Eating disorders are the type of mental disorders that are connected with food intake. They are manifested in absence of appetite, the obsession of cleansing the organism, or out-of-control eating. There are two major types of eating disorders. They are anorexia nervosa and bulimia nervosa. They begin with strict dieting, fasts, a big weight loss, and purging. Mainly young girls and women suffer from these maladies but there is a percentage of boys and young men with anorexia and bulimia. Sometimes, families of people having an eating disorder do not even suspect what can happen. Being aware of that, their behavior can be strange: the sick try to get aside from social contacts or pretend they lead the normal way of life. For instance, they r pretend they regularly eat, vomit at night when everybody is sleeping, or tell stories about eating out with friends, at school, or work. The main reasons for eating disorders are depression and low self-esteem caused by the cult of thinness created in human society. Often, anorexic and bulimic people experience bullying, teasing, and humiliation because of their weight or appearance. They try to reach their ideal or have some inner contradictions, for example, the look of their dream and their own current appearance, sexual orientation, gender dysphoria, etc. Eating disorders are very often left untreated which leads to physical problems like osteoporosis, anemia, brain and heart damage. The sooner the treatment begins, the better the outcome will be. Eating disorders influence severely human health and functioning, but the help of the professional can shorten the process of recovery and make the treatment more fruitful. The doctor and the patient can work together not focusing not on the weight or menu, but on the patient’s feelings or health, personal relationship. Group therapy can also be very helpful. Bulimic patients are often treated with medication combined with psychotherapy; patients taking medicine can experience side effects and need being closely supervised by the physician.
Each of the eating disorders has its own diagnostic criteria. The diagnostic criteria for anorexia nervosa are the restriction of energy intake (calorie counting) related to the age, sex, health condition of a person, fear of gaining weight even if a person is underweight, and denial of current low body weight. People suffering anorexia think they are not thin enough even though their do not gain their normal weight according to their physical state and sex. These people try to become thinner not eating at all, experience fasting and so-called “dry hunger” (eating and drinking nothing). They work out hard in order to burn calories and so on. The diagnostic criteria for bulimia are: using so-called “cleansing” procedures to prevent gaining weight (compensatory behavior), binge eating resulting in compensatory behavior occurs at least once a week, self-evaluation influenced by weight and body shape, the disturbance does not occur in the episode of anorexia. People suffering bulimia always cleanse their organism after overeating. Bulimic people both vomit and take purgative in order to get rid of the food they ate. Sometimes, bulimic patients purge after each food intake.
To help people having eating disorders, doctors created several types of treatment. For instance, Medical Nutrition Therapy of Eating Disorders (MNT) is a holistic method of treating various health conditions and their symptoms through the use of customized meal plans formulated by Registered Dietitian. Its components include dietary modification, assessment, and patient education. MNT is used in the recovery of patients who suffer from eating disorders with the purpose of establishing normal eating behavior. One more effective therapy is Dance Movement Therapy. It allows the patients to get involved in an alternative way of expressing emotions. Dance Therapy can also help to achieve a healthy balance. Movement is life; in movement, dance therapist evaluates the psychological state of the patient. This kind of therapy has proven the effectiveness in treating various disorders including learning disability disorder.
The plot of Unbearable Lightness: A Story of Loss and Gain by Portia de Rossi shows the life of the author, actually, her problems of being ill with anorexia and bulimia. From her childhood, Portia desired to be a photo-model, but she was not thin enough to bring this wish to life:
I wasn’t that pretty, nor was I particularly tall. I was okay looking, but I certainly wasn’t good looking enough to have one of those annoying stories that supermodels tell on talk shows about how the boys teased them at school and called them “horse face” and “chicken legs” because they were so skinny and “plain.” (de Rossi, 2010, p.15).
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Actually, she became an actress instead. She ate about 300 calories a day and purged. She became thinner and thinner and then was offered to be shot for the Shape cover. Portia was afraid she would look disgusting and stopped eating. She did not work out because she did not like strong women’s bodies. Some day she asked one of the photographers which girls he liked shooting, and he said that very thin. That moment, she understood what she needed to be beautiful. She needed to be as those girls from Maxim covers having a tiny waist and big breast. Soon she was offered to present the L’Oreal company. The readers understand that the protagonist perceived thinness as cleanliness when she visited an art school. She said she did not like the picture by Kandinsky because she thought he painted a fat person. One Christmas morning, she was almost happy when her aunt asked her why she did not eat potatoes. She found potatoes to be her personal enemies, enemies of her career and future as they can make her fatter and ruin everything she had achieved:
They will make me fat because it’s not just some potatoes that I just ate, it’s the potatoes I know I’m going to eat in the future now I’ve allowed myself to eat those. That by eating those potatoes I could get back on the same old yo-yo dieting pattern and suf er in the way that I’d suffered from age twelve to twenty-five (de Rossi, 2010. p.110).
Now, her thinness was awful and she needed medical help. Her organs were in bad condition and she probably had osteoporosis. She wanted to live no matter how thin or fat she was then: “I’m sick. I’ve successfully lowered the bar. I don’t have to be a straight-A student or be a movie star to be proud of myself. I just have to live.” ( de Rossi, 2010. p.132). Luckily, everything got right. Portia recovered, and her life was much better without permanent counting of calories, purging, weighing. The doctor wrongly diagnosed her. The seed of the problem was the lack of nutrition as she almost did not eat. When she began leading the usual life and developed healthy eating behavior, the state of her health normalized. Her mother did not care now whether her daughter was a lesbian or heterosexual; the main thing she was herself and that she was alive:
I look at my reflection in the mirror and I like what I see. I’m not looking at a childhood fantasy of what I should look like on my wedding day or a bride in a wedding dress. I am looking at me. I contemplate the idea of being better and it brings to mind my favorite quote from Wayne Dyer, our friend and the man who is about to marry me to the woman of my dreams (Portia de Rossi, 2010. p.148).
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The main character of this book suffers from anorexia and bulimia. She has low self-esteem because she cannot fulfill her dream of being a model, and she is a lesbian, a member of a social group that is humiliated, homosexuals. She is distressed with being “imperfect” and unaccepted. Therefore, starving, losing weight, and sleeping with men, she tries to run from her real self. There is a link between all of her problems in the context of the book: unrealized dreams, low self-esteem, broken heart, loneliness, again broken heart, feeling of the impossibility of self-realization, distress. All these factors merged together and led to anorexia and bulimia nervosa. It is like a distress cry, a kind of SOS signal: “Look at me, I am beautiful no matter who I am!”
According to the article “Clinicians’ Views on Parental Involvement in the Treatment of Adolescent Anorexia Nervosa” by D. Plath, L. Williams, and C. Wood, the manualized Maudsley family-based treatment is rather effective. There is an agreement that family therapy can help in treating adolescent anorexia nervosa. Parents are the best medicine in coping with anorexia. For example, family therapy includes a family meal where all family members must be present and feed the ill child in such a way that he or she will eat enough. Parents encourage their child to eat, bring the most beloved food with them. Very often, a sibling also takes part in the therapy providing the mental patient with sympathy and support. Despite the evidence for Maudsley is rather strong, this method is not considered the best in treating anorexia. To adapt standardized treatment in response to parental requests is almost impossible in the real world. There was a research on the process that optimized parents/carers’ experiences in the treatment of anorexia nervosa. The participants of the research were employed in the public Child and Adolescent Mental Health Service (CAMHS) situated in the diverse health regions of NSW, Australian metropolitans, rural and regional settings. Clinicians provide intervention to a child with moderate or severe conditions of mental health, including eating disorders. The results of the survey were the following: the majority of the clinicians were white and well-educated women, psychologists, more than half were working full-time, and more than half had over three years of experience in the family-based treatment of anorexia. Several clinicians noticed that parents felt relief telling the doctors the story of their children and the hardship they faced:
Having read the book by Portia de Rossi, I have come to some conclusions. Eating disorders are underestimated in our society because they are not obvious. People cannot see if a person suffers anorexia or bulimia. An anorexic or bulimic person always carries deeper mental problems like severe depression, dysphoria, hysteria, etc. Anorexia and bulimia are only the visible results of something personal. Stopping eating is not the way of attracting attention; it is the way of getting closer to the miraculous ideal having required. It is a way of escapism, running away from reality. As a result of the cult of thinness and appearance, beauty standards have strict measures and no one a little bigger cannot be called beautiful. Objectification of people now is not even visible, it is deep in our brains as a one more “rule” which results in many girls and women destroying their minds and bodies to please the spectators who even won’t remember their names.