............ i w V V V Vw -IV The, Seductive Disorder 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 look beautiful." 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 prevalent. 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 Judith Rodin. "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 student here. "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 Krahn says. 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 his patients. 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), and purging." 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 have problems." "You have to learn not need people," she says. "Once I was allowed to easier." 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," Sech says. 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 says. "I knew a lot of people in my class but after class everybody disappeared." "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 thought. "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 management technique." "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 condones it. Bulimics seem to internalize the rhetoric of a weight watching society. '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