Disordered Eating Past And Present

Anorexia nervosa and bulimia nervosa have become familiar household words. As recently as the 1980s, it was difficult to find anybody who knew the true meaning of these terms, much less to know someone truly suffering from one of these syndromes. Today disordered eating is alarmingly common, and having an eating disorder is almost seen as a trendy problem. Starving and purging have become the acceptable weight loss methods for 80 percent of our eighth-grade girls. Binge eating disorder, a newly named syndrome, goes beyond overeating to an out-of-control illness ruining the person's life. Eating disorders are becoming so common that the question seems to be not "Why do so many people develop eating disorders?" but, rather, "How is it that anyone, particularly if female, does not?"

The first hint that eating disorders might become a serious problem was introduced in 1973 in a book by Hilde Bruch called Eating Disorders: Obesity, Anorexia Nervosa, and the Person Within. It was the first major work on eating disorders but was geared to professionals and was not readily available to the public. Then, in 1978, Hilde Bruch gave us her pioneer work, The Golden Cage, which continues to provide a compelling, passionate, and empathetic understanding of the nature of eating disorders, particularly anorexia nervosa, and of those who develop them. Finally, the public, for better or worse, began to be educated.

With the book and the television movie The Best Little Girl in the World, Steven Levenkron brought the knowledge of anorexia nervosa into the average home. And in 1985, when Karen Carpenter died from heart failure due to anorexia nervosa, eating disorders made the headlines as the emaciated picture of the famous and talented singer haunted the public from the cover of People magazine and in the national news. Since then, women's magazines began and have not ceased to run feature articles on eating disorders, and we learned that people who we thought had everything—beauty, success, power, and control—were lacking something else, as many began admitting that they, too, had eating disorders. Jane Fonda told us she had bulimia and had been purging food for years. Olympic Gold medalist gymnast Kathy Rigby revealed a struggle with anorexia and bulimia that almost took her life, and several others followed suit: Gilda Radner, Princess Di, Sally Field, Elton John, Tracy Gold, Paula Abdul, and the late gymnast Christy Heinrich, to name just a few.

Characters with eating disorders started appearing in books, plays, and television series. Hospital treatment programs sprang up across the country, marketing to those afflicted with phrases such as "It's not what you're eating, it's what's eating you," "It's not your fault," and "Are you losing it?" Eating disorders finally made it to top billing when Henry Jaglom produced and directed a major motion picture titled simply but provocatively Eating. The scenes in this film, many of which are unrehearsed excerpts of monologues or dialogues happening between women at a party, are revealing, compelling, sad, and disturbing. The film and this book are in part about the war in which females in our society are engaged, the war between the natural desire to eat and the biological reality that doing so deprives them of attaining the standard of appearance held up for them to achieve. Talk shows on eating disorders are at an all-time high, featuring every possible eating disorder angle one can imagine: "Anorexics and Their Moms," "Pregnant Women with Bulimia," "Males with Eating Disorders," "Eating Disordered Twins," "Eating Disorders and Sexual Abuse."

When people ask, "Are eating disorders really more common now or have they just been in hiding?" the answer is, "Both." First, the numbers of individuals with eating disorders do seem to be continually increasing, paralleling society's increasing obsession with thinness and losing weight. Feelings that may have been brought out in other ways in the past now find expression through the pursuit of thinness. Second, it is easier to admit that a problem exists when that problem is better understood by society and there is help available to treat it. Even though individuals suffering from eating disorders are reluctant to admit it, they do so more now than in the past because they and their significant others are more likely to know that they have an illness, the possible consequences of that illness, and that they can get help for it. The trouble is, they often wait too long. Knowing when problem eating has become an eating disorder is difficult to determine. There are far more people with eating or body image problems than those with full-blown eating disorders. The more we learn about eating disorders, the more we realize that there are certain individuals predisposed to develop them. These individuals are more "sensitive" to the current cultural climate and are more likely to cross the line between disordered eating and an eating disorder. When is this line crossed? We can begin with the fact that to be officially diagnosed with an eating disorder, one has to meet the clinical diagnostic criteria.