American Idol Runner-up Admits Bulimia

Quest for Ideal Weight Led to Eating Disorder Before Appearance on Show

From the WebMD Archives

She wowed cantankerous American Idol host Simon Cowell with her rendition of "Somewhere Over the Rainbow." Now Idol runner-up Katharine McPhee is doing the same for troubled women across the country by disclosing her battle with the eating disorder bulimia.

According to reports in People magazine, McPhee was throwing up seven times a day when she auditioned for the popular TV show American Idol. Before she began shooting, however, McPhee, 22, entered a three-month program at the Los Angeles Eating Disorder Center of California. She first reports her problem in the August issue of Teen People, which hits newsstands June 30.

At the age of 13, McPhee told People, she became obsessed with losing weight, but she didn't begin bingeing and purging until she was 17. As is the case with many co-eds, her problems got worse during college.

About 4% of college-aged women have bulimia, according to statistics from Anorexia Nervosa and Related Eating Disorders, Inc. Bulimia is characterized by bingeing on excessive amounts of food, followed by compensatory purging (vomiting, using laxatives, excessive exercising) to stave off weight gain.

Untreated, bulimia can have serious medical consequences, such as weakness, potentially fatal heart rhythm abnormalities, kidney damage, and erosion of the teeth. It can also wreak havoc on vocal chords, which can be devastating for a singer like McPhee. That's one of the reasons she decided she needed help.

The Influence of Media

Although McPhee realized her behavior was self-destructive, she thought it was the only way to succeed as a singer. Her manager often reinforced this by telling her that if she dropped weight, the gigs would start rolling in.

"The message that women and young girls get every day to be a certain weight is so unrealistic and unattainable that it sets them up for failure and makes them not feel good about their body," says Wendy Cramer, a professional relations representative at The Renfrew Center in Philadelphia.

Renfrew specializes in treating women with eating disorders. "We have an epidemic of eating disorders, and certainly the way that we are bombarded by images of celebrities being so thin affects how girls see themselves," Cramer says. She has not treated McPhee.

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Mixed Messages

McPhee fans likely noticed the singer's shrinking body as the competition went on. "This might send a mixed message because here she says she was struggling with bulimia and got treatment, but then she got thinner on the show," Cramer says. "That is a double-edged sword."

People with bulimia are not necessarily thin. "They can be normal weight, underweight, or overweight. But it was obvious from the show that she did lose weight," Cramer says.

The fact that McPhee is going public is "wonderful in that it opens up a platform for parents to be aware that their daughters may be struggling with eating disorders, especially since American Idol is such a hugely popular show," she says. "This may be a jumping-off point to discuss eating disorder and body-image issues with their daughters."

"It can be helpful when a celebrity admits they had a problem because it opens the door for other young women to say 'I am not alone' and get help," she says. "Ultimately, [McPhee] has brought an issue to the forefront and we now have the opportunity to show that you can recover."

How Bulimia Is Treated

According to Teen People, McPhee's treatment involved reading the book Intuitive Eating: A Revolutionary Program That Works, by Evelyn Tribole and Elyse Resch, as well as attending individual and group therapy six days a week.

McPhee tells the magazine she hasn't binged since the two weeks before entering the TV program and has since adopted a much healthier attitude about food.

Today, treatment for bulimia typically involves a multidisciplinary approach, including a medical checkup, a psychiatrist who can prescribe helpful medications such as antidepressants, a psychologist to help deal with emotional triggers, and nutritional counseling, explains Linda Hamilton, PhD. Hamilton is a clinical psychologist in private practice in New York City who often treats performing artists with eating disorders; she has not treated McPhee.

"You probably need a full year to get a full handle on [bulimia], and stressstress is likely to bring about a resurgence of symptoms. But that doesn't mean you have to fall back into a full bulimic episode," she says. In People, McPhee admits she's still learning to deal with stress and has not stopped biting her nails.

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Triggers for Eating Disorders

"Like most women, McPhee doesn't fit the ideal. So then you get into this routine of dieting and that really can set you up physiologically to binge," Hamilton explains. "If you eat too-small amounts of calories, your body sends out signals to overeat."

It's a common trap, she says. "More often than not, dieting sets you up to binge and you can become bulimic."

Hamilton is quick to point out that there are other causes of the eating disorder. Bulimia can also be triggered by depressiondepression, anxiety, or sexual abuse.

"It's very positive that she came out and is talking about it [bulimia], because she can be a role model," Hamilton says. "It shows intelligence that she went into treatment before taping because the earlier you can get treatment, the better the prognosis.

"She was very brave to come forward and the message is that she doesn't want other people to fall into the same pattern that she did," Hamilton says.

WebMD Feature Reviewed by Louise Chang, MD

Sources

Published June 22, 2006

SOURCES: Wendy Cramer, professional relations representative, The Renfrew Center, Philadelphia. Linda Hamilton, PhD, clinical psychologist in private practice, New York City. Anorexia Nervosa and Related Eating Disorders, Inc web site.
© 2006 WebMD, Inc. All rights reserved.

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