COVER

A TRAGIC OBSESSION

EATING DISORDERS CAN SOMETIMES BE FATAL

D’ARCY JENISH October 9 1989
COVER

A TRAGIC OBSESSION

EATING DISORDERS CAN SOMETIMES BE FATAL

D’ARCY JENISH October 9 1989

A TRAGIC OBSESSION

COVER

EATING DISORDERS CAN SOMETIMES BE FATAL

Tall, slender and strikingly beautiful, Monika Schnarre is one of Canada’s wealthiest and most famous teenagers. In 1986, when she was a 14year-old Scarborough, Ont., high-school student, Manhattan-based Ford Models Inc. chose her as Super Model of the World over 200,000 other young women. Afterward, Schnarre signed a $250,000 contract with a New York City modelling agency. Now 18, her face has appeared on more than 50 magazine covers around the world. Yet, in her newly released autobiography, entitled Monika, Schnarre confesses to having suffered from bulimia, an eating disorder common among weightconscious young women. Bulimics, as they are known, develop a routine of fasting, overeating and purging through vomiting or taking laxatives. “I hate talking about it,” Schnarre told Maclean’s. But she said that she felt compelled to write about the disorder because “I know it kills young girls.”

Symptoms: A second common eating disorder, which usually results from excessive concern with weight, diet and body shape, is anorexia nervosa. Victims starve themselves through prolonged fasts or sharp reductions in food consumption over months and even years.

Anorexia is most prevalent among teenage girls between the ages of 14 and 16 and usually results in significant weight loss. Bulimia is found more often among women in their late teens or early 20s and is difficult to detect because it is does not always result in dramatic weight loss.

Some medical researchers estimate that the two disorders, combined, affect up to five per cent of the female population of North America and Western Europe. Treatment is difficult and can take several years, because the disorders involve a complex set of physical and psychological symptoms. Both disorders can be fatal. Patricia Perry, director of the Toronto-based Eating Disorders Clinic Inc., a private treat-

ment centre, said that the combined mortality rate is estimated to be as high as 20 per cent of victims who suffer from anorexia and bulimia over a period of several years. Said Perry: “That is the highest rate for any psychiatric disturbance.”

Doctors who have studied the disorders contend that there can be a wide variety of

causes, including a childhood disturbed by alcoholism, drug abuse or sexual abuse within a family, or an individual’s own obsession with perfection. But most believe that deeply entrenched societal values are a major factor. Dr. Miriam Kaufman, a specialist in adolescent medicine at Toronto’s Hospital for Sick Children, said that many young women become obsessed with losing weight because contemporary society equates thinness with beauty. Said Kaufman: “People want to be pencil-thin.

Models are supposed to be able to put their legs together and still have a space between their knees.”

Excruciating pressure, combined with youthfulness, led to superstar model Schnarre’s brush with bulimia. She said that, after arriving in New York to work as a model at the age of 14, she began gaining weight.

Despite her height—she is six feet, one inch tall— Schnarre said that adding any weight to her normal 135 lb. created problems when modelling high-priced tight-fitting clothes that had to look perfect. As a result, for a year, she fell into a habit of “eating a mountain of food or almost nothing at all.” To maintain her weight she used herbal laxatives. Schnarre admitted that her agent, Eileen Ford, with whom she was staying in New York, sent her home for counselling and treatment after discovering that she was bulimic. Schnarre told Maclean’s, “I didn’t realize how sick I was.”

Victim: While Schnarre managed to break the cycle of fasts, binges and laxatives, others have died of eating disorders, particularly anorexia nervosa. Perhaps the most famous victim was the American pop singer Karen Carpenter, who died in February, 1983, of heart failure brought on by anorexia. During the early 1970s, Carpen^ ter and her brother Richard o had recorded several hit pop 2 songs, including Close to You and We’ve Only Just Begun. At the time of her death, the five-foot, four-inch singer weighed 108 lb. But during the previous year, her weight had plummeted to 85 lb.

Over the past decade, anorexia-related tragedies have led to increased public awareness of eating disorders. Richard Moriarty, a professor of human kinetics at the University of Windsor in Windsor, Ont., said that his daughter, Erin, died of heart failure in March, 1982, at the age of 21 after suffering from anorexia for almost 10 years. Moriarty said that during most of her illness, there was very little infor-

mation available to the public on eating disorders.

After a newspaper story about his daughter’s death, Moriarty said that he and his wife received 58 telephone calls in one day from people across Canada who had children or friends with eating disorders. Moriarty later founded the Windsor-Essex Bulimia/Anorexia Nervosa Association, which now publishes a quarterly newsletter that is mailed to 3,500 subscribers.

Nauseated: Survivors of eating disorders have frequently endured years of isolation, illness and mental anguish. Laura Abbott, 28, a legal researcher with a Toronto law firm, suffered from anorexia for eight years beginning at age 16. Although diet and appearance were always important to her, the five-foot, four-inch woman said that her problems began when she started jogging and decided to improve her eating habits at the end of Grade 10. Within two months, her weight had dropped to 85 lb. from 110.

For the next three years, until she graduated from high school, she said that she was obsessed by numbers: her weight, her marks in school and the number of calories in her food. Abbott said that on some occasions, she would eat two crackers for lunch, then jog five miles to burn off the calories. She would wake up at night feeling nauseated and light-headed. During the day, she frequently felt dizzy and sometimes fainted. Abbott said that her low point occurred in the summer after she completed high school.

Her weight dropped to 77 lb., and she became too weak to stand up. Instead of attending university that fall, she spent four months in a psychiatric hospital. Her recovery was a long, slow process. Said Abbott: “For every step forward, there were two backward.”

Since recovering, Abbott has spoken to dozens of different adolescent-female groups about the causes and symptoms of eating disorders. She said that she possessed the classic personality traits of a victim. Abbott was a perfectionist who set impossibly high standards for herself. At the same time, she lacked the self-confidence required to deal with the pressures of adolescence. Her response was to control what she could in her life, namely her diet, weight, appearance and marks. Abbott said that her perfectionist nature, combined with her nagging doubts, quickly transformed a desire for control into an obsession. “Even if I wanted to eat I couldn’t, because it was as

though something possessed me,” she said.

Most medical experts say that treating eating disorders is easier, and the chances of success greater, if the problem is detected early. Because anorexic teenagers frequently lose 25 per cent of their body weight, and end up extremely thin or even emaciated, the illness is usually easier to recognize than bulimia. By contrast, victims of bulimia often maintain their weight, or lose and regain it promptly, said Carla Rice, co-ordinator of the Torontobased National Eating Disorder Information Centre. As a result, family or friends are unlikely to witness a radical change in the victim’s appearance. As well, said Rice, women

can suffer from bulimia for several years, which increases the potential for serious illness or even death, because they are usually secretive about self-induced vomiting or the use of laxatives.

Stress: Experts also say that treating eating disorders becomes progressively more difficult the longer the victim has suffered from the disorder. Perry said that physical recovery takes up to one year after re-establishing normal, healthy eating habits. Psychological recovery can take longer. According to Perry, anorexic individuals usually have had difficulty dealing with the transition from childhood to adolescence, while bulimics falter during the transition from adolescence to adulthood. Perry noted that a longtime victim is

usually several years behind her peers in terms of emotional and psychological development. Said Perry: “I have patients who say they feel like 10 going on 40. They have handled so much stress while being profoundly immature.”

Some doctors report that they are now seeing a disturbing increase in the number of younger anorexics. Kaufman estimates that the Hospital for Sick Children now treats about 10 new anorexic girls a year between the ages of 11 and 13. If the disease is detected early, said Kaufman, the victims can be treated more easily than older victims. But if the disease persists, a growth spurt that normally occurs at puberty can be delayed. As a result, the victim may not achieve her full potential height. These victims may also end up with brittle bones that are unusually susceptible to fractures.

Theory: While doctors are becoming alarmed at the increase in pre-teen anorexia, medical researchers are only beginning to study male victims of eating disorders. Blake Woodside, a psychiatrist and researcher at Toronto General Hospital’s Eating Disorder Clinic, said that about five per cent of anorexics and 10 per cent of bulimics are male. He said that the symptoms are the same in both male and females. But the research has not shown conclusively why some men develop eating disorders. He said one theory is that some men are more vulnerable to societal pressures to achieve an ideal body weight and shape. Said Woodside: “The men have the same concerns as the women: their stomachs, hips and buttocks.”

Many doctors who treat eating disorders, and the scientists who study them, are convinced that both anorexia and bulimia could be almost entirely eliminated if society placed less emphasis on weight, diets and thinness. Perry said that most victims are emotionally or psychologically immature as they approach adolescence or adulthood. They become obsessed with diets and weight because they can achieve some sense of control over their lives. At the same time, they believe that they are meeting a societal ideal of beauty and perfection. The sad reality, according to medical experts, is that the victims only find emotional stress, physical deprivation, and, in some cases, death.

D’ARCY JENISH

SHARON DOYLE DRIEDGER