Eating disorders are associated with a higher rate of mortality than any other mental illness, a fact that may not be widely known among the general population. As many as 20 percent of people suffering from anorexia will prematurely die from complications related to their disorder, according to a report by the Renfrew Center Foundation for Eating Disorders.
“I want to emphasize we’re seeing diagnoses at an earlier age,” says Laura Orlich, coordinator of eating disorder services, counseling and psych services at the University of Arizona Campus Health Service.
The most recent Diagnostic and Statistical Manual of Mental Disorders (DSM5) defines anorexia nervosa, which primarily affects adolescent girls and young women, as “a distorted body image and excessive dieting that leads to severe weight loss with a pathological fear of becoming fat.” Bulimia nervosa is defined as “frequent binge eating followed by self-induced vomiting to avoid weight gain.”
In the past 15 years, “we’ve seen an escalation of the severity level of eating disorders. I refer [UA students] to a psychiatrist or a therapist to provide ongoing treatment. It’s also a generational issue. It’s not surprising to see a mother, grandmother, maybe an aunt thrown in,” says Orlich.
Laura Schnaps, Ph.D., a Jewish clinical psychologist in private practice, is another local expert on eating disorders. She was the first coordinator of the eating disorders program at the UA College of Medicine and is past president of the Tucson Chapter of the International Association of Eating Disorders (Orlich is the current president). Schnaps trained in the field through a clinical internship at the UCLA Neuropsychiatric Institute in 1983-84. She holds a Ph.D. in clinical psychology from the UA.
“We didn’t know a whole lot [back then] so we were inventing as we went,” says Schnaps. People with eating disorders “were always there” and include “women who haven’t developed a voice, haven’t felt their own personal power and don’t feel safe to discuss their feelings. Women are objectified and sexualized. This takes a toll on a society,” she affirms, adding that some women are even paying to be tube-fed in California so they can wear a smaller size wedding dress.
Currently, there are at least 80 to 100 treatment centers in the United States that provide treatment for eating disorders, and a lot more research is being done, says Schnaps. “Now we know some biological tendencies run in families. Those with addiction and alcoholism issues are at a higher risk.”
Eating disorders are an expanding challenge in the Jewish community, according to a Jan. 19 article by Maayan Jaffe, published by Jns.org, “Temimah Zucker consumed by mission of tackling eating disorders in Jewish community.” Zucker, a student at Yeshiva University’s Wurzweiler School of Social Work, who is herself in recovery from anorexia, says, “When I meet people in the Jewish community and tell them I work with eating disorders, they say, ‘Me too! I never stop eating!’ There is an understanding that food plays a central role in Judaism. People overeat, emotionally eat, and it can be life-threatening.” She explains there might be challenges specific to Judaism, and especially Orthodoxy, which drive eating disorders, such as the pressure to marry young and to balance a career with being a homemaker.
On Jan. 1 in Israel, a law went into effect that aims to prevent fashion models from losing weight to the detriment of their health and the well-being of others who may follow in their footsteps. The law stipulates that fashion/commercial models should have a body-mass index of at least 18.5 and that computer-generated changes to make models appear thinner must be noted along with their images.
BodySmart, a new UA program, is sponsoring a screening of “America the Beautiful 3: The Sexualization of Our Youth,” a film by Daryl Roberts will be shown on Wednesday, Feb. 25 at 6 p.m. at the Gallagher Theatre. Filmmaker Roberts will lead a question and answer session following the screening. His first film in the series was “America the Beautiful: Is America Obsessed by Beauty?”
Orlich often sees UA students with body image disturbances who “try on jeans from last winter and aren’t looking as well as they’d like,” she told the AJP, noting that the DSM5 recognizes as a warning sign when body image “becomes disturbing to your life, if you won’t go to work or to a party because ‘I don’t look good.’ Students isolate” because of comparisons they make to images in the media.
While in our media-driven society, body image concerns are all too common, they can mask more serious eating disorders, says Orlich. “Bulimia may look healthier than anorexia but there can be cardiac issues and electrolyte imbalance. The first organ impacted by lack of nutrients is the brain, which can cause brain starvation. With the brain in an altered state maybe poor decisions are being made.”
But treatment can work, says Orlich. “We believe these diseases are recoverable not just treatable. That’s what keeps me going. On a surface level it’s about the food but it’s always about something else.”
(For more information, visit www.health.arizona.edu or call 621-3334. Contact Dr. Laura Schnaps at 696-0422.)