Because so many women in this country are obsessed with their weight, and carry around a sad sense that their bodies are never good enough (bolstered by social pressure and the proliferation of unrealistic images of beauty) stories about eating disorders resonate profoundly. The crazy drumbeat of "thinner is better" is so very familiar to most of us, it's the soundtrack we live with: "If I just lost 10 or 20 or 30 pounds, my life would fall into place — I would finally be in control." But for some, that low-level fixation grows and grows, until it takes over, crossing a line into illness and true despair.
Dr. Annie Brewster notes that about 10 million people in the U.S. have an eating disorder, according to the National Institutes of Health, and 90% are women. Approximately 4.5% of all American high school students reported in a recent survey that they'd vomited or used laxatives as a means to lose weight in the past 30 days, and approximately 4% of college-aged females have bulimia. According to the 2007 Youth Risk Behavior Survey, 35% of adolescent girls believed they were overweight, 60% were trying to lose weight. The vast majority of eating disorders go untreated.
But the numbers don't get at the atrocity of what an eating disorder involves. For our Listening to Patients series, Dr. Brewster, a Boston internist, recently conducted and edited an interview with Elizabeth, a 19 year-old college student with bulimia. "To fully grasp that terror of an eating disorder would take much more than an hour long interview," Elizabeth said. "The struggle for perfection is destructive and unbearable. Not only is this goal an impossible one, but the process is crippling and fatal. An eating disorder needs you to feel imperfect, unworthy, ugly, fat, disgusting, wrong, horrible. It strips you of your health, your self worth, your life, your soul. It blames you for everything that goes wrong and berates you if you can't fix it. You do not need to fix everything. It is not your fault. You don't need to be perfect. You just need to be the best you can be and not be afraid of who you are. That is true beauty."
Here, Elizabeth speaks openly about her bulimia, which started in childhood as an internal battle over control, self-identity and growing up. As her weight fluctuated, she describes the desperate journey from eating food out of the garbage, throwing up several times a day and punishing 4-hour daily stints at the gym, to her recent, still-fragile emergence into a kind of peace with her own body and her self.