“The media have made thin equal beautiful and healthy,” says Fiumara. “Magazines aren’t showing only thinness, but it’s almost like they’re glamorizing death. These black and white pictures seem to glamorize drug abuse and heroin abuse.” Fiumara speaks of heroin chic, the beauty standard embodied by supermodels whose bony shoulders and hips, hollowed cheeks and shadowy eyes send us troubling messages.
If you think such glamorization doesn’t make a difference to most women, think again. Millions of American women suffer from eating disorders, which begin in adolescence and encompass everything from obsessive-compulsive eating to anorexia nervosa, self-starvation that leads to drastic weight loss, heart problems and severe dehydration. A more common eating disorder is bulimia nervosa. Bulimics routinely eat large amounts of food during discreet periods of time while feeling out of control. Occasional symptoms of bulimia have been reported in up to 40% of college women, and 80% of fourth grade girls are dieting. Most people with eating disorders are Caucasian women. “They are intelligent, professional, and from upper-middle class or what I call ‘perfect’ families, families where failures aren’t acceptable and feelings aren’t addressed,” Fiumara says. “Some of the women who have eating disorders are for the first time in their lives given all these opportunities for success, opportunities that their mothers and grandmothers never had.”
Eating disorders tend to run in the family—often, mothers pass on their eating behaviors to their daughters. Case in point: One of Fiumara’s patients from the children’s module “was making herself vomit whenever she got angry, which she learned from her mom. She was 5 years old. Twenty years ago when I worked with eating disorder patients, their mothers had been given diet pills. You could get them very readily from the family physician. Now I see the children of these women who have eating disorders of their own.”
Fiumara worked for seven years at the Renfrew Center in Philadelphia, a mental health clinic for women. She says many trends have developed over the years among eating disorder patients: “I am seeing younger females with eating disorders, and more males. The general attitude patients have is changing, too. They show less concern over the medical complications of eating disorders. Adolescents proudly admit they want to look like the skinny models or movie stars while verbalizing much hatred for their own bodies.”
Recent trends in the treatment of eating disorders include the prescribing of antidepressants, with which Fiumara has had good results. She says bulimic patients seem to respond to drug therapy especially well, recovering from depression quickly. “But,” she adds, “a bulimic patient needs to learn how to then let go of her eating disorder, to stop using that as a coping mechanism for other problems in her life.” Another recent trend in Fiumara’s field is “the short hospital stays that many health insurance companies now insist on, which prevent the anorexic patients from making substantial progress in recovering from their deadly disorder.”
At any given time she treats about seven or eight patients who range in age from 11 to 19. She uses “an eclectic approach,” incorporating issues of family, self-esteem and social life into group discussions. She also focuses on identifying what triggers eating disorder behaviors in each patient. Besides the images of heroin chic that media blast at us, and besides what we observe in our mothers’ eating habits, there are many other triggers for developing eating disorders, including the criticism of peers.
“My biggest challenge,” says Fiumara, “is to help young women find their inner strengths and uniquenesses and to empower them without their entire focus being on their bodies. I love to work with young women who have enormous opportunities ahead of them, many of which I never had, nor my mother or grandmother. I’m concerned that female adolescents and women are becoming very self-destructive by dieting. They will miss out on wonderful opportunities, all for the sake of finding what they were led to believe would be true happiness—being skinny.”
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