By LAURALYN AVALLONE
Local experts shed light on a medical dark secret
Calista Flockhart, otherwise known as T.V.'s lovelorn attorney Ally McBeal, is a size zero. So are "Friends" sitcom queens Courtney Cox and Jennifer Aniston. Teen singing sensation, Christina Aguilera, also wears a size zero.
This barely existent size is becoming increasingly more popular in women's clothing stores. Is the drop in size a reflection of the slimming down of American girls, or is it a red flag that girls are wasting away in the images of what is expected to be the ideal body?
Dr. Jovita Maureen Crasta, M.D., is Director of Psychiatry at South Nassau Hospital and specializes in eating disorders. According to Dr. Crasta, the ideal body for a beauty queen in the 1960's was 5'2", 125lbs. Today's ideal body, as projected by the modeling industry, is 5'7" and under 100lbs. A women who is 5'6" and wears a size zero weighs 95lbs. or less, Dr. Crasta said.
Dr. Judith Rabinor, PH.D, runs the American Eating Disorders Center of Long Island in Lido Beach and is the author of "Starving Madness: Tales of hunger, hope and healing." Dr. Rabinor knows all too well how food obsessions can take over lives.
"'I feel fat' are three little words that contain a giant amount of information," Dr. Rabinor said. "All people want to be thin and culture plays a role. Why can't some people come to grips with the fact that they don't look like models?"
The average woman, said Dr. Rabinor, is 5'4" 142lbs. The average American model is 5'9"110lbs. The average measurements of a model are 33-32-33. The average measurements of a Barbie doll are 36-18-33.
"Everyone can't diet or exercise their way down to a size two," Dr., Rabinor said. "How do we fight back when society reinforces it? It's incredible how much cultural pressure affects normal women."
Eating disorders come in all shapes and sizes and which one afflicts which person is dependent on genetic and cultural factors.
"There is no one reason why eating disorders develop." Dr. Rabinor said. "It's very complex. The trigger is usually some kind of crisis, such as rape or divorce. The body becomes a site of shame. There's an underlying vulnerability; anxiety, low self-esteem, looking for a quick way to fix up their life. It's social, biochemical. Many patients also have obsessive compulsive disorder or depression. A lot of these women are perfectionists."
Anorexia Nervosa is often first seen in early to mid-adolescence and is marked by an obsessive fear of gaining weight. Anorexic people avoid eating meals and instead are constantly fasting or denying that they're hungry.
If they do sit down to dinner, they will often display unusual eating habits such as playing with their food or counting the number of peas on their plate, Dr. Crasta said. According to the National Eating Disorders Organization's (NEDO) website, definite warning signs that someone is suffering from Anorexia is the loss of their menstrual cycle, abnormal weight loss of 25% or more, growth of lanugo (fine hair on the body), dry skin and thinning scalp hair.
"Eating disorders can be crippling or limiting," Dr. Rabinor said. "After a couple of weeks on a low-calorie diet, most people give up and say 'forget this, I want a life.' When medical problems develop, they can't think too well, concentrate too well."
Bulimia Nervosa is similar to Anorexia in the aspect that food is used as a way of feeling more in control of one's life. However, in the case of Bulimics, they are not underweight. Bulimics will ingest large quantities of food and then dispose of it by purging, which means vomiting, misusing laxatives and diuretics. NEDO reports that Bulimics may alternate between binging and fasting, are secretive about binges and vomiting, consume high-calorie foods on a binge and tend to experience depression. After a purge, they may say to themselves „my life is pointless,‰ Dr. Crasta said.
Dr. Crasta said it is important to note that many Bulimics are also substance abusers, with alcohol being one substance of choice. Since alcohol is known to increase the appetite, it may also increase the chances of binge eating. Bulimics tend to replace one addiction for another, be it food for a boyfriend or a boyfriend for drugs and alcohol, she said.
Both Anorexics and Bulimics tend to over-exercise to an obsessive extent, regardless of fatigue, and are met with complicated health problems, from heart failure and chronic kidney problems to bone fractures and erosion of tooth enamel. It may also lead to death.
"I have patients who exercise religiously three hours a day," Dr. Rabinor said. "People running in hurricanes, 14 miles a day. Exercise fanatics are socially admired. Exercising is a way of binding anxiety. People who have eating disorders are hungry. Their life is empty and staying busy keeps them away from life challenges."
If a loved one is suspected of having an eating disorder, there are several ways to go about helping them. Saying „you must eat now‰ or demanding an immediate change in behavior will most likely drive the loved one into a deeper denial of their problem, said Dr. Crasta. Approaching the person in a non-judgmental way and suggesting they find help is a start. Family therapy is extremely beneficial to people with eating disorders, as, Dr. Crasta said, „a lot of the obsession on self image and weight is tied into family dynamics.‰
"The bottom line is when in doubt, go to a mental health professional," said Dr. Rabinor. "For women in society, good and powerful is equated with looking sickly. Women are less of a threat if they don't look strong and don't feel well."
Bulimics may find Weight Watchers and Overeaters Anonymous helpful in terms of regulating eating habits and sharing feelings with others who are able to relate. In both cases, self-esteem must be nourished as much as the body.
„The food and modeling industry play a big role in eating disorders,‰ Dr. Crasta said. „If you're vulnerable you may be caught up in the false reality that body image is tied to self worth. We can't stop the media but we can make them aware of their impact.‰
Dr. Rabinor compared the impact that the thin trend of the millennium may have on the next generation with the cigarette trend of the 1950's. "How did everyone get into smoking cigarettes?" she said. "Because it was associated with being chic."
NEDO reports one in 250 young women may be suffering from Anorexia Nervosa and 20-30% of college-age women may display Bulimic behaviors. Dr. Crasta, who also lectures on the topic, said that 50% of fourth-grade girls, age 9, have dieted. At age 17, 89% of teen girls have dieted -- 15% of whom will develop an eating disorder. The rate of boys developing eating disorders is also on the rise, approximately 4%, and is attributed to the desire to be a perfect athlete.
Fasting and purging have seen the light of the public glare, however they are not the only eating disorders that spin lives out of control. Binge eating, which is similar to Bulimia but without the purging, and obesity are also eating behaviors that carry the burden of serious health risks. Twenty-five percent of the U.S. population is overweight, including one in nine children.
For more information about eating disorders, see www.anred.com and for bulimia in males, ltspeed.com/bjblinder/blmales.htm.
Out of control: one woman's struggle with the scale
I was 15 when my boyfriend broke up with me and I started to purge. I purged with my friends. We'd go back and forth from binging and purging.
In fourth-grade I came back from summer vacation and everyone started calling me fat. Every year I would lose weight and they would say things. I'd be in the kitchen and my father would say, "Are you eating again?" when I wasn't eating all day. I'd eat cheese and tuna and throw up everything. One time my father found out I was purging and he started to pretend he's gagging.
When I was 16 years old, I'd go through the McDonald's drive-through and eat Chicken McNuggets, french fries, drinks, and then go to the bagel shop. Then I'd switch to sweets; ice cream came up easily.
I'd get home from school and eat the house--frozen dinners, snack jar, tortilla chips, melted cheese, peanut M&M's, candy bars and Lay's potato chips. Anything salty and sweet. I binge on junk, not meals. No one binges on fat-free stuff. You binge on stuff you know you're not supposed to eat.
When I was 21, there were times I didn't remember what I ate on a binge. I was in a trance. I could eat a whole pizza and then have a teaspoon of plain mustard to help me throw it up. Before a binge, I felt out of control. When my life is out of control, I obsess about food. After the binge, I feel depressed, angry and still out of control. I want to get it out of my body. It's not about gaining weight, it's about getting rid of pain.
After I throw up, I think about what was bothering me before I was binging. It's an adrenline rush, you release your anger and let go. Your stomach is empty, you feel achey. It's not a bad feeling. But your throat gets sore. The only time I worried about medical problems is when I had calcium deposits on my teeth.
When I was binging, I didn't want attention. I was single, wore sweat pants, didn't want guys to look at me. I'd been hurt in relationships. I gained 20 pounds in three months. I always had a weight problem. When I'm dating someone I care about the physical, so I'm more conscious about how I eat.
When things are out of control, the only thing I know how to do, that brings me pleasure, is food. It makes me forget about problems, it's accessible. I can't always get to the gym, but food is everywhere.
Now I binge and don't throw up. Afterward, I feel disgust, failure, disappointment in myself. While I'm binging I'm in another world, I have no control over what I'm doing. It takes a lot of strength not to throw up again, but I know if I do it today, I'll do it tomorrow.
Before I was obsessed with my body, now I'm more comfortable that I'm overweight. I had a fear of gaining weight but I know I'll never be a size seven. It's impossible for my life to never be out of control. Prozac did help in assisting me, but it was not the answer. Once on it, I thought, "I'm cured," and didn't go back to therapy. I was also diagonosed with obesseive compulsive disorder.
Culture contributes to women like me. I felt like I was not good enough, my body was not good enough. I was made fun of. Teens who are insecure and trying to be accepted look to Hollywood and all they see are beautiful, stick bodies. You want to look like them, you want be secure. It's an influential age. That's how it starts.
I told my mom I was binging and purging and it didn't matter. In school, I couldn't tell the kids they were hurting me; that was thier point. I can't say just stay strong; that's meaningless. I would tell vulnerable girls to find an outlet that helps you forget about pain, like sports or the arts.
If I'm happy, it doesn't trigger me to think about food. My family is the same way. I'd watch my mom eat cake after a fight with my dad, and my dad eat a whole thing of ice cream. My brother and sister have the same problem. When I gained weight, I had a realization that I'll never be a stick person. After years of making myself sick, starving, throwing up.... I can't do that the rest of my life. I have to accept my body and find a guy who accepts me.
