by Trish Higgins Kurowski
* Some names have been changed

Lynne Hinnant on
Christmas morning in 1994

The day Miriam Richardson* reached the end of her rope, she went out and bought a large chain and a padlock. When she brought it home, she placed it around the refrigerator, locked it, and left for work. While she was gone, her 19-year-old daughter, Abigail, used a metal file to break the links and get to the food.

Miriam was not abusing her daughter by withholding food; she was simply trying to stop her from eating every morsel of food in the house. I had to protect myself and my other children. If I didn’t lock it up there would be nothing left for breakfast, lunch, or dinner. She would eat everything that was edible.”

Miriam’s daughter is one of an estimated eight million Americans who suffer from an eating disorder. Some, like Abigail, struggle with bulimia nervosa, a condition that drives the victim to consume huge amounts of food and then resort to vomiting, laxative abuse, or excessive exercise to rid the body of the calories.

Others restrict their caloric intake so severely that their bodies slowly starve. This disease, known as anorexia nervosa, is what killed pop singer Karen Carpenter and, more recently, gymnast Christy Heinrich. According to Vivian Meehan, president and founder of the Association of Anorexia Nervosa and Associated Disorders (ANAD), more people die each year from eating disorder illnesses than from AIDS. The disease affects both genders, but 90 percent of the known victims are female.

Though the vast majority of people who suffer from eating disorders report the onset of the illness during their teenage years, recent research suggests that the seeds of the disease are planted at a much earlier age, when children are developing their sense of “self.” It is blatantly clear that eating disorders are linked to our society’s love/hate relationship with food and our absurdly idealistic definition of self, but that’s not all there is to it by any stretch.

Why are you doing this to yourself?

The first indication for Miriam that Abigail was developing a problem was when her daughter returned home from her first semester in college. “When she walked in I was shocked at how thin she had gotten. I asked her if she had stopped eating altogether and she said no. She said she just wanted to lose a few pounds. I warned her that she had lost a lot more than a few, but it didn’t have any impact on her.”

For a year and a half Abigail dieted until at one point she carried a scant 70 pounds on her five -foot frame. Her mother constantly feared for her daughter’s life and grappled with the numerous ‘whys ‘ of the disease.

“She later told me that she was having trouble adjusting to life away at college, but as a parent you always think it’s something you did to cause this. Maybe it was the divorce, or maybe I was too strict… ”

Why does it happen?

According to experts, those kinds of things may contribute to the problem, but the cause and effect of an eating disorder are rarely that simple.

“Anorexia nervosa and bulimia nervosa are very complex psychological disorders,” says Dr. Lynda Brogdon, an eating disorder specialist and founder of the Health Management Institute in Tallahassee. “They are thought to be caused by a number of factors, including messages we get from our peers, from the media, how we interpret societal messages, family expectations, and even the neuro-chemical makeup of our bodies.”

The complexity of the disorder makes it difficult to make any absolute statements regarding the causes of eating disorders, but there are some commonly shared characteristics among many victims of the disease.

“These people are often perfectionists,” says Meehan. They are frequently very intelligent, sensitive, acutely aware, but they’re looking for a way to fit in and get recognition. They are people-pleasers. And they often have difficulty dealing with issues of loss and change.

According to Meehan, their perfectionistic attitudes and compliant personalities mask deep feelings of anxiety, and insecurity. They tend to hold themselves to unrealistically high standards and live in fear of making mistakes and failing.

“I was always trying to be what everyone wanted me to be,” says Lynne Hinnant, a 34-vear-old nurse who has struggled with anorexia for 17 years. I was always trying to please everyone. I was a good student. I never rebelled or gave my parents any trouble. This really started out as just a diet. I weighed 135 at 5’8′ and I wanted to lose a few pounds.” But as the pounds came off she began to feel a sense of control that had previously eluded her. Each time life dealt her a difficult blow (her parents’ divorce, the death of her mother, and later the death of a friend), she ate less and less until eventually’ she was hospitalized with her weight hovering around 103 pounds.

“They are often in extreme emotional pain, and by focusing on food, they can ‘defocus’ on their pain, much like the alcoholic or the drug addict,” says Meehan. “If all you can think about is food and weight or when your next binge will be, everything else is blocked out. It’s the ultimate control mechanism for people who feel they have no control over any other portion of their lives. In the case of anorexia, the one thing these people can control is what does or does not go into their mouths.”

Thin is in.

This disease is particularly seductive because society considers thin to be a benchmark of health and success. The ability to lose weight is almost always seen as a sign of strength and often draws positive comments from peers, friends, and family. But when image becomes an obsession, mental illness can take hold. We also need to remember that eating disorders can be life threatening.

Lynne Hinnant one year later…
a happier and healthier 1995

It’s about feelings
“In the sub-clinical stages,” says Dr. Brogdon, “a person is stuck in not liking her body, but once it develops into an eating disorder it becomes a psychiatric syndrome. When a person’s weight drops 15 percent below her ideal body weight, chemical changes start to take place.

These people often exhibit obsessive/compulsive tendencies, and we know that people who are obsessive/compulsive are usually deficient in serotonin which is a neurotransmitter important for keeping our moods stable and signaling when we are full or hungry.”

According to Brogdon, when there is a deficit of serotonin, the ability to process information cognitively is impaired. “The person tends to think more negatively in general,” she says. “I’ve had people tell me that just a two- or three- pound weight gain makes a big difference in their ability to think rationally.”

“It’s almost like there’s another person inside you,” says Hinnant. “There was the one side of me that knew I was too thin and there was the other side of me that would come in as soon as I ate anything and say, ‘Now see, you’re going to get fat.’ It’s a constant, raging battle, and it drowns out all the healthy, normal thoughts.”

Anorexia can become Bulimia

According to ANAD studies, 50 percent of the people who are anorexic eventually move on to bulimia, which was the case with Miriam’s daughter.

“Everyone in the family was horrified by her appearance and would tell her she needed to eat,” says Miriam. “One day after about a year and a half of starving, she became afraid she might die if she didn’t eat something. So she went into the kitchen, ate a fairly normal portion of something, panicked, and then rushed to the bathroom and got rid of it. I didn’t know it at the time, but this was the beginning of her transition from anorexia to bulimia. I noticed that she started chewing a lot of gum, but she was finally eating and gaining some weight, so I thought she was getting better.”

Actually, Miriam’s daughter was descending into an even more terrifying phase of her illness. She became very secretive about her eating, doing most of her bingeing at night when everyone was asleep. Then she developed a pattern of lying and stealing to support the binges, but Miriam fought back. She locked up the food, hired therapists and psychiatrists and even started a support group for other families going through the same ordeal.

For eight years Abigail struggled with the self-loathing and destructive behavior of her illness, while her mother learned to set limits and let go of her need to “fix” her daughter’s life. Arrested for drunk driving at 26 (alcoholism is a frequent companion illness to bulimia), Abigail finally “bottomed out” and entered therapy of her own volition. Today Abigail is a sober, happy woman in her 40s who is still very controlled in her eating habits, yet is keeping her weight up by maintaining a healthy diet.

Can it be prevented?

Because there are so many contributing variables, it’s difficult to say what a parent can do to prevent a child from developing an eating disorder, but according to Brogdon, parents should look at their own attitudes about body image and think about the way they use food, as well.

“A recent study of 4000 fourth graders indicated that 7O percent of them had already dieted,” says Brogdon. “Our children get a sense of what our ideas of body image are from what they hear us say. If they hear us talk about how we think we are fat or we hate our thighs or whatever, we can be setting up a thought process of negative body imaging.” In addition, as parents we tend to set up unrealistic expectations for our children. We reward As and Bs but somehow the Cs are seen as failures, when in many cases that C may represent the child’s best effort. If we expect them to strive to be perfect, they’re going to have a hard time living up to that expectation.

Vivian Meehan agrees, “We need to aspire to raising kids who learn to express their needs, feelings, and emotions, not kids who try to be what others want them to be.

Dr. Brogdon also recommends that parents be aware of the role food plays in the family’s life. “Give hugs not cookies, when you are comforting or rewarding your child. Instead of a piece of cake, try spending time reading a story to your child or just have cuddle time. When food is used as an attempt to nurture, it often becomes paired with feelings. For example, a child who is feeling excluded by his peers may come home and use cookies in an effort to be distracted from feeling left out. If you notice that your child’s relationship with food is changing or that he is engaging in emotional eating, you may want to talk to him about how he is feeling.”

The road to recovery is long and expensive

The emotional and financial turmoil of dealing with a child who has an eating disorder can devastate a family. The treatment is often extremely expensive, with the cost of in-patient care running $30,000 or more a month. Many patients, like Lynne Hinnant, need repeated hospitalizations, and all victims require extensive medical monitoring, treatment and therapy. Add to this burden the fact that most people who suffer from an eating disorder deny their illness, and the frustration for parents can become overwhelming. According to Meehan, parents need professional help dealing with this illness. It is very unlikely that a child who is starving or bingeing is going to outgrow the behavior. “You have to find a way to get your child into therapy but she has to reach a point where she wants to get better,” says Meehan.

For Lynne Hinnant, the 17-year battle that raged in her head has finally been silenced by her participation in a very comprehensive program set up by Dr. Brogdon that included daily individual counseling sessions, group therapy several times a week, physician monitoring of her health status, dietary counseling, and even activity planning to help overcome her fear of social situations that involve food.

“Seventeen years is a long time to be thinking about food” says Hinnant. “And when you’re in the middle of it, you definitely think it’s about food, but it’s not. It’s about feelings and how you feel about yourself. People who have eating disorders think their happiness is contingent upon reaching a certain goal. I’ve heard people say, ‘Well, when I get to 70 pounds, I’ll be OK.’ But you won’t. You’ll just lower the goal to 60 pounds and then 50, until you decide to recover or you die.”

Today she’s convinced that the worst is behind her, but she’s not about to let down her guard. If things are going well and you’re really fighting back, if it [the disease] thinks you’re going to get over it, it’s going to do everything it can to come back. There are still two conflicting personalities here doing battle. It’s just that the healthy one is now the stronger one.”