Although eating disorders do not tend to capture media headlines as frequently as other psychological illnesses, the medical and psychological problems caused by anorexia and bulimia are severe. In addition to common side effects, such as fluctuations in heart rate, blood pressure, disruption in thyroid functioning and menstruation cycles, the drying of skin and hair, and weight instability, eating disorders can also, over time, cause partial or complete shut-down of the body’s critical systems and organs (Farley, 1992). Furthermore, eating disorders can cause severe psychological distress, including distorted perceptions of self and others, depression, and fatigue, among other emotional disturbances.
Despite these and other deleterious effects of eating disorders on one’s body and mind, little public attention is given to this problem because the prevalence of eating disorders is reported to be low, between 0.2 and 0.8% for anorexia and 1% for bulimia. In addition, many people view eating disorders as private problems, not diseases, but personal failings. Women with eating disorders, then, often feel trapped by their own sense of low self-worth, an unfavorable impression of them on the part of society, and the tension that they feel between stopping maladaptive behaviors and pursuing the social ideal of the body that is promoted throughout this culture (Treasure, Schmidt, & Van Furth, 2003). To further complicate things, it is almost impossible for any woman, myself included, to not feel an immense amount of pressure to be thin. Although resorting to an eating disorder is not something I personally have experienced, I have no problem understanding why many women do and think that there is a serious problem with women and body image in general, mostly because of media representations of women who are thin and thus, almost as a result, glamorous.
Despite the fact that the prevalence rates of eating disorders are reported to be low, affecting just 1% or less of the population, researchers and medical experts indicate that the actual prevalence of both anorexia and bulimia may be much greater (Treasure et al., 2003). Because women with anorexia or bulimia often feel ashamed of their illness, they tend to hide their eating behaviors from others and they do not report medical or psychological distress to their health care providers (Treasure et al., 2003). Unfortunately, due to the secrecy of the illness that is created by such shame, many women do not receive intervention or treatment before significant damage has been suffered by their bodies or their spirits (Treasure et al., 2003). Such damage, whether sustained by the body or the mind or both, can be severe indeed and even women without eating disorders can feel ashamed of their obsession with weight issues. Although the human body is remarkably resilient and adaptable, it cannot, over the long term, sustain the type of damage that eating disorders cause, largely because most of the types of damage are irreversible (Treasure et al., 2003).
It seems that every part of the human body is affected negatively by an eating disorder. On the outside, effects of long-term eating disorder behaviors eventually become evident (Treasure et al., 2003). The skin becomes translucent or yellowed, much like parchment, and is vulnerable to damage (Farley, 1992). Hair and nails become brittle, breaking easily (Farley, 1992). The individual with an eating disorder will often have a general appearance that suggests the absence of wellness: circles under the eyes, extreme thinness, and an air of fragility (Farley, 1992). The internal effects of eating disorders are harder to see, of course, but are often more difficult to sustain. In addition to those consequences mentioned already, such as the instability of vital signs, women with eating disorders often have problems such as acid reflux, thin lining of the stomach that makes them sensitive to gastrointestinal discomfort, and heart palpitations (Farley, 1992).
If the eating disorder is persistent and severe, premature death can result. As Treasure et al. (2003) indicate, “In studies [of people with eating disorders] specifying the cause of death, 54%…died as the result of eating disorder complications [and] 27% committed suicide….” (p. 18). The negative health impacts of having an eating disorder are numerous and will only serve to increase a woman’s low self-esteem and self image, especially since some of these visible health changes are immediately noticeable and have a direct effect on how a woman looks. Unfortunately, the problem is that being thin is seen as being healthy and for many women, the line between thin and ill is rather blurred and this is having a serious impact. While I do wish to look healthy and not overweight because of the pressures I feel from society (people at work, school, and even my family and friends) I have a hard time sometimes deciding what is healthy and what is simply thin. I cannot help but think that many other women, especially those on the verge of an eating disorder have this same issue.
Since being thin is equated with being healthy in our society, there are a number of important avenues to explore that involve women’s health more generally. When one is not getting enough nutrition or is being worn away from the effects of bulimia, it is important to note that these more outward and obvious health issues are not the only ones present. In addition to the physiological effects experienced by women with eating disorders, many women also experience significant psychological problems (Farley, 1992; Treasure et al., 2003). First, because women often withdraw from their familial and social relationships in order to hide their behaviors, they often suffer from loneliness (Treasure et al., 2003) and this mental side also has an effect on women’s health. Most, if not all, women with eating disorders also have severely distorted perceptions of themselves and of others. They believe themselves to be fat, even when their actual weight suggests otherwise (Treasure et al., 2003). Because the perceptual disorders can be so severe, the American Psychological Association has diagnosed eating disorders as a category of mental illness, and recommends psychotherapy in addition to medical treatment for women who have anorexia or bulimia (Treasure et al., 2003).
Despite the fact that eating disorders affect a relatively low percentage of the population overall, it is important for society to examine the ways in which it may contribute to eating disorders. As Treasure et al. (2003) point out, our culture promotes mixed messages about the relationship that we should develop with food and with our bodies. On the one hand, we are encouraged to buy super-sized value meals that have more fat, calories, and cholesterol than are recommended for an entire day’s consumption (Treasure et al., 2003). On the other hand, we are told, both directly and indirectly, that we should be thin and conform to a specific beauty ideal (Treasure et al., 2003). Clearly, it is impossible to fulfill both of these directives simultaneously. Even for a women without an actual disorder, these contrary notions can have a dizzying effect. Women are often shown in the media as being thin and glamorous and many of them are desperately underweight and look as though they sick. Nonetheless, these same body types advertise to us on McDonald’s commercials. There are too many mixed messages about weight in this country and it is having an extreme effect on women’s health. Even women without eating disorders suffer a great deal of stress trying to live up to the image of the ideal body and whether I care to admit or not, I, like most other women I know, cannot help but fall victim to these prevalent assumptions about what is “beautiful” or even healthy.
Women engage in eating disordered behavior because they are attempting to achieve an ideal body type defined by the larger society. Whether women binge and purge or whether they starve themselves, the general objective is the same: to achieve a body weight that is supposedly ideal. The problem, however, is that because the ability to see oneself accurately becomes so distorted and because one’s body cannot handle the stress that is put upon it, that beauty ideal can never be achieved. As a society, we need to become more accepting of diverse body types. Not everyone, even through a disciplined diet and exercise, can maintain the ideal body type that is portrayed by advertising and popular culture. We should work towards promoting total health, which is not only about having a functional body we can enjoy, but is also about promoting tolerance and acceptance, both of ourselves and others. At that point average women such as myself can achieve a good balance between true health and a balanced self-image.
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References
Farley, D. (1992). Eating disorders require medical attention. FDA Consumer, 26(2), 27.
Treasure, J., Schmidt, E., & Van Furth, E. (2003). Handbook of eating disorders. Hoboken, NJ: John Wiley & Sons.