The webinar is my new favorite information dissemination tool. Without having to leave your home, experts, interesting ideas and insights arrive through your computer's screen and speakers. It's a gift and a crutch to people like me who, if given the opportunity, are all too willing to dispense with the formalities of dressing and grooming before beginning work.
The Renfrew Center Foundation, always engaged in interesting areas of practice when it comes to eating disorders, held one of these online seminars last week on the topic of special issues involved in assessing and treating observant Jewish women.
Dr. David Hahn, assistant medical director of the Philadelphia Renfrew Center (who led the seminar, along with Jodi Krumholz, RD, LDN, and former Renfrew patient Rocky Horowitz), painted a picture of a Jewish culture and religion that holds both risk factors for eating disorders and some unique tools for recovery.
All the panelists agreed that there is no data to support an increase in eating disorders among observant Jewish women, but that there may be an increased willingness among this population to seek help for such problems.
To start with the risk factors:
The "centrality of food," in Jewish culture. Dr. Hahn noted that weekly Shabbat, or Sabbath, dinners are like "Thanksgiving once a week, where family conflicts are played out at the table." Not only that, he added, it is often "a very public table" involving guests, and featuring "micro-managed patterns of eating."
Dr. Hahn described Jews as "an anxious cohort," noting that, especially in the orthodox Jewish world, "where drugs, sex and rock and roll are not readily available," food can be viewed as a vehicle for rebellion.
Keeping kosher requires an inordinate investment of time in preparing and thinking about food in order to adhere to specific dietary guidelines.
The tradition of early arranged marriages and childbearing can make an eating disorder seem like an effective way to slow down these rapid changes. Some orthodox Jewish women, expected to give birth many times over, might see restricting food intake as a method of birth control to slow down the growth of the family.
The flip side of the equation is that within the rich Jewish culture and religion, there are many pathways to health as well, Dr. Hahn said. Some examples:
Kashrut, or Jewish dietary laws "can be viewed as a blueprint for healthy eating," a way of exercising control over eating. For example after a meat meal, one must wait before being able to eat any dairy products. Children are told that "ice cream is not a bad thing, but must be eating according to God's rule."
Shabbat can be seen as "an opportunity to learn how to eat as a family again," in a world where family meals are increasingly rare.
The many Jewish holidays can be viewed as an opportunity to "practice the message that all foods should be taken at the right time and appreciated." Even fasting, Dr. Hahn said, can be appropriate on occasion. In the Jewish tradition this is "a communal shared experience, not the private fasting of the anorexic person. It has a very clear beginning and end." Holidays, Dr. Hahn added, "show both how to overeat and under-eat, which is really the normal pattern of someone who doesn't have an eating disorder."
Shiva, the period of grief and mourning following the death of a close relative, can be a lesson in how to "stick with sadness," rather than trying to avoid or deny it; "a good pattern to reinforce for a woman with an eating disorder who may not want to seek help or face what's happening."
The Jewish idea of "practice before belief" can also be of great benefit to the woman struggling with an eating disorder. Eating regular meals and snacks before it might feel "right" to an eating disordered person is "in sync with the way a Jew is asked to practice Judaism," explained Dr. Hahn.
The rabbi can often be called on to help a woman with an eating disorder by directing her into treatment, or perhaps advising a struggling patient on the advisability of fasting. Dr. Hahn believes that any rabbi would tell such a patient that "health trumps religious practice," meaning that she should not fast if it might mean a relapse, or set back recovery from an eating disorder.
I'd love to hear your comments on this provocative webinar.
Nancy
Marcia Herrin and Nancy Matsumoto are co-authors of The Parent's Guide to Eating Disorders. Marcia is the author of Nutrition Counseling in the Treatment of Eating Disorders
Copyrighted by Marcia Herrin and Nancy Matsumoto