Lindsay Lohan graced the cover of Vogue magazine. Mary-Kate Olsen made headlines in People. Ashlee Simpson was featured on "Entertainment Tonight." Young celebrities are highlighted in major publications and on television shows every day for their entertainment successes, extravagant vacations and steamy love lives.
More recently, however, these three celebrities shared a story much closer to the reality of many young women: All admitted to struggling with an eating disorder.
When you read these celebrity confessions or learn that a friend or family member has an eating disorder, do you feel sympathetic? Do you empathize with the severity of the situation? Or, do you blame it on vanity and a selfish quest for cosmetic perfection?
Unfortunately, in a country that places so much emphasis on "looking good," the latter is all too often the case. And those facing this devastating illness often pay a hefty price for society's rash dismissals of the severity of eating disorders.
Our culture is obsessed with body image, and being slim is a common goal for many of us. Magazine covers have convinced us that the pictures we see of young ultra-thin celebrities are, in fact, the ideal. And drastic attempts to obtain this ideal often go unnoticed - or worse, are applauded. Many women are perceived as finicky eaters or congratulated for their willpower, when in reality they are dealing with a potentially life-threatening illness.
"Unfortunately, being unhappy with your body image and trying to limit what you eat is normative in our culture," said Dr. Marlene Schwartz, co-director of the Yale Center for Eating Disorders. "Eating disorders are glamorized in the media. The problem with this is that it contributes to the perception that eating disorders are not serious illnesses, and that people get eating disorders to look like models."
Eating disorders like anorexia nervosa and bulimia nervosa ARE serious illnesses and affect approximately eight million people each year. Although many Americans, particularly women, put themselves on restrictive diets, skip meals or become preoccupied with nutrition, exercise and body image, this does not necessarily indicate an eating disorder. In some cases, these behaviors are bordering on an eating disorder and may be classified as "disordered eating."
"Many behaviors that people who are 'dieting' engage in could be classified as borderline eating disorder behaviors," said Tara Gidus, M.S., R.D., an American Dietetic Association spokesperson. "It is difficult to teach balance in today's society. We are an all or nothing society, and moderation and balance are concepts that are not easily embraced."
When balance is ignored and a preoccupation with food, nutrition and exercise begins to interfere with everyday life, disordered eating can quickly morph into an eating disorder.
According to the National Association of Anorexia Nervosa and Associated Disorders, an eating disorder stems from a complex mixture of social, psychological and biological issues. At the core of all eating disorders is a severe disturbance in the perception of body shape and weight. Without treatment, the majority of people with eating disorders cannot outgrow the debilitating behaviors on their own.
Eating disorders are often stigmatized and seen as an indulgence, a sign of weakness or an act of vanity. Furthermore, people with eating disorders are often blamed for their condition, similar to the way alcoholics are blamed for their dependence on alcohol. Thus, people suffering from the illness may delay seeking treatment at a time when treatment is essential.
"Most people think that eating disorders are all about appearance and food, when, in reality, they are a coping mechanism for people who cannot deal with the emotions they are experiencing," said Jessica Cunningham, Director of Education and Outreach at the Massachusetts Eating Disorder Association. "This misconception can lead to the glamorization of eating disorders, which can be very dangerous."
If treatment is delayed, serious medical consequences, such as dehydration, low blood pressure and muscle loss, can occur. Once treatment is sought, however, many patients find they face another challenge: getting insurance companies to recognize their illness as a disease. "Eating disorder treatment is very expensive, and it is not uncommon for individuals to have difficulty getting their treatment covered," Cunningham said. "Until eating disorders are recognized as a mental illness, those struggling will continue fighting insurance agencies for coverage."
In many cases, if insurance does pay for treatment, the amount of insurance is so limited that the necessary components of a successful program - including nutrition counseling and intense therapy - are not covered.
"The truth is that eating disorders are a very serious psychiatric illness, and have among the highest mortality rates of any psychiatric illness," Schwartz says.
People with eating disorders cannot simply decide to start eating again; they need proper treatment. They also need - and deserve - their illness to be recognized as a serious medical condition not only by insurance companies but also by the general public and the media.
If you would like more information on eating disorders, please visit the Massachusetts Eating Disorder Association Web site at www.medainc.org or call them at 617-558-1881.
Lesley Shiery is a registered dietitian and a graduate student in nutrition communication at the Friedman School of Nutrition Science and Policy. She has a BS in dietetics from Michigan State University.
