One reason eating disorders are so insidious is that many early warning signals associated with them seem so innocent. Who hasn't worried about one's appearance, tried to conform to our culture's unrealistic standards of beauty, or dieted at one time or another? Even behaviors that once may have seemed strange and out there, such as purging and cutting, are unsurprising among certain circles. Psychologist Carolyn Costin has noted the "normalization of these behaviors," and it's absolutely true. Why would anyong seek treatment when what they're doing seems completely ordinary?
Yet the sobering truth is that eating disorders can kill. An estimated 10 million Americans struggle with eating disorders. More people die from anorexia and bulimia than from any other mental disorder, and the most vulnerable population is teenage girls. Forty percent of newly identified cases are among girls ages 15 to 19.
It was this aspect of deadliness hiding in plain sight that prompted actress Robyn Hussa to take an off-Broadway show called Nor.mal: A Family Musical of Hope and Survival and develop a 90-page companion curriculum to help educate students, parents and others about eating disorders. The non-profit organization that grew out of this project, NORMAL, has produced two DVDs, "ED 101" and "Speaking Out About ED."
"ED 101" is a free, 30-minute program suitable for high school and college audiences, and the longer "Speaking Out About ED" is available for purchase ($29) from Gürze Books. All the related curricular materials to "ED 101" are available for free from the web site. The DVDs do not pull any punches. Interspersed with snapshots of young women who have died from eating disorders, a roster of psychologists, researchers and former eating disorder sufferers give viewers a full picture of how devastating these mental disorders can be.
There are statistics galore and some sobering facts about how often treatment is delayed, with each week or month without treatment making recovery harder and harder to achieve. Dr. Stephen Hinshaw, chair of psychology department at UC Berkeley, tells us that the average length of time between someone becoming aware of the eating disorder and getting help for it is ten years. We learn that the co-morbid (or co-occurring) conditions often seen with eating disorders make them even harder to solve. Depression is a rampant among eating disorders sufferers. Dr. Ken Weiner, who heads Denver's Eating Recovery Center, tells us that the average woman has a 28% chance of suffering from major depression in her lifetime. If she has an eating disorder, that risk rises to over 70%.
Renowned expert Dr. Craig Johnson talks about the role of genes in eating disorders, noting that some people are born into this world "hardwired not to feel good about themselves." Eating disorders become a way to dull the pain of existing for such people. But they are not only genetically determined. Human genetic makeup has not changed drastically in the last several decades, says Hinshaw, yet we are seeing earlier expression of the genetic predisposition to eating disorders, says Hinshaw. Why? In part because of our culture's unrealistic beauty ideals, the pressure girls, women, boys and men to look like the actors/singer/models/celebrities they idolize. "It's not just nature versus nurture," explains Hinshaw, "they work together."
I hope these DVDs open the way to a more open dialogue about eating disorders among families, friends and at schools and institutions.
Nutritionist Marcia Herrin and Nancy Matsumoto, co-authors of The Parent's Guide to Eating Disorders, Gūrze Books. Marcia is also author of Nutrition Counseling in the Treatment of Eating Disorders.