Society's obsession with the idea "thin is beautiful" has resulted in an epidemic of eating disorders. An estimated seven million women are struggling with anorexia, bulimia, and binge eating.
"Anorexia is a problem of Western civilization, a problem for the prosperous," says Dr. Mary Pipher, a prominent psychologist and author of Reviving Ophelia: Saving the Selves of Adolescent Girls. "Peter Rowen likens it to being thirsty in the rain. Anorexia is both the result of and protest against the cultural rule that young women must be beautiful. In the beginning, a young woman strives to be thin and beautiful, but after a time, anorexia takes on a life of its own. By her behavior, an anorexic girl tells the world: 'Look, see how thin I am, even thinner than you wanted me to be. You can't make me eat more. I am in control of my fate, even if my fate is starving.'" In many cases, anorexia is both a cry for help and a protest against a culture that incessantly commands: Thou shalt be thin and beautiful.
Once entrenched, anorexia is among the most difficult disorders to treat, and it has the highest fatality rate of all psychiatric illnesses. Its victims are mostly bright young women. The Renfrew Center, which specializes in the treatment of eating disorders among women, estimates that 12 percent of its patients are Jewish. Though the results of scientific studies are mixed on this question, Dr. Brian Greer, a psychiatrist and former medical director of the Renfrew Center, maintains that "one of the largest emerging groups of women with eating disorders...is comprised more and more of Jewish women.... Being Jewish appears to increase one's likelihood of developing an eating disorder."
Anorexia and bulimia disorders often are a cry for help from an individual who is in emotional and spiritual distress. According to Dr. Greer, "In many ways, an eating disorder is an existential disorder in which the individual attempts to fulfill her needs for meaning and emotional/spiritual connectedness through food and/or identify her self-worth with physical attractiveness rather than inner beauty."
For the past two years, I have been a spiritual counselor to some 200 women at the Florida Renfrew Center. One of my patients, Alice,* 17, came from a very prominent family with strong religious/moral values. She fits Phipher's profile: "It is the good girls, the dutiful daughters and high achievers, who are at the highest risk for anorexia." In high school, Alice became involved with a partying crowd; soon after, she began to feel depressed. When she stopped eating, her parents sent her to Renfrew for treatment. Alice seemed genuinely baffled by her predicament. I sensed that on some level she felt shame. She asked me straight out: "Why do you think I am depressed and having difficulty eating?" "Because your behavior, your partying, is in conflict with your spiritual values," I replied. "I believe your soul has rebelled. That is why you are depressed." Alice burst into tears and nodded her head affirmatively. Like so many teenagers, Alice had succumbed to the pressure of an adolescent culture that rewards thinness, drinking, sex, drugs, and other excesses. Her anorexia was a cry for help. Fortunately, she received individual and group therapy at Renfrew and recovered.
Perfectionists are particularly susceptible to developing eating disorders. When I asked participants at a recent women's spirituality group, "Who is struggling with a perfectionism problem?" every person raised her hand. The obsession with being perfect translates into needing to have a "perfect" body. In the zealous pursuit of thinness, food becomes the enemy.
Many women with eating disorders are obsessive pleasers who blame themselves for their perceived failure of not having won greater affection and acceptance from their parents. Though the perfection syndrome usually begins with the desire to gain parental love, it often takes on a life of its own, becoming a dominant compulsive personality trait. The fear of making a mistake, of not being thin enough, of not being good enough, can overwhelm the person and cause a breakdown.
Lisa, 16, told me bluntly: "I hate my body." "Why?" I asked. "Because I am fat, and I would rather die than be fat." I explained to Lisa that the values our society upholds are, by and large, inverted. What is inherently unimportant society makes important; what is truly important society makes unimportant. American secular culture places great value on the individual, material possessions, status, and instant gratification. What is important in life from a Jewish perspective is relationships, family, community, respect for the sanctity of life, love, gratitude, uplifting the world, seeing our lives as a gift and our bodies as a sacred vessel. "Do you believe in God?" I asked. "Yes," she said. "Well," I explained, "do not forget that God proclaimed to the angels: 'Let us make man in our image.' You too are created in God's image; you too are very special. You have a soul that is Godly." We then talked about food as God's gift to keep us alive, and the preciousness of life because it comes as a gift from God.
Lisa responded hesitantly that this was a new way of thinking, one that was difficult to accept. But she wanted to see if this approach might work for her. Gradually, Lisa's perspective changed as she opened herself to letting go of the self-hatred caused by the relentless pursuit of thinness and physical beauty. Lisa continued to improve and made an excellent recovery.
Joanne, 27, struggled with anorexia and depression since adolescence. Her father had berated her constantly, leaving the young woman with an abysmally low self-image. At our sessions, we talked about her father's inability to love. I learned that his father had been an abusive alcoholic, and the cycle of abuse continued. Joanne remembered hoping that if she could somehow become the perfect child, her father would stop demeaning her. But all her accomplishments and attempts to please her father had failed. She then tried therapy, and, unsatisfied, found her way to Renfrew. "I need to move on," Joanne told me. "I have to stop trying to be the perfect person."
Joanne underwent both individual therapy and family therapy. When her father became aware of his abusive attitude and its source, he asked for Joanne's forgiveness. In her sessions with me, Joanne found comfort in the Book of Psalms, particularly its message of turning to God at moments of fear. She was a very frightened person and needed support and empowerment to let go of her parents and to become an emotional adult. Over a period of several weeks, Joanne made excellent progress and overcame her illness.
With teenage girls especially, the perfection-thinness syndrome is a hovering storm cloud that can wreak havoc on an emotionally fragile adolescent. In a culture that worships thinness to the point of idolatry, teenagers who violate the tenets of thinness are often subject to cruel sanctions. Jane, 16, was shunned by classmates because she wasn't thin enough. "I have no friends," she told me. "So I turned to sports. But still no one wants to be my friend, because I'm fat." Actually, Jane was not fat at all, but she was not thin enough to meet the standard set by her peers.
The demands of adolescent culture are only part of the problem. Parents are sometimes at fault because, directly or indirectly, they too communicate the idea that thin is beautiful. When mothers expend a great deal of time and money on their outer appearance, their daughters may learn the "lesson" that physical beauty is of utmost value and should be pursued at all costs. Alison, 17, suffered severe depressive moods culminating in anorexia. From the time she was very young, her father frequently commented that her legs weren't thin enough. Both parents, who were constantly dieting, took Alison to task for her tendency to backslide whenever she, like them, went on an eating binge. Guilt and self-loathing would lead to the next diet, and so the cycle continued.
Many of my eating-disorder clients have also been scarred badly by divorce. Children will commonly take the blame for their parents' breakup, with devastating emotional consequences. Lynn, 14, became severely depressed, anxious, and unable to function in school following her parents' divorce. Convinced that she was responsible for her parents' unhappiness, she stopped eating. "If I had been a better daughter, maybe they would not have divorced," she confided.
"Teenagers need parents who will talk to them, supervise them, help them stay organized, and support them when they are down," observes Dr. Mary Pipher. "Divorcing parents often just don't have the energy to give. Adolescents feel an enormous sense of loss -- of their parents, their families, and their childhoods. And, unlike younger children, when they express their pain, they are likely to do it in dangerous ways."
Parents can help children who are susceptible to eating disorders by recognizing that there is often a spiritual component to this affliction. With only one exception, my young clients have all wanted "something spiritual" in their lives, a connection to God or a Higher Power. Parents can bring spirituality into their children's lives by making a conscious effort to live by the values of the Torah, and by allowing God to enter their families' lives by observing the Jewish holy days, beginning with the Sabbath. It is also very important to change the common teenage perspective of food from a threat to thinness to a gift from God.
Below are a series of suggestions to aid parents in combating the destructive "thin is beautiful" message. Parents: you are vitally needed as an essential component in the prevention of eating disorders. Your teenager's soul needs nurturing. Share a spiritual path with them. Above all, be involved in their lives. They need your caring and guidance.
1. Share your spiritual/religious beliefs with your children. Especially focus on Judaism's teaching that every person is created in God's image. This means that God dwells in each of us. Tell your teenagers: "You are special. You are Godly. You are worthy of respect and love."
2. Explain to your child that life is a gift that comes from God. Our bodies are on loan from God, as are our souls. Therefore, we need to take good care of ourselves. Starving ourselves is an abuse of the body that violates our people's covenant with God.
3. Express unconditional love toward your children. Embrace them regularly. Let them know that you know how difficult the teenage years are and that you are "there for them." Ask what they expect and need from you as parents.
4. Practice active listening as a concrete expression of love for your children. Let your children know that you care about their concerns and want to hear what they have to say. Also, tell them that you want to know if you have unwittingly disappointed them and that you are open to their criticism, as no one in this world is perfect. Develop a caring, open, non-punishing, non-judgmental relationship.
5. Stress to your children that you do not expect them to be perfect. Explain that you want to support them to do their best, but that you will love them no less if they do not meet your expectations, or their own.
6. Mothers who are constantly dieting and showing excessive concern about their bodies are communicating a potentially dangerous message that is antithetical to the teachings of Judaism; thinness is not a Jewish value. Judaism rejects worship of the body, which includes preoccupation with physical beauty. The body is a vehicle for the soul, placed in our care by God. Thus, caring for our body becomes a sacred responsibility.
7. Use Shabbat family celebrations as an opportunity to show appreciation for God's creations. Take this sacred time to thank God for the food on the table. When food is truly thought of as a gift from God, a person with an eating disorder will no longer perceive it as "the enemy."
8. If you are a divorced parent, assure your children that you have not divorced them. Every child of divorce fears being abandoned. Express your caring, support, and unconditional love in concrete ways. Listen to your children's pain, fear, and disappointment without becoming defensive. Set aside time to be with them and keep assuring them that you will remain an important part of their lives.
9. Help your children build a foundation of self-esteem. Self-love is difficult for a person with anorexia or bulimia. Parental encouragement can be very helpful. Assure your children that you strongly support and admire their efforts to heal, and that their present difficulties are part of their spiritual/emotional growth. You understand that life can be difficult at times, but the difficulties can be overcome. Adversity can be one of life's best spiritual teachers.
Most important, if you let God into your life and your child's life, there will be no space for the destructive negativity that culminates in anorexia and bulimia. The ultimate antidote to eating disorders is authentic spirituality that encompasses moral values and sanctified living.
*All names have been changed to protect anonymity.
Sanford H. Jarashow, HUC-JIR class of 1950, rabbi emeritus of Temple Judea in Massapequa, NY, received his MSW from the Wurzweiler School of Social Work at Yeshiva University in New York City. He is currently spiritual counselor at Renfrew Center in Coconut Creek, FL.
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