Eating away at life: does someone you know have an eating disorder?

Cheryl. She teaches handicapped teens, is active in her church, and has served as a missionary overseas. But Cheryl has a problem. Only her pastor knows that she has been bulimic for six years,

Eating disorder, is a term coined to describe eating behaviors that are used as weapons to control one's life. The National Association of Anorexia Nervosa and Associated Disorders, Inc., estimates that in the United States alone there are several million anorexia nervosa and bulimia sufferers. Six percent die; 90 percent are women. And the symptoms of another eating disorder, compulsive overeating, are so deceptive that experts have not been able to educate the number of people who might be affected.

These three disorders can ruin the digestive system and heart, as well as cause sufferers to withdraw from friends, and misunderstand everyday situations.

Eating disorders commonly begin in the teen years, but today a significant number of sufferers are between 20 and 50.

Cheryl's disorder, bulimia (from two Greek words meaning ox and hunger), is a cycle of binging on food and then purging it. Purging may take the form of vomiting, overexercising, or using laxatives, diuretics, or weight-reducing drugs. Bulimia is usually triggered by intense emotions such as loneliness, anger, rejection, or stress. Bulimics secretly consume 1,000 to 10,000 calories, then feel sick, bloated, and guilty. As a result, they purge.

The bulimic irrationally fears getting fat, according to Goucher College psychologist Rolf Muuss, and sees life in extremes. He or she tends to view foods as "good" (vegetables) versus "bad" (sweets and starches). Over time, he or she may build up a resentment over missing the "bad" foods and feels that "as long as I've broken my diet with ice cream, I might as well binge."

Anorexia nervosa, a form of self-starvation, is another manifestation of internal battles. Warning signals include poor eating habits, drinking diet sodas excessively, constant worrying about becoming obese, and claiming to feel fat even when extremely thin.

Nineteen-year-old Regina is a typical anorexic. She began strict dieting when she was attracted to John, whose former girlfriend was slender. Regina found that she liked the control she exerted over her body by denying herself food-but now she can't stop. She's since dropped out of college because hunger kept her from concentrating.

Regina wonders if her problem relates to how her father used to punish her by denying her food. Now she starves herself when she feels guilty about something; it's her self-punishment. Many psychologists believe that anorexics repressed their emotions as well-behaved, submissive children.

The compulsive overeater is a person who habitually eats too much, then diets. This person loves food and depends on it for comfort, celebration, and companionship. A compulsive overeater doesn't have to be excessively overweight-many are not.

For example, Rob began his continual snacking at the age of 14 to deal with the trauma of an alcoholic parent and the insecurities of adolescence. He absorbed the extra calories until he was 30. Then he began a yearly ritual of dieting, losing weight, and gaining it back. During those diets, he was irritable with his family and felt deprived of the one thing he loved - food.

After 12 years of this cycle, he refused to diet anymore. "Food was my best friend. I either ate or thought about food all day. if I met a client for lunch, I'd eat a sandwich first so I wouldn't embarrass myself by ordering too much. I didn't think I had a problem." Why don't they just stop? Eating disorders are classified as addictions. They progress in intensity, create withdrawal symptoms when disallowed (headaches, nausea, anger), and pop up even after a person is "cured." Like alcoholics, eating-disorder sufferers turn to these behaviors to cope with life, to fill a void inside them when their needs aren't met.

For Christians with eating disorders, the guilt can be heavy. They lecture themselves with Scripture, hoping that a self-scolding will do the trick. However, this creates guilt, making them practice their compulsion to mask the guilt, and so it becomes a cycle-short-term relief, more guilt, more compulsive behavior.

In order to live with themselves, they deny the problem, push the disorder to the back of their minds, and rarely if ever talk about it. Why does it happen? Popular thought points to the "distant father, domineering mother" profile as the reason behind an eating disorder. But Dan Brown, who leads a substance abuse self-help group in California that includes those with eating disorders, says it's not that simple. "It would be easy to blame it all on parents, but nobody comes from a perfect family. All humans, including parents, are fallen. People respond to their flawed upbringing in different ways."

Many experts place blame on our overly-weight conscious society. For example, recent studies at City College of New York show that magazines, television, and films promote a slimmer standard for women than men, and that standards of attractiveness for women in these media include a thinner body today than 50 years ago. How can disorders be treated? Many people with eating disorders are admitted to inpatient hospital programs, where they eat three balanced meals a day and discuss the internal problems that cause the disorder. The difficult part is in maintaining a compulsive-free behavior once they leave.

It's easy to think that if compulsives (another name for those with eating disorders) just had more self-control, their problems would be solved. The paradox is that they've told themselves the same thing-and then overdosed on control. That's what eating disorders involving self-starvation, binging, vomiting, and constant dieting are all about-control.

Their best alternative is surrender. In order to surrender, two things must occur, says Peter Robbins, who treats persons with eating disorders: 1) abstinence from compulsive practices, and (2) changing foundational beliefs about one's self. Abstinence means eating three balanced meals a day. For the bulimic and the compulsive overeater, it also includes eliminating binge foods. (At first, the anorexic and bulimic may do better with four smaller meals because a moderate meal may be too much.)

How is abstinence achieved? First, those with eating disorders must set up their lifestyle carefully. This means bulimics and overeaters don't keep binge foods in the home; anorexics eat their meals with another person.

As the compulsive works toward abstinence, he or she begins to understand his or her feelings, no longer masking them with eating behaviors. This allows the person to discover and correct wrong beliefs about self and how he or she views life.

Brown points to two wrong foundational beliefs that drive compulsions: (1) I can feel good only if others feel good about me. (2) 1 can feel good only if I achieve a certain level of prestige, financial power, or social influence. How can these erroneous beliefs be corrected? First, people with eating disorders need to talk about their food behaviors. "That's why support groups work," says Robbins. They tap into the principle of confession allowing people to expose their eating patterns and strategies.

Those with eating disorders need to recognize and share their negative feelings, even if their feelings sound wrong or unfair. For example, Rob felt that his parents never loved him. He now realizes that they did love him but didn't show it in ways that he wanted them to. Talking about it has helped him release negative emotions and accept his parents. Support groups also provide unconditional acceptance.

Second, compulsives need to acquire new coping skills. An essential one is not living in the realm of feelings. Compulsives," says Robbins, "see feelings as an indiscriminate dark cloud that hovers saying, 'Who am I going to get today?' It's important to identify and examine feelings and ask if they're based on reality or exaggerated."

They also need to express negative feelings in constructive ways. For example, compulsives can learn to ventilate anger and frustration through writing about feelings, talking with friends, gently confronting others, and seeking counsel. How to help a friend. Cindy and Chery) were with a group of other women who went out for pizza one night. When they went to the bathroom afterward, Cindy heard Cheryl throw up. "Are you OK?" she asked. Cheryl came out of the stall and smiled faintly. "Yes, it feels so good to get rid of it."

What can I do to help Cheryl? Cindy wondered. Actually, very little. Cheryl needs professional help. Yet Cindy can still do what she probably does well-be a friend.

If you find yourself in Cindy's place, try these suggestions.

1. Encourage your friend to get help from professionals such as counselors and nutritionists. Let your friend know that you consider his or her problem to be a serious one.

2. Help your friend find a support group. First visits to these meetings can be scary, so you might offer to go with your friend.

3. Spend time together. Your friend might try to isolate himself or herself, not knowing how to handle free time.

4. Don't be shocked by anything that is said or done. Let your friend confess to you. Say, "You can call me anytime and say anything you need to say."

After your friend begins to recover, he or she may need your accepting ear more than ever. Says one compulsive overeater, "During the first 30 days of abstinence, I cried every day. I dealt with feelings I'd been numbing for years."

5. Respond to confessions with love and acceptance.

6. Don't encourage long discussions about food and dieting, which is a part of the ritual of food addiction.

7. Don't preach, but do share how Christ has helped you through your own problems. If you strongly object to what your friend says, ask nonjudgmental questions to get him or her to think, such as "I wonder if . . ." observations.

8. Encourage your friend to become involved in service for others. This will help your friend to look beyond his or her problems. Jan Johnson is a free-lance writer who lives in Inglewood, California. Recommended Reading About Eating Disorders

B., Bill, Compulsive Overeater, Minneapolis: CompCare Publications, 1981.

L., Elisabeth, Keep Coming Back, San Francisco: Harper/ Hazelden, 1988.

Meier, Paul, Frank Minirth, et al. Love Is a Choice: Recovery for Codependent Relationships, Nashville: Thomas Nelson Pub., 1989.

Minirth, Frank, Paul Meier, Robert Hemfelt, and Sharon Sneed. Love Hunger. Recovery From Food Addiction, Nashville: Thomas Nelson Publishers, 1990.

Roth, Geneen, Breaking Free From Compulsive Eating, New York: New American Library, 1984.

, Feeding the Hungry Heart, Indianapolis: Bobbs-Merrill Pub. Co., 1982.

LeSourd, Sandra Simpson, The Compulsive Woman, Old Tappan, NJ.: Fleming Revell Pub. Co., 1987.

Vredevelt, Pam, and Joyce Whitman. Walking a Thin Line, Portland, Oreg.: Multnomah Press, 1985.