KANSAN.COM / THE UNIVERSITY DAILY KANSAN / THURSDAY, APRIL 28, 2011 / NEWS
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"The medicine was just a little push to get going." Heidi said.
Six years later, Heidi is at a healthy weight and in a happy place. Still, she admits that neither the therapy nor the medicine were able to completely wipe obsessive eating thoughts from her mind.
She's just learned how to stop negativity before it goes too far.
"Whenever I get the tendency to go back there, I think, "No," Heidi said.
She has also developed strategies for dealing with stress. Rather than obsessively working out, she listens to music to calm down. Instead of getting caught up in a chaotic day and winding up with a "good, empty feeling" in
her stomach, she carries granola bars in her backpack so she'll have something to eat on-the-go.
"People don't realize that eating disorders have very painful grips on these lives that can ultimately be life-threatening"
Where she once fixated on counting unwanted calories, she now appreciates healthy food that fuels her body.
These afflictions aren't limited
For her, that means finding balance.
"I've come so far to have a healthy relationship with food." Heidi said.
"There's nothing wrong with being healthy. Just don't go past that line."
UNREALISTIC EXPECTATIONS
Society's expectations play significant roles in why women with eating disorders drastically outnumber men. According to one study by Ohio State University, the majority of college men feel pressure to be muscular. In contrast, women think they should be thin.
Women's magazines contain 10 times more advertisements for dieting and weight-loss articles than men's magazines, according to the Media Awareness Network, a Canadian non-profit program.
The problem is defining where that line is.
Another study by the Just Think Foundation, which promotes critical consumption of media, showed that the average female model weighed just three-quarters of what an average woman weighed. Yet these models are often portrayed as ideal images of how women should look.
STEVEN ILARDI psychology professor
"Girls often go into college already afraid to gain weight," Chapman said.
"By the time girls finish high school, they are already indoctrinated with how to look," she said.
As a dietician at Watkins Memorial Health Center, Ann Chapman meets with students about their nutritional habits.
With the abundance of skewed media messages, Chapman said it was no surprise that many young women had warped body images.
SLIPPERY SLOPE
An additional one-third of college women don't meet the criteria for anorexia or bulimia, but display disordered eating habits such as binging, taking laxatives or using diet pills.
In many cases, disordered eating tendencies lie dormant throughout high school, when girls eat healthy meals provided by parents, play competitive sports and live in a generally calm, and supportive home environment.
"The transition from high school to college is always stressful, even if you're excited." Chaman said.
Often, it's not until a stressful or traumatic event occurs that disordered eating behavior manifests. For Caitlin, it was when her friend died. For Heidi, it was a devastating breakup. For others, it's the move from home to college.
According to the National Institute of Mental Health, the average onset age of anorexia is 17 and for bulimia it's 18 to 20 - the very age of many college women.
Chapman said part of this might stem from students fearing weight gain so much that they move in the opposite direction.
aren't limited to thin girls. One study in the Journal of Obesity Related Mental Disorders found that overweight girls are more likely to develop disordered eating tendencies during their young
adult years.
Even seemingly normal behaviors can be the beginning of a slippery slope.
A bad breakup? Eat a carton of Ben and Jerry's ice cream.
Not motivated to get out of bed?
Skip breakfast.
Worried about gaining weight? Count and cut calories.
Taken together, these behaviors can evolve into legitimate eating disorders. And, when combined with other psychological disorders such as depression, bipolar disorder and generalized anxiety disorder, eating disorders can be even more difficult to overcome.
"Although there are exceptions to every rule, the longer people are engaged in unhealthy practices, the longer the recovery," Chapman said.
If eating disorders are ultimately left untreated, they can carry grave physical and psychological consequences.
Anorexia has the highest mortality rate of any mental health disorder. One in 10 anorexics die at a young age from suicide, heart failure or other medical complications related to low weight.
Bulimics are also at risk for permanent organ problems, such as esophageal tears or gastrointestinal damage. The suicide rate among anorexics and bulimics is 23 times higher than that of the general population, according to one study in the British Journal of Psychiatry.
"People don't realize that eating disorders have very painful grips on these lives that can ultimately be life-threatening." Ilardi, the psychology professor, said.
The problem for many with eating disorders is learning how to let them go.
TWO-FOLD THERAPY
Chapman said it was important for treatment to address all issues that feed into an eating disorder. In addition to nutrition education, therapy should help patients come to grips with the underlying reasons why they feel compelled to restrict, binge or purge.
"If they've just come to see me to get the eating disorder under control, it's like putting a band aid on a problem," Chapman said. "Next time there is a major stressor, they'll revert back."
Watkins Memorial Health Center has a policy of automatically referring any student who seeks treatment for an eating disorder to a doctor, nutritionist and counselor.
A 2003 study that tracked the recoveries of anorexic patients showed that fewer than one-quarter of the patients who received CBT and nutritional counseling had relapsed to clinical anorexia. In contrast, more than half of the patients who met only with nutritionists had reverted to anorexic behavior.
Chapman said this multifaceted treatment was vital in helping patients recover.
Cognitive Behavioral Therapy (CBT), or "talking therapy," has proven successful among people with eating disorders.
Even with therapy, one of the biggest obstacles to overcome is the codependency that many people have with their eating disorders.
Chapman said that she has seen KU patients who had "love affairs" with their eating disorders. These people were so attached to their behaviors and mindsets that they struggled to emotionally commit to therapy even when their lives were at stake.
In a few cases, Chapman quit providing nutritional advice to patients who were unwilling to confront underlying psychological issues. Otherwise, she said meeting with her was just giving them an excuse to justify their problem.
"They might say, 'Well, I'm working on it,'" she said. "But this can go on for years if they feel validated for it."
CHANGING VIEWS ON HEALTHFULNESS
Much of that validation goes back to the pressure that society puts on women and that women put on themselves.
College can be a particularly difficult time, as many women come in fearing the infamous Freshman 15
— the pounds that they put on when they replace nutritional meals from home with excessive alcohol and fast food.
For some, avoiding this issue is a simple equation: Eat less to weigh less. Chapman said this becomes a problem when people don't recognize that there is more to overall health than food.
"I certainly see lots of students who obsess about food,but not really about their overall health,"Chapman said.
On the other hand, Chapman said there are many students who don't worry about being healthy at all. Ultimately, neither obsessing about nor neglecting nutrition is healthy, especially when negative habits continue throughout life, she said.
"If you live in an apartment and have a terrible diet, you aren't likely to eat much better after you graduate and get a job," Chapman said. "Establishing healthy eating and activity patterns in college is really important."
Chapman also stressed that part of finding balance was growing as an individual.
"Many students are very egocentric and constantly worried about their bodies when they could be devoting this energy to their church, a class they have a passion for, a community shelter in need or to a friendship," Chapman said.
A LIFETIME OF RECOVERY
Even after committing to treatment, the road to recovery can be challenging. It requires changing how someone associates with food as well as learning how to deal with emotions in a positive way.
For Caitlin, this hasn't always been easy. After her stay at the Menninger Clinic, Caitlin continued to struggle with depression and was eventually diagnosed with bipolar disorder. Along with the mental highs and lows, Caitlin also dealt with bouts of disordered eating.
She is learning to recognize impulses to restrict her eating before they go too far. She likes going out with friends. She knows her dog, Giseppi, a small Yorkie who loves to snuggle, will be there to comfort her when she's feeling sad.
At first, she was thrilled. Then, negative thoughts set in as she told herself, "You'll just screw this up like everything else."
Still, she admits to having a person-with-depression mentality. This reared its head in March, when she was admitted to the School of Social Welfare.
The difference is that, unlike three years ago when she felt hopeless about life, this time she's determined to try.
"I'm finally getting to the point where I see improvement," she said. "It's trial and error."
Edited by Dana Meredith
MY ARTICLE MYSTORY
McCoy used to keep a food diary with everything she ate. She said, "While I was dealing with my eating disorder, I obsessively wrote down all my meals. Occasionally, I feel a tendency to do this, but I know it's a trigger for me."
It was five in the morning and the dull pain of hunger in my grumbling stomach wouldn't let me sleep. It didn't help that my protruding hipbones painfully jutted into my mattress.
Above is a photo of writer Emily McCoy in February 2010. She was inspired to write this article after learning from her own experiences. She said, "Even though I love photographs, I avoided being in them while I was anorexic. A part of me didn't want to accept the way I looked."
Below is a photo of McCoy from this year. She said, "During the past year, I've reached a stable place with my weight. Now I feel much stronger, healthier and happier."
Restlessly, I went downstairs. With pride, I avoided the fridge and resisted the temptation to grab one of the carrot sticks I had sliced the day before. The 15 calories weren't worth it.
Instead, I pulled on my shoes and went to run two miles — or more.
Just as it often did when I turned down invitations to hang out with friends or made up excuses about not being hungry, my anxiety had gotten the best of me — which, I later learned had really gotten the worst of me.
Contributed photo
At 5 feet 9 inches tall and about 100 pounds, I was 30 pounds under my healthy weight range. I knew this wasn't a "good thing." I also remembered doctors telling me that because of my weight, working out would put my heart at risk.
But, at that pre-dawn moment, all that mattered was getting to run more and eat less. Why should my weight really matter when I looked at my skinny legs
and instead saw fat on my thighs?
Taking my life just more than one year ago. It's still hard for me to pinpoint where my "turn around" was. It could have been when my mom considered taking me out of school.
It could have been when my dad looked at my arms, which were as thin as a broom handle, and said he was worried for my life. Even though I couldn't see my true self in the mirror, I could see in his eyes he was telling the truth.
But, most likely, it was when I finally began meeting with a therapist who specialized in eating disorders.
By talking with her, as well as meeting with my nutritionist and doctor, I was able to address the excruciating sadness I felt at my cousin's sudden death the year before. I was able to recognize my anxiety about gaining weight and not being as beautiful as my mom. I was able to heat and I was able to move on.
That's not to say it was easy. I still have to make decisions about what to eat every single day.
Back then, I lost sight of whom I was. Instead of reaching out to my friends and family, I withdrew into myself, shrinking inward just like my body.
When those feelings of anxiety creep back, I look at the big picture and realize that life is so much better now than when I was both skinny and depressed.
It didn't take long for the depression I felt inside to show on my face. I vividly remember a time I took the bus from the gym to class and caught a glimpse in the mirror of a sullen girl with sunken cheeks. It wasn't until I did a double take that I realized it was my reflection.
Since committing myself to recovery, I've gained so much more than that desperately needed weight. In the past year, I ran three half-marathons. I spent eight weeks studying in Germany. I even got engaged and learned how to really love another person.
I wouldn't wish my experiences on anyone else, but I am grateful for what I learned. Dealing with both an ing disorder and depression gave me perspective and it gave me a cause. I'll do whatever it takes to prevent any one else from going down that same path. Writing this article was just one step in doing that.
Visit my blog at www.pursuitofhealthfulness.com for more about my journey.
Contributed photo