits she is in trouble.
If she has lost a significant amount of weight or is binging and purging on a daily basis, get professional help. Be a smart consumer; slick brochures and fancy buildings do not guarantee competent treatment. Ask pointed questions: What are the credentials of those who will be working with your loved one? Will they respect her religious beliefs? Do they have a genuine interest in treating eating disorders? Stay away from programs where therapists view eating disorders from a single perspective or promise magic cures.
Be involved in the treatment. The whole family may need to change to accommodate changes your loved one will make in therapy.
Don’t let your concern for her be contingent upon her changing. Interact in ways that don’t center on her problem.
Freely express your thoughts, feelings, and shortcomings. Then she will be more likely to do so, too. One of the mistaken beliefs of eating-disorder victims is that they should not be having any difficulties or negative feelings.
Be patient. There are no quick or easy cures.
People with eating disorders have hopes and dreams, just like everybody else; they seek love, success, and happiness. However, they have been misguided in their efforts to find these things. But with the right kind of help, love, encouragement, and patience, they can return to a knowledge of “things as they really are.” (See Jacob 4:13.)
Caloric restriction, binge eating, secretive eating
Extreme preoccupation with food—preparing food or shopping for others, reading cookbooks and food magazines frequently, dreaming about food, developing peculiar eating rituals
Preoccupation with dieting and calorie-counting
Abuse of laxatives, diuretics, enemas, diet pills
Evidence of forced vomiting
Insomnia, constipation, dry skin, hair loss, weak and brittle nails, feeling of always being cold, lack of menstrual periods
Distorted body image—feeling fat when one is emaciated
Inordinate amounts of exercise
Inability to concentrate
Withdrawal from friends and social activities