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For some in our thin society, bulimia
becomes the answer to all life's problems
By Dov Cohen Ph
Sarah had what her sister called a "vogue disease."
Her routine consisted of going to class, working in a food
store, binging on sweets in the evening, and spending half the
night in the bathroom as the 90 laxatives she had taken that
day began to run through her system.
She thought constantly of food and steadily worked her way
up to the 90 laxatives a day after reading that figure in a book.
She was a bright but lonely student, binging and purging to
escape her loneliness.
Before she was hospitalized for laxative abuse, her system
had been run down so that she had trouble climbing stairs, and
her preoccupation with weight and food became the focal point
of her life.
Sarah's case of bulimia began like many others - as a
simple attempt at controlling weight in the midst of a weight-
conscious society. However, for her and for many of its
victims, the syndrome became a horrible, seemingly
unstoppable, escape into numbness, isolation, and despair.
At any given point, about 1 to 5 percent of college women
will have clinical bulimia (which involves binging and
purging or fasting at least twice a week), researchers say. And
bulimic behaviors - which can range from binging and
purging or fasting once a week to once a year - are much
more widespread, with estimates as high as 40 percent of
college females being affected at one time or another.
It's a remarkably seductive disorder. For its victims it can
become the answer to all life's problems, the "last step in
perfection," a "stress management technique" to "unwind" after
work, or a way of escaping problems, feelings of loneliness,
and insecurity. And what makes the disorder all the more
otos by Andi Schreiber
"Thinness doesn't only get you more attention, it gets you
to be intelligent, in control, successful."
In a society where the "hottest topic of conversation of
women in a cafeteria is 'I shouldn't be eating this,' thinness,
for the bulimic, "becomes a magic answer to life's
uncertainties," he says.
"In adolescence, it's very attractive. It's a one-step answer
to the world."
And in this last 20 years, the world has gotten a lot more
complex for women, points out Judy Banker, director of the
Center for Eating Disorders. The exacerbation of the eating
disorders problem has "coincided with the women's movement
and the emphasis on thinness," she says.
There are "a lot of options for women (because of the
women's movement)," Banker says, "but not a lot of role
models - except for the movie stars, and models, who all
Says Krahn: "It's not like when (women went) out in the
work force, we're going to ease up on the demand to be
sexually attractive. Nobody said that...it's not surprising
(women are) under a great deal of pressure."
The demands on women increased and the idea of "If I can
only look good...things will come together" became more
But if looking good became the panacea, it also became
more inaccessible for the American woman. Because of an
increased emphasis upon nutrition, women were gettting
heavier as "the ideal" was getting lighter. Using weight tables
for young female life insurance holders, researchers headed by
David Garner found that as Playboy centerfolds and Miss
America Contestants were losing weight in the last 20 years,
the average woman was putting it on. Only about five percent
of the policy holders could meet the "ideal" weight as set out
by the Miss America Contest winner.
The unrealistic "thin" message that is sent to women subtly
encourages anorectic behaviors, in what tend to be teen-age
women, and bulimic behaviors in what tend to be late
adolescent and adult women.
And yet, researchers say, the encouragement isn't always
subtle. "The mass-market weight control industry almost
prescribes (bulimic) rituals" for weight control, hyphothesizes
Yale researchers Lisa Silberstein, Ruth Striegel-Moore, and
"The bestseller Beverly Hills Diet Book advocated a form of
bulimia (where) binges are 'compensated' by eating massive
quantities of raw fruit to induce diarrhea." In addition,"mass
media (makes available) what one might call manuals for 'how
to develop an eating disorder."'
"If you pick up the standard women's magazines, you'll see
at least one article in a couple months that comes close to
bulimia" in perscribing binging and restricting, Silberstein
says, adding that she once saw a newspaper ad offering to
teach "responsible bulimia" as a weight control device.
Says Banker, "I think most of the women in this country
are at risk for developing eating disorders. Most of the women
"It was my way of de
dealing with anything that
numb, forgetting" said C
behaviors for eight years
"After you binge and pi
numb. I don't mean physi
numbness," she says.
Carol who wore a moh
and treble-pierced ears "den
liked by others). I'd go out
different as possible."
"If I started to really f
binge and purge," says the
homemaker. "It becomes a
don't want to deal with."
"It was a time filler, bin
Whenever I didn't want to 1
other people didn't want to
would never reject me.
Her preoccupation wit
thinking about anything el
one of the major reasons sh
shared an apartment wi
exacerbated the condition."
today.' And then your room
of groceries ready to binge.'
It wasn't, however, unt
nightmare come true" that
late night at an out of the w
when she went in for couns
She had been living wit
and he never knew about t
was afraid I was going to lo
Luckily for Carol and S
bulimics is good.
In a study done in 198
Drewnowski found that foi
women here will develop
year. However, he noted, a
the disorder will recover wil
And among those wh
prognosis is also good.
treatment can be expected
However, Krahn notes,
done. After three to five y
persists, he says. (Though i
for quite a long time. Kra
been anorectic and bulimic
been bulimic for 30 years.)
In the more severe cases
developed to fight depress
mood, Krahn says. The d
percent of the time and Kr
In-other cases, recovery
change the way they thi
thinness and learn new ways
Carol, the woman who
and purging, had to allow h
a hard process allowing my
myself to feel bad (before),
The woman who "went
had to learn that she at lea
"Feeling secure enough to
makes any sense," she says.
And Sarah, the woman
problems," learned new way
Before, "I was the per
problems. I wasn't suppo
remembering how she used
Now, "I don't have to I
"You have to learn not
need people," she says.
"Once I was allowed to
in this country are perfectionistic." The eating disordered
persons are the ones who "go for it hook, line, and sinker."
Who is particularly at risk? And what are the reasons
individuals do this?
These are questions researchers are working on but admit
they don't know a lot about.
For some, thinness would be "the last step in perfection"
in what tends to be "hardworking, bright, perfectionist
women," says Eithel Sech, chief social worker at the Student
Counseling Office For others, their weight becomes the one
thing in their lives they can control, Krahn says. And for
many, the syndrome becomes an escape, a way of avoiding
problems. "Part of therapy is finding out why you're using it,"
For Sarah, the problem was loneliness. "I started binging
because I was lonely. It gave me something to think about
and it was an act of rebellion because I didn't get along with
my mother. But mostly because I was really lonely," she
"I knew a lot of people in my class but after class
"I hit bottom by living by myself."
Sarah's life became so wrapped up in her bulimia that she
escaped dealing with her loneliness. "You'd eat and food
became your friend."
"It gave me something else to think about. If you're
thinking about eating, and stuffing your face and then afterward
how nautious you feel, you don't have to think about anything
else," she says. "You spend all your time thinking about it so
you don't have to think about anything else."
"A pound of M & Ms, a box of cookies, a few chocolate
bars, and (some) ice cream" later and "it's like being drunk."
It becomes an all-involving "vicious cycle." "You wake up
every morning and say 'I'm not going to do this. I'm not
going to do this. I'm going to be good today.'"
After thinking about food all day, "You'll eat one thing and
that will trigger you and you'll eat everything in the house,"
she says. And as you're eating, the whole time you're
thinking,"You have to throw up. You have to throw up."
The tension that is built up is culminated with an "ironic
horrible victory" after the purge, she says. And "after you've
been through so many emotions, you're so tired...you want to
go to bed.
"You wake up the next morning depressed because you fell
for it." And the cycle begins again.
"I didn't care what it took as long as I got thin," she
"My mother instilled in me the idea that only thin people
were happy, successful," she says. "If you were just thin, that
was the answer to it all."
But in as much as thinness can represent the answer,
bulimia can serve as an escape - as a very perverted "stress
"Stuffing yourself is like a narcotic," Banker says, noting
that it makes one feel sleepy and tired. And throwing up is a
release of tension, which can loosen up a tight chest area, she
theorizes. One can feel really "limp" and "relaxed" afterward,
she says. (A still tenative hypothesis associates bulimic
behaviors and endorphins, the brain's natural pain-killers that
produce things like "runner's high.")
Banker has counseled professional women who "use
(bulimia) as a stress management technique, instead of having
a cocktail. It's a way to unwind. It brings you down."
Emotionally and physically, the purge serves its purpose..
"It's a way of releasing all your inner emotions," says a
counselor at the Center for Eating Disorders. Occasionally,
the purge becomes almost violent. Banker remembers one
person telling her that they "pictured people in the toilet when
they were throwing up."
Using the purge to deal with emotions was what was
attractive to Carol.
seductive, researchers feel, is that society fosters it and subtly
Bulimics seem to internalize the rhetoric of a weight
'Thinness becomes the ultimate positive virtue," says Dean
Krahn, director of University Hospital's eating disorders clinic.
Cohen is a Daily news staffer; Schreiber a photo editor
PAGE 6 WWEEKEND/OCTOBER 30, 1987
WEEKEND/OCTOBER 30, 1987