By P.H.I.Berroll

For most of her life, Susan B., now 51, has struggled with eating disorders of one kind or another.  As a child, she was a compulsive overeater; as a “size 16” teenager, she was taken by her mother to a doctor who prescribed diet pills. She spent most of the next decade on a dietary roller coaster – “I’d go up and down 20 to 25 pounds,” she says – but didn’t think she was abnormal until, at 28, she was diagnosed with hypoglycemia and told to cut sugar out of her diet.  She tried, but the “withdrawal” drove her into bulimia, the disorder whose victims compulsively purge their bodies of recently eaten food, usually by vomiting. Though she repeatedly underwent therapy and hospitalization, this condition plagued her for years.

By 1995, says Susan, “I knew I was going to die” from a heart attack, a common occurrence among bulimics – “They’d find me over a toilet bowl.”  But her daughter, herself a former bulimic, convinced her to again enter therapy, as well as a 12-step program.  (Because the program requests anonymity from its participants, Susan does not publicly reveal her last name.)  After another two years of struggle, she believes – or hopes – that she is finally on the right track:  “I’ve maintained my weight for nine months.”

Susan’s story was part of a seminar, “Eating Disorders: The Mirror Has Two Faces,” held this past Sunday at the Yeshiva of Flatbush elementary school auditorium. (The seminar was the third in a series organized by the Yeshiva’s ladies auxiliary; earlier programs had dealt with stress management and the problems of the “sandwich generation” in caring for elderly parents.)  A group of about 60 people, almost all of them women, came to hear a panel of speakers discuss the topics of  nutrition, dieting and body appearance, and how unhealthy attitudes in those areas can cause devastation to women’s lives — as they did to Susan’s.

The statistics in this area are disturbing – and they go beyond the more extreme disorders, such as bulimia and anorexia (self-starvation).

“Fifty percent of nine-year-old and 80% of ten-year-old girls in the U.S. have dieted,” said auxiliary vice-chair Flora Bienstock, the panel’s moderator.  “We must not allow these trends to continue.”

One of the panelists, Amy Wysoker, a psychiatric nurse who teaches at Long Island University, cited studies showing that “95% of people in diet programs such as Weight Watchers are women” and that “99% of the people who lose weight put it back on within two years.”

Wysoker emphasized the societal pressures on young women to lose weight at all costs that often contribute to their problems.  “Every time our children pick up a magazine, they see all these pictures of thin women,” she said.  “You pick up The New York Times and there’s the fashion section… We need to start getting to children when they’re very young.”  She asserted that “it will take a grass-roots effort to counteract these media images.”

Another panelist, social worker Ilene Fishman, founder of The Eating Disorders Center of Montclair (NJ), agreed with Wysoker that parents have to help their children develop a healthy self-image:  “What do you teach them about their own value and worth?  Is it based on achievement, or based on appearance?” She added that it was important for women of all ages to come to terms with their own appearance, to avoid perfectionist attitudes.  (“I’ll always have fatter arms than I’d like,” she joked.)

While Wysoker and Fishman spoke mainly about obsessive weight loss, panelist Rick Shields, a psychologist and nutritionist, emphasized the other end of the spectrum:  overeating, a particular problem in this country because of the unhealthy nature of the common American diet.

“Today,” he said, “the average American consumes about 130 pounds of sugar a year” – up more than 400 percent since the days of the early colonists – “and the equivalent of a stick of butter a  day” in unhealthy oils and fats.  Shields also noted that as much as 90 percent of the nation’s food supply has been processed and refined, thus removing many essential nutrients.

Like many American nutritionists, Shields spoke highly of the traditional low-fat-and-sugar Japanese diet, which emphasizes fish, vegetables and brown rice, and recommended something similar for his audience.

“Since I’ve been talking,” he said, “over one million red blood cells have died in each of our bodies.  The danish you had for breakfast won’t replace them.”

Shields flavored his presentation with several quotations from Rambam (Maimonides), whom he called “the first holistic physician” because “he understood the mind-body connection” and the importance of a healthy lifestyle.

“Rambam says, ‘Overeating is like poison to the body,’ even good foods,” said Shields.  “He says you should leave the table before you’re full.”

In the question-and-answer session which followed, some audience members wondered whether Shields, with his condemnation of certain foods, was contradicting the other panelists, who had spoken of getting away from the idea of “bad” foods (and of women thinking themselves “bad” for eating them).  Shields replied that he hadn’t meant to suggest there was no place for higher-fat and -sugar foods, just not on a regular basis – “I’m more concerned with (their) abuse and overindulgence.”

And Wysoker made it clear that she was not condoning overeating or obesity.  But the problem, she asserted, was that many women distort the concept of healthy weight loss, wanting to shed additional pounds for cosmetic rather than health reasons.  “They need to lose 10 to 15 pounds,” she said, “but they’ll try to lose 60.”

Most of the questioners were clearly worried about their own children – what, they wondered, could they do to have a positive influence? Fishman reiterated that it was important to set a good example: “If (children) see Mommy obsessing about her weight,” she said, “they’ll be affected.”

Shields added, “If parents know the harm they’re causing by putting bad habits in place at an early age, they’d try to change… It’s not that people don’t care, it’s that they don’t know.”

Bienstock, like the other women in attendance, was clearly impressed by what she had heard.  But she also spoke of the ongoing need to deal with these problems – which, she asserted, could be seen outside the walls of the Yeshiva any day of the week.  “We promoted [this program] within the local community,” she said, “and even the neighborhood pizza man thought it was a good idea.  He said teenage girls who come in to his place are constantly talking about their weight.”

As for Susan, her struggle goes on.

“I have to admit that I still want to lose more weight.  It’s always there,” she says.  “But I’m very grateful that I’m taking care of myself … and that there is help for everyone out there if you really, really want it.”

Originally published in Jewish Week weekly newspaper, 1997.

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