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No body is perfect: Eating disorders often 'bio-psycho-social' illnessess

Food is a necessity for survival. But for the millions of Americans who suffer from eating disorders, it's an obsession; an instrument of addiction; and a mode of control. 

Eating disorders have been quietly plaguing the population for years with the incidence of anorexia in women between the ages of 15 and 19 on the rise every decade since the 1930s, according to the National Eating Disorders Association. 

In an effort to bring public attention to the critical needs of those with eating disorders, the National Eating Disorders Association launched its 27th annual National Eating Disorders Awareness Week, running from Feb. 23 through Saturday, March 1. The campaign – themed "I Had No Idea" – aims to correct the common misconceptions that surround eating disorders while highlighting the sometimes life-threatening severity of the illness.

NEDA defines anorexia nervosa – which has the highest fatality rate of any mental illness – as being characterized by self-starvation and excessive weight loss; and bulimia nervosa as being characterized by a cycle of binging and self-induced vomiting that compensates for the effects of binge eating.

"[Food is] not like a lot of addictions where you can give it up like cigarettes or alcohol," said Aurora resident Jen Buhot, 36, a recovered anorexic and child therapist. "You can't give up food. So, it is something you have to learn to live with, and you can't just abstain from it, which I think makes it that much harder." 

Katherine Walker, a therapist who specializes in clients with eating disorders at Cadence Behavioral Health in St. Charles, said that similar to an addict, a “recovered” anorexic’s or bulimic’s relationship with food will be a daily struggle for the remainder of that person's life.

“[They’re] always going to have that battle, similar to an alcoholic,” Walker said. 

How an individual develops an eating disorder cannot be pinned down to a single soluble entity, because it is largely a multi-faceted, "bio-psycho-social” illness, according to NEDA.

The desire for physical perfection brought on by the media's idealized standard of beauty, "thin-is-in" propaganda and the abuse of Photoshop in advertising campaigns play a role in the development of an eating disorder, but it's not the whole picture, Walker said.  

The causes of eating disorders can be placed into "four different camps," Walker said, which include psychological factors, such as depression, stress and low self-esteem; interpersonal struggles, such as relationship issues or if there is a history of abuse, being bullied or teased; social factors, such as the media and cultural pressures that glorify "thinness;" and, potentially, biological factors – which are still being researched – like genetics. 

"The problem is, so often, when we're dealing with eating disorders, we're also dealing with other mental health issues … ." said Walker, adding that issues could include depression, obsessive compulsive disorder, substance abuse or other mood disorders. "A lot of times, the depression is what gets reported and not the eating disorder. Very rarely is an eating disorder a stand-alone problem."

Former model Kerri Branson, 43, of North Aurora, began her own battle with bulimia and anorexia – not as a way to keep up with beauty-industry standards – but, rather, as a means of coping with a stressful home life and depression as a teen, she said. 

Branson went through phases of anorexia and bulimia from ages 14 to 19. 

"[Anorexia and bulimia] are more about the inner struggle of feeling like you have control more than what people think about how you look," Branson said, adding that she would sometimes go days without eating. "I'd give myself one thing that I could eat. … And then you get hungry and you go on your binges, and you eat a lot; then you feel guilty after you eat it, so you throw it up. And then you think, 'I don't want to throw up anymore,' so I'm just not going to eat. That was my only way of feeling like I had some sort of control – the control over my body."

Because of her eating disorder, Branson said she didn't begin menstruating until she was 19, which, Walker said, is a significant sign in understanding the severity of the illness.

Ironically, it was Branson's modeling career that forced her to finally get healthy, she said.

"When I got into modeling I actually did a turnaround," she said, adding that as a swimwear and lingerie model, she needed to look healthier and [curvier]. "Instead of being obsessed with being skinny, I am obsessed about being healthy."

Though Branson is now a doting mother of four, she said she experienced infertility problems because of hereditary issues that were exacerbated by having had an eating disorder earlier in life. To get pregnant she had to have surgery, but once she gave birth to her twin boys, she said "everything kicked into gear,” and her third and fourth children were born naturally after that.

Buhot – a child therapist and member of the Naperville-based National Association of Anorexia Nervosa & Associated Disorders – said her three-year battle with anorexia began as a diet, and gradually morphed into a yearning for physical perfection.

"The pressure was all internal ... I was competing against myself. Every day I wanted to be better than the day before," she said.

Buhot started dieting in college – at age 18 – in preparation for a spring break trip to Panama City Beach.

"It was a way to get control, and once it started, I felt like it was something I was good at, and it kind of became my identity," she said.

When Buhot's father visited her at school in October of her sophomore year of college, there was a staggering difference in her weight from when she left home in August.

"It was enough for him to be like, 'I'm pulling you out of school,'" she said, adding that if her father had not interfered, the problem would have gotten progressively worse.

Buhot and her family sought treatment and received counseling for anorexia.

"It took them a lot of family therapy to understand that I wasn't just choosing to do this," Buhot said of the recovery experience. "To this day, if I lose a few pounds, my family goes into panic mode, because it takes them back to that time."

Buhot's own experience with an eating disorder inspired her to pursue a career in child therapy as a counselor so that she could help others with their own struggles. "Dealing with an eating disorder or any type of addiction can give you a lot of clarity into what other people might be going through," she said.

Some of the young children she counsels already have body image and perceived weight issues, she said, which she blames, partially, on images projected by media.

“Our culture as a whole defines beauty and success, and I don’t think we can escape it,” Buhot said.

When modeling for Playboy and as a producer, Branson got to work behind the scenes at photo shoots, often witnessing the photo-manipulation process first hand. 

"They didn't do what they do now. They make a new person out of these photos," she said. "And the problem is that people who are not behind the camera, they don't know how this production works; they think that it's real."

Walker said that young people are the ones being most affected by the media.

"[Eating disorders are] creeping down into middle school, which is really concerning for me," she said.

In addition to younger women being diagnosed with eating disorders, Walker is starting to see more men coming forward, as well as women who are pregnant.

"They're really trying to manage and control their weight ... even while they're carrying their baby to term," Walker said. 

Help is not only an option for those struggling with eating disorders, but is imperative to combating the disease. Often, the most difficult part of seeking help is being “honest with yourself and realizing that you have a problem,” Branson said.

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