Starving for Perfection

Junior Emily Richards*, a petite blond dressed in sweatpants and a baggy Colgate sweatshirt, sits curled up on a couch in her apartment. Clutching a cup of tea, she unwittingly displays the scars on her right hand, permanent reminders of a compulsion from which she's - tenuously - freed herself. She used to inadvertently scrape her knuckles, she explains, because her teeth would gnash against her skin as she stuck her hand down her throat to gag herself.

Richards is one of approximately eight million Americans - 90 to 95 percent of whom are women - who suffer from eating disorders. She has worked to overcome both anorexia nervosa, characterized by self-starvation and excessive weight loss, and bulimia nervosa, an often secretive cycle of binging and purging through vomiting, excessive exercise and/or laxative abuse. One can hardly underestimate the seriousness of the consequences: bulimics can develop heartbeat irregularities from vomiting and laxatives, and anorexia is fatal for 20 percent of its victims. Richards knows how lucky she is that the only lasting physical reminders of her illness are scarred knuckles.

According to a study published earlier this year in the Journal of Counseling and Development, mental health professionals have long debated over two modes of conceptualizing mental illness. The Diagnostic and Statistical Manual of Mental Disorders (DSM) - which contains the criteria used to diagnose mental illness - defines eating disorders categorically. That is, the DSM delineates anorexia and bulimia as the primary eating disorders, with a third category for combinations of symptoms that may or may not constitute diagnosable eating disorders. Some experts maintain this perspective, according to the Journal of Counseling and Development, viewing mental illness as a "set of categorical (i.e., qualitatively different) disorders, distinct from normal development and from each other."

But lately many researchers and clinicians - including Colgate's Director of Counseling & Psychological Services Mark Thompson - have begun to assess mental disorders as "dimensions occurring along a continuum on which individuals vary in degree but not in kind." In other words, perhaps eating disorders fall at the extreme end of a range of eating behaviors which, according to Thompson, encompasses everything from "body image dissatisfaction - maybe behaviors that are troubling and interrupt a student's regular routine - to the extreme end of the continuum, something that would qualify as an eating disorder." In the counseling center's annual compendium of statistics related to the treatment of Colgate students, perhaps the most startling figures are those detailing therapists' diagnostic impressions of their patients. That is, Conant House's therapists tallied the numbers of students falling into each diagnostic category, often filing a student under more than one. Eating disorders, prominent as they are on Colgate's campus, only account for nine percent of the problems treated, which suggests that disordered eating is often symptomatic of some other, overarching illness - such as anxiety or depression, the top two psychological disorders Colgate's counselors treat. Therefore, part of the reason Thompson and his colleagues believe in the effectiveness of the continuum approach is because they have treated numerous students with problems that manifest themselves in terms of food but that have roots in issues more complex than a simple desire to lose weight.

It's important to sort through these issues because statistics indicate eating disorders are epidemic among college women and are on the rise among men. In February 1998 approximately 600 college campuses participated in a National Eating Disorders Screening Program; of the 26,000 students who filled out questionnaires, 4,700 were referred for treatment for serious eating disorders. A study in the Journal of American College Health, published in the same year, reported that about one quarter of the female undergraduates surveyed felt they were not in control of their eating habits. Therefore, even though about 10 percent of the general population of women suffer from diagnosable eating disorders, that figure jumps to anywhere from 18 to 25 percent among college women.

According to Thompson, eating disorders rank among the most difficult mental illnesses to treat. Experts can't pinpoint a single cause for anorexia or bulimia, and, according to researcher Sheila Lintott, "behind any eating disorder there is likely to be a complicated web of social, familial, psychological or biological determinants," even in a single individual. We probably aren't wrong to blame eating disorders on the preponderance of media images of dangerously underweight female bodies, the intense pressure on women to conform to narrow definitions of beauty, or our culture's idolization of the celebrities who embody those standards. But if we hope to understand the mysterious and dogged determination with which millions of eating-disordered people systematically starve themselves, we must appreciate the complex intersection of these and other forces in the psyche of the contemporary young woman.

Karen, Calista & Mary-Kate:

The Cultural Obsession with Eating Disorders

"The beautiful is the symbol of the morally good."

- Kant

The existence of eating disorders was propelled onto our cultural radar in 1983 when singer Karen Carpenter starved herself to death, at which point a magazine cover reported, "Carpenter Dies of Anorexia Nervosa - A Rare Mental Disease." In photos taken during the final weeks of her life, Carpenter looked emaciated and frail, and she could barely walk or hold up her head. In the same magazine, on the very next page, was a liquor advertisement featuring a model in a white bikini, sprawled out and sexually provocative - but her body looked a lot like Carpenter's.

According to Mary Pipher, Ph.D., author of Hunger Pains: The Modern Woman's Tragic Quest for Thinness, "We are living in a culture that promotes a monolithic, relentless ideal of beauty that is quite literally just short of starvation for most women." Recent psychological research indicates that virtually all American women are ashamed of some aspect of their bodies; moreover, 90 percent of women overestimate their body size. Pipher recalls an evening spent talking with a friend, Sandra, over wine and cheese: "Every time she had a slice of cheddar, she interrupted her conversation to comment, 'This will be my last' or 'I feel evil tonight.' Sandra was not an exception. Like most of us, she'd been socialized to apologize for her appetites. Food was her enemy. Her body was her enemy. To enjoy food was to sin." The American woman's paranoia about weight manifests itself in the diet support groups, dangerous weight-loss drugs, and the low-calorie and low-carb industries that flourish in America; we give billions of dollars to those who can incite the fear of weight gain and promise to help.