All eating disorders are related to one another through excessive dieting, poor self-esteem, and negative feelings. That starts it. But eating disorders take on a life of their own. They are addictions. In medical terms, this means that eating disorders involve biology as much as, if not more than, psychology. Eventually, a woman's eating behaviors change the circuitry in her brain. This phenomenon is best illustrated in the Minnesota Semistarvation Experiment, conducted in 1944 by Ancel Keys and his colleagues at the University of Minnesota. The researchers wanted to observe how prisoners of war adapted to starvation and how best to rehabilitate them. Thirty-six conscientious objectors enlisted in the study and agreed to starve.
The experiment began with the participants eating normally for three months. Then the subjects' normal caloric intake was cut in half. Not surprisingly, over the next twenty-four weeks, the subjects became utterly obsessed with food, talking, fantasizing, and dreaming about it. At the same time, they became depressed, anxious, and irritable.
After the semistarvation period, the subjects were allowed to eat whatever they wanted for the next three months. They ate as if in a frenzy: they shoveled in huge meals (up to 10,000-calorie binges) but left the table complaining of hunger. They noted that their appetite ratcheted up rather than damped down right after a meal; some participants ate to the point of becoming sick - and still, they were not sated. In short, the subjects were eating as if their lives depended on it, which is understandable: they had been starving to death.
But even after they regained their lost weight, some subjects still indulged in strange food behaviors. In fact, the behaviors got more bizarre: the subjects, all robust men in their twenties, started to obsess about their body weight. They started complaining about fat around their buttocks, thighs, and abdomens. Some started to diet, trying to go back to their skeletal state. Losing weight and being thin somehow had caught hold of each man and, inexplicably, filled his thoughts. This study shows the biological power of dieting. It can be addictive, and not driven only by a cultural pressure to be thin. This study was conducted in 1944–1946, and the men were in their twenties. They were not likely to care about fashion. So why should these men become obsessively concerned about fat on their buttocks and bellies?
The answer is that starvation does something to the mind. It takes hold and distorts normal thinking about food and body image. Distorted thinking describes the paradox of anorexia: women with the disease constantly think about food, even when they do not eat. What is going on, at the molecular level, is that a girl is splitting her body from her brain: her starving gut is trying to tell her brain's appetite centers, in loud molecular screams, "Eat!" But she forces the brain circuits that control eating to override the message. She starves in the midst of available food.
With bulimia, she starves until she can starve no longer. She gives in to the red alert, which by now is at overkill levels. She engages in a free-for-all, as demonstrated by the Minnesota men who ate frenetically when allowed to "come off their diets." Eating disorders occur when a girl has broken her body's ability to sense hunger and fullness. For this reason, experts such as psychologist Cynthia Bulik, former president of the Academy for Eating Disorders, do not advocate diets in any form. The majority of girls diet at some point in late adolescence but let go of the intensity after a diet or two. The most puzzling aspect of this phenomenon is why some girls can't stop.
To solve this mystery, psychologists have had to shine a light deeper into the psyches of girls. There are theories of what should happen during adolescence in order for healthy development to occur. A girl is supposed to face herself in these crisis moments and learn how to deal with problems, such as unrequited love. She is supposed to shine her own light inside, take a good look at what is there, and come up with her own answers about who she is, accepting that a crush she develops may not be reciprocated. Then she might start experimenting with other ways to behave. She could even find tools other than food to deal with life's increasingly complex problems.
But by turning to an eating disorder, she is sidestepping the necessary inner work of adolescence to develop a healthy response. The great risk is that as time passes, and she reaches early adulthood and beyond, her eating disorder may wax and wane, but inevitably remain - because she has never accomplished the goals of adolescent development. Even as she ages, she remains a girl on the inside. For her, true womanhood is elusive.
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1. Recover from an eating disorder by knowing your inner self
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