Falldownseventimes,standupeight.

SaraMcCombs

WatchingEyes

MEDFORD,Mass.__
ThewomenofMonteNidoLaurelHill(MNLH)allcastskepticaleyes
onmeasIsatwiththeminthegrouptherapyroominmidSeptember.Eightwomensatinthe
room,withtheclinicaldirector,aprimarytherapistandamentalhealthworker.Itbecame
apparentveryquicklythatthecommunitywasfacingahugedivide.Halfofthewomenwere
fightingtoregainaholdontheirlivestheyhadlosttotheireatingdisorderstheotherhalf
openlystatedtheydidnotwanttogetbetterandwerenottryingtoworkwiththeirteamatthe
treatmentfacility.

Thedivideinthecommunityreallyhadanegativeeffectonsomeofthewomenwhowereina
healthiermindset.

Imgettingreallyfrustratedinthefactthatitsbotheringmeandaffectingme,saidone
woman.Therewasadiscussionofsomeclientshidingtheirfoodunderneaththeirchairsduring
mealtimes.Whenotherclientsinformedthestaffofthecircumstances,thewomenhidingtheir
foodreactedviciouslytothewomanwhohadtattledonthem.Theideabehindgrouptherapy
wasaspaceforwomentosupporteachother,andtalkopenlyabouttheirstrugglesandtheir
emotions.ThecommunityIwitnessedwasdoingnosuchthing.Sometriedtoconnectwith
othersinthecommunityoutsideofgroups,butothersblatantlyrejectedthehelptheirpeers
offeredthem.Itwasatensecommunitytocomeinto.

IfelteyesonmeasIwalkedaroundthehouse,andIcouldtellthewomenwerelookingatmy
body.Manyofthewomeninthehousewereaboutmyage,andIcouldfeeltheirstaresasI
walkedby,sensingthemcomparingtheirbodiestomyown.Ifeltsomewhatselfconscious,asI
knewthesewomenwerelookingatahealthypersonandjudgingmyworthbasedonmy
appearanceandweight.IhadtoremindmyselfthatIamaperson,withabody,butmybodywas
notreflectiveofwhoIam.Whenfirstarriving,IwasveryawareofthewayIwasmoving,butas
timeprogressedIrealisedthatbeingselfconsciousinfrontofthesewomenwasnotwhatthey
neededtosee.IloosenedupandstoppedoverthinkingthewayImoved,hopingtorepresenta
healthyfigureinthecommunity.Itwasobviousthesewomenwereextremelyinfluencedby
othersrelationshipstotheirbodiesandfood,andaskedmealotofquestionsaboutnormal
eating.IansweredtheirquestionsaboutfoodeasilyandalsotoldthemsomethingsIhadnoticed
aboutchangesinmyeatinghabits.TheywereshockedwhenItoldthemhowmytastesfor
certainfoodshadchanged,asifthethoughtofcravingcertainfoodwasunfathomable.Ispoke
withthemjustasIwouldspeaktoanyoneelse.

WhenIreturnedhomefrommyfirsttriptoMNLH,myroommateasked:Sowaseveryonejust
like,reallyskinny?Thisquestionmademeangry,especiallyconsideringeverythingIhad
1

learnedthroughMNLH.No,noteveryonewasskinny,butthathasnothingtodowithwhatis
goingoninsidetheirminds,andthemindsettheywerein.Onebodydoesnotfitalleating
disorders.

WhatIwasmoststruckbywasthewaythestaffinteractedwiththeclients.MNLHiseven
differentintheirterminology.Mostclinicsrefertothepeopleintreatmentaspatients.
Clientsmakesthewomenfeelmorelikepeoplechoosingtofindthemselvesintheprogram.
ThestaffatMonteNidotalkstothepersonthatisinfrontofthem,nottheeatingdisorder.A
statementoftenusedamongstthestaffisItisaboutthefood,anditisnt.Thereasontheclients
begintohavedisorderedeatinghasnothingtodowithfoodatall,butmoreabouttheirown
internalstruggles.Clearly,foodhasalargerolewhenitcomestoapersonsrecovery,butMonte
Nidoaddressedthedeeperproblemsapersonwasfacing.

FactorsinEatingDisorders

Understandinganeatingdisorderisextremelycomplicated,especiallytoapersonwhohasnever
experiencedone.Aneatingdisordercanbedefinedasarangepsychologicaldisorders
characterisedbyabnormalordisturbedeatinghabits.Eatingdisordersareoftencorrelatedwith
othermentalillnesses,likedepression,anxietyorbipolardisorder.Foodisasymptom,notthe
rootoftheeatingdisorder.Theyaffectbothmenandwomen,butstatistically,womensuffer
moresothanmen.Itsaverynuancedsetofstandardsthatrequireapersontobediagnosedwith
aneatingdisorder.Somepeoplewhoareconsiderednormaleatershavedisorderedbehaviours
aroundtheirfood.Contrastly,somedisorderedeatershavemanynormaleatinghabits.Thereare
verysubtledifferencesthatdefineapersonsdiagnosis.

Thereisnoprimarycauseofeatingdisorders.Manyfactorsgointowhatcausesapersonto
begineatingdisorderbehaviours.Theyoftenarisefrombehavioural,emotional,biological,
psychological,interpersonalandsocialfactors.Thereisstillmuchresearchthatneedstobedone
topinpointexactlywhatgoesintoaneatingdisorder.Initially,thedisorderpresentsitselfjustas
preoccupationwithfoodandweight.Thecontrolthepersonputsintotheirfoodisoftenthe
controlthattheywishcouldapplytotheirlives.Itbeginsasameanstocope,butatsometimeor
anotherthepersonlosescontrolofthedisorderanditessentiallyrulestheirlives.Eating
disordersareverycloselycorrelatedtopoorselfesteemandfeelingsofinadequacy.
Additionally,interpersonalrelationshipsplayahugeroleineatingdisorders.Itiscommonthat
someonewithaneatingdisorderhastroubledpersonalrelationships,difficultiesexpressingtheir
feelingsandhasahistoryofsexualabuseorbeingteasedbasedontheirbody.Nottomention,
theenormouspressurefromsocialnormsthatpeoplefeeltofitacertainbodytype.Genetic
factorsplayahugeroleineatingdisorders.Forexample,mygrandmother,auntandcousinhave
allstruggledwithanorexianervosa.Anotherfactorthatcontributestothecauseofeating
2

disordersischemicalimbalances.Thechemicalsthatcontrolappetiteanddigestionmaybe
skewed,causingapersontoeatabnormally.Chemicalimbalancescanalsoattributetoapersons
anxiety,depression,andaslewofothermentalillnesses.

Thepsychosisistriggeredbyselfworthandadistortedsenseofonesownappearance.Aperson
withaneatingdisorderplacesenormousvalueontheirbodyanditsappearance.Theywilldo
anythingtoachieveaveryspecificbody.Someonewithaneatingdisorderalsowillstrugglewith
bodydysmorphia.Theydonotseetheirbodiesastheyactuallyareandalsoholdtheirbodiestoa
veryspecific(usuallyunattainable)shape.1Differentdisordersbeginindifferentways.Bulimia
andanorexiausuallybeginwithalargefocusondietingandlivingahealthierlifestyle,and
thoughtsaboutfoodbeginstobecomeintrusiveonapersonsdailylives,andsoontheyare
consumedentirelyaboutfood,weightandappearance.Theyareunabletoperformnormaldayto
dayactivities,astheyaretoopreoccupiedwithexerciseorfood.Certainpeoplehavehigherrisk
factorsthanotherstobetriggeredintohavingdisorderedeating.Stressandagearealsofactors
thatcancontributetoapersonhavinganeatingdisorder.Eatingdisordersusuallypresent
themselvesduringapersonsteensand20s.

VanityintheUnitedStates

Therearemanytriggersthatleadapersontoaneatingdisorder.HereintheUnitedStates,
television,magazinesandotherpopularmassmediahavedefinedtheideaoffemalebeauty.As
humananimalslivingintheUnitedStates,onecannothelpbutbeoverexposedtothisidealof
thefemaleform,whichequatestothis:tobebeautifulintheUnitedStates,onemustbeyoung,
white,athletic,bustyand,mostimportantofall,thin.Glancingattheglamourmagazines,one
canseethearchetypepresentedagainandagainwhatmanypeopledontknow,andwhatthe
fashionworlddoesntwantyoutounderstand,isthatmanyofthesemodelsareteenagersand,in
somecases,evenpreteensdressedupandpresentedasadults.Whatisdemonstratedby
mainstreammediaisabodytypethatisnotattainablebymajorityofpeople.But,thesheer
amountitispresentedtolargeaudiences,majorityofpeopleassumethisbodytypeisnormal,
andeasilyachievable.

Thepressureoursocietyfeelstofillthesebodytypesishuge.Athletesinparticularhave
immensepressuretolookorweighaveryspecificbodytype.Themostcommonmalesports
associatedwitheatingdisordersarewrestlingandcrosscountry.Astudyperformedon695male
andfemaleathletesshowedthatnearlyaquarterofthembingedonceaweek.Thefemaleathlete

"FactorsThatMayContributetoEatingDisorders|NationalEatingDisordersAssociation."
Factors
ThatMayContributetoEatingDisorders|NationalEatingDisordersAssociation
.N.p.,n.d.Web.23
Nov.2015.
1

isdoublyatriskforthedevelopmentofaneatingdisorder.Sheissubjecttotheconstantsocial
pressuretobethinthataffectsallfemalesinwesterncountries,andshealsofindsherselfina
sportsmilieuthatmayovervalueperformance,lowbodyfat,andanidealised,unrealisticbody
shape,size,andweight.Constantexposuretothedemandsoftheathleticsubcultureaddedto
thosebombardingherdailyonTV,inmovies,inmagazines,andtransmittedbypeers,maymake
herespeciallyvulnerabletotheluresofweightlossandunhealthywaysofachievingthatloss.2

Thereisalsoanimmensepressureplacedonpeople,startingfromaveryyoungage.Bythetime
astudentreacheshighschool,1of10willhaveaneatingdisorder.Inthe1960sSlumberparty
Barbiewasreleasedtotoystores.Thisbarbiedollsetincludedascale,permanentlysetat110
poundsandabooktitledHowtoLoseWeight.Theonlylegiblethinginthebookread
DONTEAT!,whichledtoacommonphraseusedbyeatingdisordersloganonlinetoday
I.D.E.A,IDontEatAnymore.Obviously,thebarbiedollspresentyoungchildrenwith
unrealisticideasofwhattheirbodiesshouldlooklike.Astudydoneongirlsages6to10,the
girlswhoplayedwiththebarbiedollatesignificantlylessfoodthanthegirlswhoplayedwith
normalsizeddolls.Smallchildrenfeelpressuretolooklikethedollspopularlysoldworldwide.
Sadly,therearemanyonlinesupportgroupspromotinganorexia.ProAnatumblraccountsare
common,andpeoplesharehowtheybestloseweight.Therearenumerouswebsitespromoting
andteachingothershowtostarvethemselves,whicharemetwithalotofpositivefeedback.
Somewebsitesopenlyencouragepeopletoremainintheireatingdisorders,seeingitasawayof
life.Suchsitesdonotjustaffectdisorderedeaters,theyalsohaveanaffectonhealthywomenas
well.Proeatingdisorderwebsitesareontheriseandarehavingadefiniteimpactonits
audiences.3

Additionally,womenwhoparticipateinbeautypageantsfeelimmensepressuretofulfill
societysstandardsofbeauty.NinaDavuluri,MissNewYork2013,wassupposedlycaughton
filmcallinganotherpageantcontestantfatasfuck.Davuluriquicklydeniedtheseclaims,and
wentontodiscussstrugglingwithbulimianervosawhileshewasincollege.A2003studydone
onbeautypageantcontestantsfoundthatof131contestants,aquarterofthemhadissueswith
disorderedeating.2008MissAmerica,KirstenHaglundconfessedtoreceivingtreatmentfor
anorexia.SheisnowanambassadorfortheNationalEatingDisorderAwareness,andhopesto
educateothersabouteatingdisorders4.Beautypageantsoftensexualiseyounggirlsascanbe
seeninrealitytelevisionshowslike
ToddlersinTiaras.
Manyoftheimagespresentedtoyoung
childrenonTVareofthin,beautiful,sexywomen.Obviously,thisinstillsanimageintoyoung

"U.S.NavalAcademy."
AthletesandEatingDisorders
.N.p.,n.d.Web.23Nov.2015.
DyingtobeBarbie|
EatingDisordersinthePursuitoftheImpossible.
N.p.,n.d.Web.16Nov.2015
4
Fatcommentreporthighlightsbeautyqueenbodyissues|
TodayHealth&Wellness
byD.Mapes.Web.
16Sept.2013
2
3

womenwhattheyshouldlooklike.Theseimagesbeingpopularisedbythemediacontinuesto
havenegativeeffectsontheyouthofournation.

ProfessorKamilleGentlesPeartatRogerWilliamshasstudiedatgreatlengththeeffectmedia
hasonitsaudiences.Shedescribednuancesthatgointostudiesresearchinghowthemediacan
influenceapersonstrugglingwithaneatingdisorder.Shesaidthemediacanbedangerous,it
spreadsfarandwideideasofwhatthebodyshouldlooklike.Nottomention,thefashion
industryportraysawomaninaveryparticularbody.GentlesPeartsaidthisindustryis
implicatedinreinforcingthisexistingideaofbeauty.Herresearchstudieswomenin
EnglishspeakingCaribbean,andhowwomenwhotraveltotheUnitedStatesstrugglewith
maintainingacertainbodytype,whichismuchdifferentthantheAmericanstandardofbeauty.
Culturally,socialconstructsofbeautyvaryenormously.GentlesPeartwentontodescribe
womenintheCaribbean,andthebodytheystrivetohave.Havingafullerfigureisseenas
attractive,andmanywomenadmittedtohavinginsecuritiesinnothavingthisdesiredshape.
GentlesPeartnoticedatrendinsomewomenwhowouldbingeeattoachievelargerhipsand
buttocks.Tocombatsocialconstructsofbeautyisverydifficultacrossvaryingethnicitiesand
cultures,butcontinuestobeaprobleminsocietiesworldwide.

CenturiesofEatingDisorders,Unreported

Eventhroughevolution,thereareclearproblemsthatarisewhenitcomestoapersonandhow
theyfunctionaroundfood.Neanderthalsoftendidnotknowthenexttimetheywouldeat,soif
theopportunitypresenteditself,theywouldovereat.Thistraitisstillengrainedintoourbrains.
Thinkaboutwhenapersongoestoanallyoucaneatbuffet.Althoughthatpersonstillhas
opportunitiestoeat,possiblyevenlaterthatday,thatpersonwillstilloverloadtheirplatewith
thefoodtheywanttoeat.

Historically,eatingdisordersreallydidnotariseuntilaboutthe1970s.Noonerecognisedthem
asaseriousmentalillnessuntilthelaterhalfofthe20thcentury.Evenduringthistime,some
doctorsonlyviewedaneatingdisorderasanendocrinedisorder,andwastreatedwithhormones.
Oneoftheearliestcasesofanorexiacanbereportedasfarbackas1684toS.MaryAxe,the
daughterofamedievalparishinLondon5 .TheyoungwomansufferingwasanalysedbyRichard
Mortonin1689inhisbookentitled
Pthisiologia.
ItwasclearthatMortonwassimplybaffledby
Axessuffering.Hehadnocomprehensionabouthowtohelpher,ortrytobegintounderstand
herillness.Unfortunately,Axesuccumbedtoherdisease.In1952,anorexiawasthefirsteating
disorderwrittenintheDiagnosticandStatisticalManualofMentalDisordersasaneurotic
AnorexiaNervosaCasereport,Circa1684|
OneoftheEarliestReportedCasesofAnorexiaNervosab
y
J.OToole,published23Dec.2011.Web.16Nov.2015.
5

illness,andbingeeatingwasntrecogniseduntil1980despitenowbeingthemostprevalent
eatingdisorderintheUnitedStates.Itsalmostunbelievablethatalthoughthismentalillnesshas
reportsdatingbackoverthreecenturies,ittookthatlongtofinallyhaveanofficialdiagnosis6.
Initially,eatingdisorderswereseenonlyamongstwhitewomenintheupperandmiddleclasses,
butastimecontinueditbecameapparentthatmanyothergroupssufferedaswell7 .

Mortonlaterdiscoveredayoungmansufferingfromanorexia,someonehewasthesonofa
friend.AfterfailingwithAxe,Mortonhadmoreexperiencewithhowtotreathisnewpatient.
Insteadofstrictlytreatingwithmedication,Mortonusedadifferentapproach.Headvisedthe
youngmantoquitschool(anobviousstressorinhislife),andtogotothecountryandfocuson
ridinghorses,andconnectmorewithnature.Thefreshairwasthoughttohelpcleartheyoung
mansmind.Mortonalsoprescribedaveryspecificdiettotheyoungman,hopingtoalterhis
emotionssurroundingthingsheconsumed.Therewasanapparentimprovementintheyoung
manshealth8.

Anorexianervosa,specifically,wasnotgivenitsnameuntilnearlytwocenturieslater,in1868
byWilliamWitheyGull.Forcenturies,womenhavestrivedtoachieveacertainbodytype,
dependingonwhatwasinstyleatthetime.Inmedievaltimes,beingskinnyrepresentedthe
poor.Itshowedthattheywerebusyperformingphysicallabor,andnotnecessarilyhaving
enoughmoneytomaintainaproperdiet.Apersonwhohadafullerbodywasthoughttohave
moremoneyandbeabletospenditonfood,andnotworking.DuringtheVictorianera,aslim
figurebecametheidealwomensbodytype,andstarvationbecameameansofhysteriato
achievethisbody.Womenwouldusecorsetstomodifytheirbodiesintoshapestheywerent
meanttobein,andwouldoftentimesfaint,orhavemoreserioushealthconsequences,likethe
movementoforgansinsidetheirbodyfromcinchingtheircorsettootightly9.

Clearly,ifwomenweregoingtosuchlengthstochangetheshapesoftheirbodies,therewere
issuesofbodyimage.Butbythe20thcentury,dietingbecameawayforwomentoachievethe
idealimageoffemininityportrayedtothembythemedia.Eatingdisordersseemtooccuronlyin
westerncultureboundsyndrome.Moresothanothereatingdisorders,bulimianervosaisviewed
asacultureboundsyndrome.Inourculture,theidealbeautyisofsomeonewhoisthin,andin
shape(which,bynomeans,constituteshealth).Inoursociety,thereisaveryspecificconstruct
ofbeauty.Womenwithbigbreasts,smallwaistsandlargehipsarewhatmenfinddesirable.
ChallengesinEatingDisorders,:PastandPresent|
AmericanFamilyPhysician
byJ.Tenore,published
Aug.2001.Web.16Nov.2015.
7
AnorexiaNervosa|
NewWorldEncyclopedia.
N.p.,n.d.Accessed16Nov.2015
8
FirstKnownCaseHistoryofaMalewithAnorexiaNervosa|
KartiniClinic
byJ.OToole.Published8Jan.
2011.Web.16Nov.2015.
9
CinchingUpintheVictorianEraCorsets!|
Shoot!Magazine
byD.Winter.PublishedMay/June2005.
Web.16Nov.2015
6

Thenthroughthefashionindustrywomenaresupposedtolookshapeless,nobreasts,nohips.
Runwaymodelsareessentiallyjustusedashangersfortheclothingtheyaremodeling.Therehas
beenlistedaspecificscienceofbeauty.Inoursociety,itsbeencalculatedthatwomanwhose
waistcircumferenceis70percentofherhipmeasurementisideallywhatmenfindmost
attractive.TheGenerallyAcceptedStandardofawomansbodyis342434inches
(bust,waist,hips),withaheightoffivefeetseveninches.Thisisnotrepresentative,norrealistic
formajorityofwomen10 .

Statistically,menarelesslikelytosufferfromaneatingdisorderthanwomen.Menandboys
alsostrugglewithpressurefromsocietytofitacertainbodytype.Maleswitheatingdisorders
oftenareunderreportedormisdiagnosed,whichcanskewtheactualfactsabouthowmanymen
trulystruggle.Bothmenandwomenexperiencedecreaseinsexualdrivewhileinthemidstof
theireatingdisorders,butitseemsthatmenfeelmuchmorepressuretoperformsexuallythan
women.Theshamesurroundingapersonsbodyandhowtheyinteractwithithaveahugeaffect
ontheirsexdrive.Menwitheatingdisordersaresignificantlylesslikelytobesexuallyactive
duringtheireatingdisorderthanwomen.Womenwhosufferfromaneatingdisorderaremuch
lesslikelytousebirthcontrol,andstatisticallyhavebeenshowntohavehighernumbersof
sexuallytransmitteddiseases.Homosexualityalsoappearstohavearoleineatingdisorders.A
homosexualmaleistwiceaslikelytohaveaneatingdisorderthanaheterosexualman11.Men
whostrugglewitheatingdisordersareprominentinsociety.

Despitehavinghundredsofyearsofrecordsofeatingdisorders,veryfewdoctorsaretrainedto
treatthesementalillnesses.Oftentimes,whenapersonfinallyadmitstotheirdoctortheybelieve
theyhaveaneatingdisorder,thatdoctorwillimmediatelyreferthemtoanotherprofessional.
Additionally,insuranceagenciesrarelycovertreatmentforthosesuffering.Whenaninsurance
companyisdeterminingiftheyregoingtopayforapatientstreatment,theyoftentimesstrictly
basetheirdecisiononthephysicalhealthoftheperson.So,somepeoplethataredying,andare
seekinghelpfortheirdiseasearedeniedbecausetheynotsickenough,accordingtoinsurance
companies.Manypeoplewhocometothedecisiontoseektreatmentoftenwillspendmonths
fightingwiththeirinsurancecompaniestocovertheirtreatmentteam.Companieswillconclude
thatapersonisntbadenough,andwillrefusecoverage.Notonlyisinitialdenialofcoverage
oftreatmentaproblem,butmanypatientswhoentertreatmentcenterswillbestrippedoftheir
coverageafteronlyafewweeks.Whenapersoncomestothedifficultdecisiontopursuetheir
recoveryjusttohaveinsurancequitafterafewweeksripstherugoutfromundertheirfeet,and
oftensendsthatpersonrightbacktotheireatingdisorderbehaviours.Thebiggestchallenge

IdealFemaleBodyMeasurements|
FitnessandBodybuildingWorkouts
n.p.,n.d.Web.16Nov.2015
ResearchonMalesandEatingDisorders|
NationalEatingDisorderAssociation
n.p.,n.d.Web.16Nov.
2015
10
11

faceddailybytreatmentcentersistheconstantbattleforinsurancecoverage.Manyclinicians
hatewastingtheirtimearguingwithinsurance,whenthattimecouldbespentwiththeirpatient.

Thelevelofcarethatinsurancecompaniescoveralsoplayalargeroleindeterminingwherethe
personwillseektreatment.Hereisaquickbreakdownofthelevelofcare:thehighestlevelof
careisinpatient.Thisoftentimesdoesnotincludewhatthepatientneeds,intensivetherapy.In
inpatienttreatment,itismeanttomedicallystabilisethepatientandstopdestructivebehaviours.
Ifapersonneedstobeplacedininpatienttreatment,theirvitalsignsareinacriticalcondition,
andtheirsymptomscontinuetoworsen.Thenextstepdownisresidentialtreatment.Residential
isnecessarywhensomeonedoesnotrequireimmediatemedicalattention,buttheirmentalhealth
isseverelyimpaired.Apersoninresidentialtreatmentlivesatthetreatmentcenter,foraslongas
theinsurancecompanywillcovertheirexpenses,orpayoutofpocketuntiltheirteamdecidesit
isappropriateforthemtoreturnhome.Thenextstepdownprogramispartialhospitalisation.A
personwillattendtherapyduringtheday,andreturnhomeattheendoftheday.Apersonin
partialhospitalisationrequiresassessmentsoftheirmentalhealthdaily,butareunableto
functiononadaytodaybasis.Thelowestlevelofcareisintensiveoutpatientprogram,which
meetsafewtimesaweekforpsychiatriccheckins.Thepersonismedicallystable,andis
capableofanormalschedulefortheday12.Manytimes,insurancewillnotcoverpatientsthat
requirehigherlevelsofcare,sotheyareplacedinlowerlevelsthanwhattheyshouldbein.
Treatmentisveryexpensive,costingthousandsofdollarsaday.Forsomepeoplewho
desperatelyneedthetreatmenttheysimplycantgoiftheirinsurancedoesntcovertheexpenses.

KarenCarpenter,awellknownsingerduringthe1970sandintothe1980sshedlighttothe
severityofeatingdisorders.Carpentersufferedfromanorexianervosa,anddiedduetoher
illnessin1983.Carpenterwasplacedonanintravenousdripin1982,whichcausedhertoputon
30poundsinthespanofjusttwomonths.Thisrapidweightgainputstrainonheralready
weakenedheart,eventuallycausingcardiacarrest.Beforeherdeath,littlepublicationofeating
disorderswasknowntotheworld,butthegrammyawardwinningsingershowedtotheworld
thatitwaspossibletobetoothin.AfterCarpentersdeath,othercelebritiesbegantoconfessto
theirstruggleswitheatingdisordersaswell,mostnotablyPrincessDiana13.

Evenaslateasthe1970sbulimiahadonlyjustachieveditsowndiagnosis,whenpreviouslyit
hadjustbeenknownasanotherformofanorexia.Peoplesufferingfrombothdiseaseswere
treatedseparately,andnotincludedingrouptherapytogether.The1970sand1980sourcountry
sawasteepincreaseinthenumberofanorexiaandbulimiacases.Anotherdisorderthatis
TreatmentSettingsandLevelofCare|
NationalEatingDisorderAssociation.
n.p.,n.d.Web.15Nov.
2016.
13
HowKarenCarpentersDeathChangedtheWayWeTalkAboutAnorexia|
TimeMagazine
byJ.
Latson.Published4Feb.2015.Web.16Nov.2015.
12

definitelystillprevalentinoursocietyisbingeeatingdisorder.Casesofbingeeatingbehaviours
datebackforcenturies.Ofallthepeoplewhoseektreatmentforobesity,athirdofthemsuffer
frombingeeatingdisorder14 .

Asmediahascontinuedtoportraytheidealthatthinnessisbeautiful,eatingdisordershave
becomemoreprevalentinwesternsocieties.Eatingdisordersstillarenotfoundindeveloping
nations.Morestudieshavebegantoresearchtocausesofeatingdisorders,andithasbecome
apparentthatthereisageneticfactorleadingtothesementalillnesses.Disorderedthinkingoften
arisesfromotherchemicalimbalances,suchasbipolardisorder,depression,obsessive
compulsivedisorder,oranxiety.Certainqualitiesinapersonoftenleadstotheirdisorderfor
example,someonewhohasperfectionisttendenciesismorelikelytosufferfromanorexiathan
bulimia.Althoughananorexicmayqualifyasaperfectionist,itisselfimposed,notbroughton
bytheircommunity15 .Bulimicsarewidelyknownasbeingextremelyspontaneous,whichleads
toimpulsivedecisionswhenitcomestobingingandpurging.

Thereisadefinitestigmaassociatedwitheatingdisorders.AnnaSweeney,anexpertonnutrition
spoketothis.Ihatetheideathataneatingdisorderonlycomesinonebody,saidSweeney.A
lotoftimesdyingpatientsarentappropriatelyaddressedbecausetheyliveinabodythatdoesnt
saysick.Thestigmassurroundingacertainbodytypeineatingdisordersalsoleadstofeelings
ofshame.Notonlyistheirshameofthebodythattheyarelivingin,butalsoshameofliving
withaneatingdisorder.Somewhoareuneducatedonthetopic,scoffwhenalovedopensupto
themabouttheirstruggles.Someresponsesarecompletelyinappropriate,callingtheperson
selfish,selfinvolved,oraccusingthemofoverglamourisingtheirappearance.Anothercommon
responseisJustgoeatahamburger.Theseresponsesdonothingtoalleveapersonssuffering.
Ifanything,responsessuchastheseforcethepersontoconcealtheireatingdisorderevenmore,
andpromotingmorefeelingsofshamesurroundingtheirillness.Astudyfoundthataperson
withaneatingdisorderfelttheywereinvoluntarilysubordinatedundertheirpeers,feeling
externallyashamedofthemselves.Externalshamewascloselycorrelatedwithapersonsuffering
fromanorexia,whileinternalshamewasmoreprominentinbulimia16 .

Toputthenumberofpeoplesufferingfromeatingdisordersinperspective,onlyoneoutofevery
10willreceivetreatment.Outofeverymentalillness,eatingdisordershavethehighestmortality
rate,halfofthedeathscomingfromsuicide.86percentofwomenwithaneatingdisorderhave

AHistoryofEatingDisorders|
PsychologyToday
byE.Deams.Published11Dec.2011.Web.16Nov.
2015.
15
PerfectionisminAnorexiaNervosa|
InternationalJournalofEatingDisordersb
yA.Bastiani,R.Rao,T.
Weltzin&W.Kaye.Published13Feb.2006.
16
Shameinwomenwithahistoryofeatingdisorders|
USNationalLibraryofMedicineNationalInstitutes
ofHealth
byN.Toole,S.Allan,L.Serpell,&J.Treasure.PublishedNov.2008.Web.!5Nov.2015.
14

anonsetoftheillnessbeforetheageof20.Somechildrenbeginstrugglingwiththeirdiseaseas
earlyasfiveyearsold.Eatingdisordersareespeciallyprevalentoncollegecampuses17 .

TheHousethatSitsAtopaHill

MonteNidoisanationaleatingdisordertreatmentprogram,startedbyCarolynCostininthe
UnitedStates.Theyhave10treatmentcentersonbothcoasts.Costinisarecoveredanorexic.
Duringthetimeshewasill,therewerenotreatmentsavailable.Costintookituponherself,and
curedherownanorexia.Thesheerstrengthittookforhertodothiswasenormous.Carolyn
begantreatingpeoplewitheatingdisorderssince1977,andinMarchof1996,sheopenedthe
doorstoherfirstMonteNidointhefoothillsofMalibu,Calif.

Settledinaresidentialneighborhood,MonteNidoLaurelHill,thefirstMonteNidotoopenon
theEastCoastinJune2013,sitsatthepeakofahill.BeforeMonteNidoboughtthehome,ithad
previouslybeenafamilyruntreatmentcenteraswell,calledLaurelHill.Despiteyearsof
treatment,thefacilitywentunder,andCarolynCostintooktheopportunityasshesawitand
purchasedthefacility.Thehouse,alargewoodenVictorianhomedoesnotlookatallclinical,
whichisthecaseformajorityoftreatmentcentersworldwide.Thehomeisdecoratedwithplush
couches,largeshagrugs,andwelcomesyoutocomeinsideandmakeyourselfcomfortable.
Inspirationalquotesanddrawingswrittenbytheclientsdecoratethewalls.

Thehousehas10bedrooms,atonetime10girlscanbetreatedatthefacility.Eachroomhasits
ownbathroom,andhastwobeds.Uponfirstenteringthetreatmentcenter,womenwillsleepon
thesecondfloor.Astheyprogressandothersgraduatefromtheprogram,womenwillshift
rooms,movingupstairswheretheroomsandbathroomsarelarger.Daily,cleaningstaffcomes
intothehometocleanthehouse.Thecleaningstaffstripsthebedsdaily,andremakestherooms
fortheclients.

Yes,MonteNidohasmadethishouseintoahomeforclients,butsoon,onebeginstonoticehow
manyprivilegesaretakenaway.Thebathroomdoorsarelocked,andwomenmustask
permissiontousetoilet,andhavesomeoneelseflushitforthem.Thepantryandrefrigeratorare
lockedaswell,andaspecialkeyisneededtoopenthesharpscabinet.Theymustask
permissiontousetheirrazors,tweezersandnailclippers,whicharelockedinthesharpscabinet.
Thegirlsarenotallowedbackupstairsintotheirroomsafterbreakfastandcannotreturnuntil
laterthanninepm.Theyarewokendailyat6amtohavetheirvitalstaken,firstlayinginbed,
nextstanding.Theyareforcedtourinate,thenstripnakedandslipintoahospitalgowntotake
theirweight,whichisdonewithouttheirknowledgeofwhatthenumberis,calledablind
17

EatingDisorderStatistics|
AnorexiaNervosaandAssociatedDisorders.
n.p.n.d.Web.16Nov2015.

10

weight.Unlesstheyhavewrittenpermission,theyarenotallowedtoleavetheproperty.When
enteringbackintothehome,theirbagsaresearched.Whenawomanfirstentersthefacility,her
bagsarestripsearched,andmanyoftheirbelongingsaretakenandlockedinacabinetuntiltheir
departure.Therearetwomirrorsintheentirehouse,theyaresmallandarehungjusttolookat
onesface,sotheycannotlookattheirbodiesinthemirror.Ifaclientreceivesapackagefroma
lovedone,theymustopenitinfrontoftheirprimarytherapist,whoensuresnocontrabandis
foundinthepackage.10womenshareasinglephoneandcomputer,ascrambleinbetweenthe
hoursofgrouptherapyduringtheday.

Despitetherigidityoftheprogramandrulesclientshadtoabideby,IchoseMonteNidoto
researchspecificallyfortheworkthattheydowiththeclientsandhowhardtheyworktorecover
everyindividualwhocomestotheirfacilities.Theirworkhasproducedlongtermpostgraduate
successratesinthe88percentrangeforfullandpartialrecovery18.KarinLewis,theClinical
DirectoratMNLHspokeofthestaffhighly,theressomethingverypassionateaboutthepeople
thatworkatMonteNido,shesaid.IcantgiveasingleansweraboutwhatIlovemostabout
myjob,shecontinued.KarinsetsthestandardforhowpassionateworkersatMNLHare,and
howmuchefforttheyputintotheirwork.

Thetherapyisessentialtotherecoveryprocess.Severaltypesoftherapyareusedsuchas
cognitivebehaviouraltherapy,arttherapy,anddialeticalbehaviouraltherapy.Additionally,they
promotehealthyexercise,andmindfulnessandspiritualenhancement.Theprimarytherapisttoa
clientatMonteNidodoesnotshyawayfromanysubject,andforcesaclienttotalkabout
everythingthatledthemtoaneatingdisorder.ManywomenatMonteNidodiscussabuseand
traumasthathappenedtothemandareaskedinlengthtoprocessalltheemotionsthatcame
alongwiththeabuse.AusualstayatMonteNidoisabouttwomonths,iftheinsurancecovers
theirstayforthattime.Uponenteringthefacilitytherearefewborderswhenitcomestothe
relationshiptheclientbuildswiththeirprimarytherapist.Commonly,peoplewitheating
disordersportraytheirmemuchdifferentlythantheirI.GeorgeHerbertMeadcomposeda
theoryofsocialself,andhowapersoninteractswiththevoiceintheirheadandalsowiththose
aroundthem.ThemeMeaddescribesisformedbasedonsocialinteractions,andislearned
basedonexpectationsofothers.Iisseenastheindividualsidentity.Themetendsto
overpowertheI,becausethemeiswhatsocietysees19 .Intreatment,apersonwithaneating
disorderbeginstofindcongruencewiththeirmeandI.Itsvitalforsomeonerecoveringtobe
extremelytransparentandhonestwiththeirteamandsupports,sofindinguniformitybetween

FAQsMonteNidoEatingDisorderTreatmentCenter|
MonteNido&Affiliatesn
.p.,n.d.Web.16Nov.
2015.
19
GeorgeHerbertMead|
StanfordEncyclopediaofPhilosophyn
.p.published13April2008.Web.27Nov.
2015.
18

11

whattheythinkandwhattheydoisahugestepintheprocess.MonteNidoencouragesclientsto
usetheirvoice,andjustspeaktheirthoughtsandemotionsratherthanbottlethemup.

MonteNidoalsoworksverycloselywithapatientsfamiliesandsupports.Weekly,theyhave
familygroup,whereaclientssupportscomeandmeetoneanotheranddiscussopenlywhat
strugglestheyfaceastheyhelptheirlovedone.Monthly,theyhavefamilyweekend,where
supportshavetheirowntherapymeeting,wheretheycantalkmoreopenlywithoutupsettinga
client.Additionally,aclientsprimarytherapistwillhavefamilytherapysessions,sotheycan
workthroughtheirstrugglestogether,andalsolearnhowtobestsupportthepersonwithan
eatingdisorder.Familytherapyisessential.Itallowsforopenandhonestyinrelationshipsand
bettercommunication.Iteducatesthesupportsonhowbesttoaddresstheirconcerns,especially
whenawomandischargesfromthefacility.

MonteNidohasadistinctiveprogramtolettheclientsgainmorefreedomsastheyprogress
throughtheirtimeintreatment.EachMonday,clientssigncontractsrequestingmoreprivileges
ortomoveupanotherlevel.Goodbehaviourisrewardedwithmoreprivileges.Badbehaviouris
punishedbytakingawayprivileges.Tuesday,theentirestaffmeetstodiscusstherequestsmade
bytheclients.Themeetingtakesseveralhours,startingat9amandlastingthroughintothe
afternoonat3:15pm.Formostoftheday,theclientsaregonewiththestaff,onaweeklyouting
forlunch.Theannouncementoftheirrequestsaremadeduringcontractgroup,judgementday,
asdescribedbysomeclients.Uponenteringthefacility,aclientisplacedonEntryLevel,with
verylittleprivileges.ThenextweektheycanapplyforLevelOne.Therearestillfewprivileges
allowedonLevel1.Iftheclientisshowinginitiativeintheprogram,thenextweekshewill
usuallyrequestthenextlevelandreceiveherrequest.LevelTwogivestheclientmorefreedom,
allowingthemoutonpassesifappliedanddecidedamongstthetherapiststhatsheisreadyand
canbetrusted.Clientsmustbeaccompaniedbyahealthysupport,whomustsigntheclientin
andout.ThefirstweekofLevelTwothepasslastsaboutanhourandahalf.Ifpassesgo
successfully,astheweeksprogresstheclientcanrequestsnackpasses,allowingthemtoleave
thefacilityforlongerperiodsoftime.TheclientusuallystaysonLevelTwofor3weeks.Level
Threeisalargestep.Theyareallowedmorefreedomsandaregivenmuchmoretrustthanon
otherlevels.LevelThreealsoallowsformealpasses,givingtheclientmuchmoreallottedtime
outofthehouse,stillwithasupport.Theclientusuallyspendsaround4weeksonLevel
Three(thetimeframesgivenareallbasedontheassumptionthattheclientsinsurancecontinues
tocovertheirtreatment).Thelastlevelisrarelygiven.AclientonLevelFourwillspendmore
timeoutsideofthehousethanin.Theyareawardedindependentpasses,wheretheycanleaveby
themselves.Again,theindependentpassesstartwithsnackpasses.AclientthatreachesLevel
Fourhasinsurancecoveragethathasallowedthemstayforlongerthantheusualstay.Usuallyat
thispoint,theclienthasdoneenoughworkwiththeirtherapistanddietitianandtheyareableto
leavetreatmenttostarttheirstepdownprogramprocess.
12


Therapeutically,aclientatMonteNidodoesalotofwork.Additionally,theyarerequiredto
receiveweeklyoneononesessionswiththeRegisteredDietitian,CertifiedSportsNutritionist
andownerofprivatepracticeWholeLifeNutrition,AnnaSweeney.Anna,apetite,bubbly
blondewomancomesacrossverystrongly.Hervocabularywouldmakemostadultscringe,
pepperingeveryothersentencewithafuckorshit.ItbecameclearveryquicklythatAnna
wasextremelygoodatherjob,andtakesprideinhelpingherclients.Nothingmakesme
happierthanseeingsomeonegetbetter,saidSweeney.Sheopenlytalkedaboutherpassionfor
hercareer,butalsoherabsolutehateforthementalillnessthatisaneatingdisorder.Idontgive
afuckaboutyoureatingdisordersfeelingsanditstickingaroundaslongasitscomfortable,
saidAnna.Getoff.

Clientsareservedsnacksandmealssixtimesaday.Breakfastat7:30am,morningsnackat10
am,lunchatnoon,afternoonsnackat3:30pm,dinnerat5:30,andnightsnackat8:45(varying
slightlydailytoaccommodatedifferentschedules).Astheclientprogressesthroughthelevels,
theyareallowedtoservethemselvesmealsandsnacks.Atfirst,thebeginningmeasuring
appropriateservingsizesusingmeasuringspoonsandcups.Oncedeterminedready,theclient
willthenmeasuretheportionsbysight.Eachweek,clientsaregivenamenuwhichtheydiscuss
withAnna.Theylearnappropriateportionsizesorincreasetheirmealplanifneedbe.Thereis
noinformationprovidedaboutthenutritionofthemeal.Clientsareabletochoosetheirsnacks
fromashortmenuofoptions.Onceaweek,MNLHstafftakestheclientsandafewmental
healthworkersoutforlunchandsnackintheafternoon.Annatakesclientswhohavereachedthe
higherlevelsoftheprogramonceaweek(usually34peopleatatime)forasnackandthey
choosewhattheywanttomakefordinner,andcookfortheotherclients.

AnnacouldnotspeakmorehighlyofMNLH.Iveneverseenanyotherplacelikethiswhere
peoplemakesuchhugeleapsandbounds,saidSweeney.

Thetableisoftentimeswheremanywomenstruggle.Somewomenstareattheirfoodforseveral
minutes,othersfacialexpressionschangeentirely.Cryingisnotuncommon.Constantjigglingof
thelegsandfingersareagivenateverymeal.Thereareveryspecificrulesabouthowtheyare
allowedtoeattheirfood.Thisisdonetopromotenormaleatingbehaviours.Atsnacktimes,
15minutesaregiventotheclientstoeat.Mealsusuallylast30minutesbutabitofextratimeis
allowedatdinner.Themealsaresurveyedbytwomentalhealthworkers,andusuallyaprimary
therapist,nurseordietitian.Thereisalotofsupportgiven,fromthestaffbutalsoamongst
clients.Theysometimesmakepositiveaffirmationsandplacethemattheseatofaclientwho
mayneedtheextrasupport.Despiteallthesupportgivenatthetableduringmeals,manygirls
stillwillmanagetohidetheirfoodwithoutanyonenoticing.Sometimes,otherclientswillinform
staffwhenthishappens,butthiscausesproblemsbetweentheclients.Itiscommonforthe
13

clients(especiallyuponfirstenteringthetreatmentcenter)tosimplyrefusemeals.Refusalsare
notedbythementalhealthworkersondutyduringthemeal,anditisaddressedduringcontract
groupmeetings.Ifsherefuses,sheisgiventheoptiontodrinkamealsupplementshake.Ifthe
shakeisrefusedaswell,thisisamoreseriousmatter.Ifaclientrefusesthreemealsandthe
supplement,shewillbeaskedtoleavethetreatmentcenter.MonteNidotakestheserefusalsvery
seriously,andconsiderthemasignthatthewomanrefusingdoesnotwanttorecoverfromher
eatingdisorders.

Anybodysfearasaneatingdisordertherapististhatsomeoneisgoingtodie,saidKarin
Lewis.Especiallyastheiranxietiesanddepressionincreaseasapersonisnolongerusingtheir
eatingdisorderbehaviourstocope,suicideormedicalcomplicationsaredefinitelyaconcern.
Fortunately,atMNLHnoonehasdied.

IwaswelcomedintoMonteNidothedayIfirstvisitedtotalktoKarinverywarmlyandthis
reiteratedtomehowappreciativethecommunityistosomeonelookingtobecomemore
educatedwhenitcomestotherealmofeatingdisorders.Sheledmeupstairstoagrouptherapy
room,where12chairssatinacircle,forclientsandtherapiststositandtalk.Thetwoofus
occupiedtheroomforoveranhour.AsIlistenedtoKarinsstory,itwaseasytohearclientsand
therapistsgoingabouttheirdaydownstairs.Atonepoint,thesoundofabellchimedthroughout
thehouse,signalingtotheclientsitwastimeforanothermeal.

Karinisarecoveredanorexic,hasbeenrecoveredforover20years,andhaspursuedacareerin
therapyspecificallyforeatingdisorders.IbegantalkingtoKarin,andthefirstthingIwantedto
knowaboutwasherstory,andhowshegottoaplaceofhealingothers.Herstorycarriedonfor
over45minutes,andthatwastheextentofourinitialinterview.Iwasabsolutelyfascinated.As
shespoke,sheshiftedcontinuouslyinherchair,huggingherkneestoherchest,crossingand
uncrossingherlegs,sittingindianstyle.Hermovementsshowedtheenergyofamuchyounger
woman.

Hereducationweirdlymirroredmyown:shebegancollegeatEndicottCollege,whereisalso
whereIstarted.ShelatertransferredtoRogerWilliamsUniversity,whereshepursuedadegree
increativewriting.Again,shetransferredtoEmersonCollegeinBoston,Mass.,whereshe
graduatedwithadegreeinwriting,publishing,andliterature.Aftergraduatingfroman
undergraduateprogramatEmerson,Karinreallybegantostrugglewithanorexia,butafter
dealingwiththeillnessforseveralyears.Shewasdiagnosedattheageof21,butatthetimeof
herdiagnosis,therewasnotreatmentforeatingdisorders.Herparentstookonthesole
responsibilityofhelpinghertorecoverandrenourishherbody.

14

Afewyearsaftershebeganherdifficultprocessofrecovery,someoneintroducedherto
psychology.Karinwasabsolutelyfascinatedfromherveryfirstclass,andknewshewantedto
becomeatherapisttohelpothersachievetheirrecovery.Sheshylybegantoassociateherself
withCostin,andfinallyCostinaskedhertobecomeaclinicaldirectorataprograminBoston,
andencouragedKarintoopenherownprivatepractice.

HealthRisksAssociatedwithED

Obviously,eatingdisorderscauseanguishtothepersonsuffering,butitalsocausessevere
damagetotheirbodyandbrain.Eatingdisordersarecomparabletoaddictiontodrugs,mostlyin
thesensethatitcompletelyaltersthebrainschemistry.Thedisordersareusedasacoping
mechanism,toblockemotionslikeanxietyanddepression.Eatingdisorderbehavioursanddrugs
oralcoholcanbeusedtocombattheseemotionsthroughtheuseofchemicalstimulation(ED
behavioursanddrugs).Thereareclearpleasurereceptorswhenapersonconsumesfood,andalso
aversionstofood.Specificallytoanorexia,apersondevelopsregimentedhabitsinregardsto
theireating.Oncetheseroutinesaredeveloped,itisencodedintotheirbrainand
neurotransmittersandisverydifficulttobreakthesehabits.Whenapersonishungry,somebrain
cellsbegintoconsumetheothers,whichisanormalfunctionforthebraintoaddressthebody
thatapersonishungry.But,asananorexicbeginstostarveandbecomemalnourished,thebrain
shrinks,losingbothgreyandwhitematter.Ina2010study,researchersatYaleexaminedthe
wayrestrictiveeatingbehavioursdamagethebrainoffemales.Inahealthybrain,theaverage
graymatteris680millimeters.Inanindividualwhowasrestrictiveinhereatinghabitshadan
averageof648millimeters.Evenaftertheindividualwhohadbeenrestrictiveregained
appropriateweight,theirgraymatterwasstillaffected.Onlyincreasingtoanaverageof663
millimeters20.Therearealsodisruptionsintheneurotransmitters,thebrainexperiencesstructural
changes,nottomentiontheeffectsonapersonsthinkingandemotions.Additionally,asa
personrestricts,theirheartrateslows,causingalackofoxygentoreachthebrain.Eating
disordershavehugeaffectsonapersonsbrain21.

Eatingdisordersalsohavehugenegativeeffectsonthebody.Thereisanincreaseriskofheart
failure,osteoporosis,muscleloss,dehydration,toothdecay,ulcers,potentialfortheesophagusto
rupture,andamyriadofothersymptoms.Eatingdisordersoftentimesalsoleadtoinfertilityand
moreoftenamenorrhea,orlossofawomansperiod.Althoughawomancanrecoverfromher
eatingdisorder,itspossiblethatshewillcontinuetostrugglewithinfertilityandcarryingachild
Howeatingdisordersaffecttheneurobiologyofthebrain|
TheEmilyProgram
n.p.,23March2015.
Web.16Nov.2015.
21
Likingandwantingfoodrewards:Brainsubstratesandrolesineatingdisorders|
USNationalLibrary
ofMedicineNationalInstituteofHealth
byK.Berridge,14July2009.Web.16Nov.2015.
20

15

toterm.Eatingdisorderscancauseirregularovulationanddamagetohereggsandovaries.
Studieshaveshownthattheuterusofawomanstrugglingwithanorexiaregressestoprepubertal
functions.Ifawomandoessuccessfullybecomepregnantanddeliversachild,itismuchmore
likelythattheinfantwillhaveamuchlowerbirthweight22 .Inrecentyears,dentistshavebecome
aredherringtoapersonsuffering.Dentistscaneasilyseethesymptomsthroughtoothdecay,
halitosis,orgumdeterioration.Medically,therearemanysymptomsthatarecorrelatedwith
eatingdisorders.

Additionally,tocopewithsevereweightloss,thebodyproducesfinehairalloverthebodyto
aidinkeepingthebodywarm.Apersonshairandnailsbecomeextremelybrittle.Itscommon
forapersonshairtofalloutandfornailstosplitorbreak.Bruisesseemtoeruptfromnowhere,
marringthebodyfromthesmallestthings,likesittinginmetalchairsorjointsliketheknees
touchingeachother.

EatingDisordersonCollegeCampuses

Eatingdisorderscanbetheslowestpossibleformofsuicide.Apersonturnstoselfmutilationto
hidefromfeelingstheydontwanttofeel.Thesementalillnessesaffect20millionwomensuffer
fromand10millionmennationally23.AtRogerWilliamsUniversity,eachsemester35students
struggleseverelywitheatingdisorders,accordingtoJimAzar,theDirectorattheCounseling
Center.

Mentalhealthoncollegecampuseshasbecomeagrowingprobleminrecentyears,especially
witheatingdisorders.Therearemanyreasonswhypeoplestrugglewithaneatingdisorderupon
enteringcollege.Afreshmanisassaultedwithnewpeers,findingnewfriendgroups,livingon
theirownwithoutaparentsguidance,livinginadorm,academicandfinancialstress,notto
mentioninfluencescomingfromtryingtofitin.Tofitin,somewilldrink,oreatmoreliketheir
peers.Thisoftenleadstoafearofgainingthefreshman15.In2006,aNEDAsurveyshowed
that20%of1,000studentssurveyedstruggledwithaneatingdisorder24 .Lewismentionedin
passingapersonstrugglingwithaneatingdisordercantevenhandlebeingincollege.Itsa
waste,shesaid.

Seekingtreatmentoncampusisanadditionalstressforsomeonewhoisstruggling.Many
studentswhostruggleopenlydonotseekhelpformanyreasons.Somearenotawarethatthereis
ReproductiveIssuesinAnorexiaNervosa|
USNationalLibraryofMedicineNationalInstituteofHealth
byE.Hoffman,S.Zerwas&C.Bulik,July2011.Web.15Nov.2015.
23
GetTheFactsOnEatingDisorders|
NationalEatingDisorderAssociation
n.p.,n.d.Web.16Nov.2015
24
EatingDisorders&CollegeStudents|
MultiServiceEatingDisorderAssociation
n.p.,n.d.Web.16Nov.
2015
22

16

opportunitiestoseekhelp,orsomearefranklyembarrassed.Thereisalsoconcernaboutgetting
theirparentsinvolved,andalsohowthetreatmentwillbepaidfor.

RogerWilliamsinparticularhasanexcellentcounselingcenter,andseveralspecialistsoneating
disorders.Howcanyouworkatacollegecampusandnotseeaneatingdisorder?askedAzar.
Thenumberofpeoplewhostrugglewitheatingdisordersismuchlargerthanmostwould
suspect.25percentofcollegestudentshaveresortedtobingingandpurgingtocontroltheir
weight25.

Recoveringv.Recovered

Thereisalsosomequestionswhenitcomestotheterminologyofsomeonewhoistryingto
recoverfromaneatingdisorder.Somewhonolongerstrugglewiththeireatingdisordercall
themselvesrecovering.Althoughthesimilaritiesbetweeneatingdisordersandaddictionare
large,therearehugedifferencesintherecoveryprocess.Arecoveredalcoholicknowsnotto
drink,butapersonwhoisrecoveredfromtheireatingdisorderstillhastoeat.

Recoveringmakestheillnessseemasthoughitwillalwayscontinue.Apersonintreatmentwill
saytheyarerecovering,astheyarestillintheprocessofgettingbetter.Thetermrecoveredis
muchstronger,statingthatthepersonseatingdisorderisathingofthepast.Italsoencourages
otherswhoaresufferingthataneatingdisordercanbebeat,andwillcometoanend.Theseare
bothusefulterminologiesonapathtowardswellness,butMonteNidospecificallyisvery
outspokenonusingthewordrecovered,andlettingtheirclientsknowthatitispossibletobe
recovered.Thewordrecoveredshowsthatthereisanabsenceofsymptoms.Recoveredmeans
thatapersonhasreturnedtotheirnormalweightandshape,foodandweighttakeaproper
perspectiveintheirlives.CarolynCostindefinesrecovered:Whenrecovered,youwillnot
compromiseyourhealthorbetrayyoursoultolookacertainway,wearacertainsize,orreacha
certainnumberonthescale.Beingrecoveredisnotspecific.Itdoesnotjusthappensuddenly.
Theprocessisveryslowandgradual,andoftentimesapersondoesntrealisetheyarerecovered
untilitstrikestheminapassingthought.

ClosingAnotherChapter

AsIwalkedupthefamiliarstepstoMonteNidoLaurelHillinmidSeptemberinsuburban
Boston,abouquetofflowersinmyhand,Ifoundmyselfstrugglingtokeepfromcrying.Iwas
greetedwarmlybyKarin.Karinmetmewithatightembrace,myfaceburiedinherthickmane
ofbrowncurlyhair.Iwaslookingforwardtointerviewingher.
25

EatingDisorderStatistics|
AnorexiaNervosaandAssociatedDisorders
n.p.,n.d.Web.16Nov.2015

17


CanIgetyouanything?Water?Asnack?sheasked,asIplacedthepinktearosesinavasein
thekitchen.Webegantochatcasually,whiletheclientswereinagrouptherapysessionin
anotherroom.So,areyoureadytogointoprimarygroup?Karinasked.Iwasecstatictobe
invitedintothetherapysessionwiththeeightwomenattendingthefacilityatthetime.Karin
startedtellingmeabouthowthecommunitywasgoingandthingssomeofthewomenin
treatmentwerestrugglingwith...andthesearesomeofthethingsIwantyoutoaddresswhen
youtalktothem,shesaid.

What?Iresponded.

Iwantyoutoleadprimarygroup.Ithinkitsreallyimportanttheyhearfromsomeonewho
wentthroughthisprogramandcameoutsuccessfully,saidKarin.

Myhandsstartedsweatingandmyheartstartedracing.Ihadnotpreparedforthisatall.

Yeah,Illhaveaglassofwater,Isaid.

In2013,Iwasdiagnosedwithanorexianervosaattheageof19afterstrugglingwiththedisorder
forseveralyears.Istarvedmyself,eatingonlywhenmyparentspleadedwithme.Mydiet
consistedofobsceneamountsofcoffee,cigarettesandmostlyblueberries.WhatlittleIdideatI
compulsivelyburnedoffthroughexercise.Eatacracker?34squats.Abiteofafriends
sandwich?200jumpingjacks.Shit,thosedaysIknewmyparentswouldforcemetoeatdinner
werethedaysIranforhours,refusingtositstillforlongerthan2minutes,thenpushmyfood
aroundtheplateandhidemostofitinmynapkin.InFebruary2013,mymothercameto
EndicottCollege,whereIwasattendingcollege,andtoldmeitwastimetotakeamedicalleave
ofabsencefromschoolandgohome.I(somewhatunwillingly)attendedapartialhospitalisation
facilityinConnecticutfortwomonths.ByAugust2013,Ihadfullyrelapsedandreachedmy
lowestweight,askeletal96poundsonmy5feet7frame.Afteranepisodethatlandedmeinan
ambulancewithanIVpumpingmefullofliquidsandelectrolytes,Ifinallycametothedecision
nottolivemylifedying.Afterresearchingtreatmentcentersacrossthenation,IchoseMonte
Nido,andbeganmy3monthstayattheresidentialfacilityinMedfordonSeptember2nd,2013.

MonteNidosavedmylife.

Now,hereIwas,twoyearslaterandKarinledmeintothegrouptherapyroom,mymindracing
theglassofwaternearlyslippedoutofmyhands.Sheinvitedmetositinthemostcentralchair,
aplushvelvetygreenarmchair,standingaloneamongsttheotherlargecouches.Ithadbeena
longtimesinceIdbeeninaroomwithdisorderedeatersandthinkers,andasIsaidpreviously,I
18

foundmyselfveryselfconsciousaboutthewayIwasmoving.Onewomanintheroomopenly
askedHowcanyouexpectusnottocompareourrecoverytoyourswhenyourerecoveredand
stillskinny?Thiswasatoughquestiontobeasked,andalsoanswer.Iimmediatelyshutdown
thecomparison,sayingMybodyisnotyourbody,butIknowthiswasntthewomanwas
lookingformetosay.WhenIbegantointroducemyself,IdliketothinkIappearedcollected,
butIcouldbarelyhearmyownvoiceoverthesoundofmyheartbeatinmyears.OnceIbegan
speaking,Ibegantorelaxmore.AsIbegantotelltheclientsmyownstoryItriedtogetafeelof
theroombylookingattheirfaces.Somewereextremelyskeptical,hardlymakingeyecontact.
Otherfaceswerepurelyhopeful.

Althoughcompletelyunprepared,Italkedforoveranhour.Someofthewomenaskedquestions
animatedly,genuinelycuriousabouthowIcameawayfromtheprogramsuccessfully.TheonesI
wasmoreconcernedaboutweretheoneswhofailedtospeak.Asthegroupcontinued,Ifound
myselfgettingemotional,notbecauseIwassad,butbecauseIwassoproudofhowfarIhave
come.Ihadneverbeenmorehonestinagroupofalmostcompletestrangers.Oncegrouphad
concluded,someofthewomencametome,thankingmeforinspiringthem.

Onewomaninparticular,K******pulledmeasideandbeganaskingquestionsspecifically
aboutherstruggles,withothergirlsstreamingaround.Iofferedtositandtalkwithher,
oneonone.WesatonthefrontporchofthefacilitywhereIansweredmanyofthequestionsshe
had.Karincameoutside,readyformetoconductaninterviewwithher.Althoughthiswasmy
reasonforvisitingthefacility,IaskedformoretimewithK******,towhichKarinagreed.I
spentanadditional30minutetalkingwithher.ShecontinuestomessagemeonFacebook,in
hopesthatIwillbevisitingagainsoon.

Currently,Iweigharound120pounds,whichisstillsomewhatunderweightconsideringmy
height.Asanadult,Ihavebeenonthesmallersideandputtingontheweightwasaverydifficult
process,letaloneprocessingthechangestomyappearance.Ittookmesixmonthstogainthe
extra25ishpoundsandlearnhowtomaintainthatweight.IntimesofstressIstilltendtolose
weightwithoutintention.ItookplaceinascientificstudyduringmystayatMNLH,examining
theaffectsofanorexiaonbonemass.IlearnedthatIhadsevereosteoporosisinmyupperspine
andbothhips.Osteoporosisusuallyaffectspeopleintheir70s,andcausesbonestoeasilybreak.
ItcantbereversedandprogressivelydeterioratesasIage.Thishasledtoearlyonsetarthritisas
well.SomedaysIfindmyselfinpain,limitingalotofmymobilityandmakingitdifficultto
rotateorsleep.This,assofar,hasbeentheonlyremindernowtomethatIhavestruggledwith
aneatingdisorder.Iconsidermyselfrecoveredfrommyeatingdisorder,butnotwithoutthe
occasionaldisorderedthought.Sometimes,IstillfindmyselfangrywithpeopleIhadthought
weremyfriends,andsituationsthatledmetoresortingtoaneatingdisorder.Beingableto
recognisetheangerandprocessitandsurroundingmyselfwithpeopleIknowcareaboutmy
19

wellbeingisextremelyimportanttome.Inolongerseeatherapistordietitian,butIstilldokeep
incontactwithmyteamathomeandalsoatMonteNido.MybiggestsupportsIrelyonnoware
myparentsandmygoodfriends.

Attendingafacilitywheremanyofthestaffwasrecoveredwasveryhelpfulforme.Itwas
inspiringtolookatwomenwhobattledwiththeirdemonsandcameoutstrongerontheother
side.IknewIcouldbeopenandhonestwithmyteambecausetheyhadbeenthroughit
themselves,theyhadseenanddoneitall.Thewomenwhoworkedwithmerepresented
everythingIstrivedtobeloving,intelligent,emotional,beautiful,andalsoseeingtheir
friendshipsandrelationships.MonteNidotaughtmewhatitmeanttobeafriend,andalsowhatI
wantedinafriend.

MonteNidohasmademyrelationshipswithmyparentsverystrong.Ithasallowedformeto
speakopenlywiththemaboutanytopic.ThiswasvitalwhenIfirstdischargedfromthe
program,asIreliedonthemheavilyforsupportasIstruggledontheroadtorecovery.Before
MonteNido,therelationshipIhadwiththemwasentirelydifferent.Theirsupporthasbeenan
importantroleinmyrecovery.AsIhaverecovered,myrelationshipwiththemstillremains
strong.Beingabletotalkwiththemaboutanythinghasbeenveryimportant,especiallyasfamily
dynamicshaveshifted.

Choosingthetopicofeatingdisordersforthesiswasasomewhatdifficultdecisionforme.I
startedthinkingofpsychologyasaminor,orperhapsgoingontofurthereducationspecialisingin
psychologyandeatingdisorders.ProfessorScullyexpressedhisconcerntomeaboutwhether
thistopicwouldbecometriggering,towhichIrespondedthatIwasnotconcerned.Ifatall,this
processhasbeenempoweringtome.TalkingtothewomenatMNLHandtheirresponsestomy
honestyhavemademefeelevenstrongerinmyrecovery.Ifeellikewritingthisthesisisa
closingchapterforme.Allthedetailsthatgointoeatingdisordershavetrulybeenfascinatingto
meandlearningmoreaboutthehealingprocessandhealersthathelppeoplerecoverfromtheir
eatingdisordershaveonlyencouragedmyinterestsinthetopic.Ihopetohelpeducatemore
peopleaboutmentalillness,andtopromotesocialacceptanceofpeopleseekingtreatment.

Afterspendingquiteabitoftimeresearching,talkingandinterviewingatMNLH,Ifeltalittle
sadleavingthefacility.WhenIsaidgoodbyetotheclients,someofthewomenstooduptohug
meandthankmepersonallyforspeakingwiththem.WhenIgottomycar,Iturnedandlooked
attheoldVictorianhouse.Iwasexcitedtovisit,butbeingabletoturnmybackonthehouseand
leavewithoutknowingwhenIwouldbebackagaingavemethemostsatisfaction.

20

Works
Cited

Aboulafia,M.(2008,April13).GeorgeHerbertMead.RetrievedNovember27,2015,from
http://plato.stanford.edu/entries/mead/

ANAD.(n.d.).RetrievedNovember16,2015,from
http://www.anad.org/getinformation/abouteatingdisorders/eatingdisordersstatistics/

ANAD.(n.d.).RetrievedNovember16,2015,from
http://www.anad.org/getinformation/abouteatingdisorders/eatingdisordersstatistics/

Anorexianervosa.(n.d.).RetrievedNovember16,2015,from
http://www.newworldencyclopedia.org/entry/Anorexia_nervosa

Bastiani,A.M.,Rao,R.,Weltzin,T.andKaye,W.H.(1995),Perfectionisminanorexianervosa.Int.J.
Eat.Disord.,17:147152.doi:
10.1002/1098108X(199503)17:2<147::AIDEAT2260170207>3.0.CO2X

Berridge,K.(2009,July14).Likingandwantingfoodrewards:Brainsubstratesandrolesineating
disorders.RetrievedNovember16,2015,fromhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2717031/

Deams,E.(2011,December11).AHistoryofEatingDisorders.RetrievedNovember16,2015,from
https://www.psychologytoday.com/blog/evolutionarypsychiatry/201112/historyeatingdisorders

DyingtobeBarbie|EatingDisordersinPursuitoftheImpossible.(n.d.).RetrievedNovember16,2015,
fromhttp://www.rehabs.com/explore/dyingtobebarbie/#.Vkki5YT8FUR

EatingDisorders&CollegeStudents.(n.d.).RetrievedNovember16,2015,from
http://www.medainc.org/wpcontent/uploads/2015/09/MEDACollegeGuide.pdf

FAQsMonteNidoEatingDisorderTreatmentCenter.(n.d.).RetrievedNovember16,2015,from
http://www.montenido.com/faqs#what_is_your_success_rate

FactorsThatMayContributetoEatingDisorders|NationalEatingDisordersAssociation.(n.d.).
RetrievedNovember16,2015,from
https://www.nationaleatingdisorders.org/factorsmaycontributeeatingdisorders

Hoffman,E.,Zerwas,S.,&Bulik,C.(2011,July1).Reproductiveissuesinanorexianervosa.Retrieved
November27,2015,fromhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192363/

21

Howeatingdisordersaffecttheneurobiologyofthebrain.(2015,March23).RetrievedNovember16,
2015,from
http://www.emilyprogram.com/blog/howeatingdisordersaffecttheneurobiologyofthebrain

IdealFemaleBodyMeasurements.(n.d.).RetrievedNovember16,2015,from
http://www.fitnessandbodybuildingworkouts.com/idealfemalebodymeasurements.html

Latson,J.(2015,February4).HowKarenCarpenter'sDeathChangedtheWayWeTalkAboutAnorexia.
RetrievedNovember16,2015,fromhttp://time.com/3685894/karencarpenteranorexia/

Mapes,D.(2013,September16).'Fat'commentreporthighlightsbeautyqueenbodyissues.Retrieved
November27,2015,from
http://www.today.com/health/fatcommentreporthighlightsbeautyqueenbodyissues8C11131587

O'Toole,J.(2011,December23).Oneoftheearliestknowncasereportsofanorexianervosa,circa1684
KartiniClinic.RetrievedNovember16,2015,from
https://www.kartiniclinic.com/blog/post/anorexianervosacasereportcirca1684

O'Toole,J.(2012,January6).FirstKnownCaseHistoryofaMalewithAnorexiaNervosaKartini
Clinic.RetrievedNovember16,2015,from
http://www.kartiniclinic.com/blog/post/richardmortonsdescriptionofanorexianervosainayoungman/

Prevalencevs.Funding.(n.d.).RetrievedNovember16,2015,from
https://www.nationaleatingdisorders.org/getfactseatingdisorders

ResearchonMalesandEatingDisorders|NationalEatingDisordersAssociation.(n.d.).Retrieved
November16,2015,fromhttp://www.nationaleatingdisorders.org/researchmalesandeatingdisorders

Tenore,J.(2001,August1).ChallengesinEatingDisorders:PastandPresent.RetrievedNovember16,
2015,fromhttp://www.aafp.org/afp/2001/0801/p367.html

TreatmentSettingsandLevelsofCare|NationalEatingDisordersAssociation.(n.d.).Retrieved
November16,2015,fromhttps://www.nationaleatingdisorders.org/treatmentsettingsandlevelscare

Troop,N.,Allan,S.,Serpell,L.,&Treasure,J.(2008,November1).ResultFilters.RetrievedNovember
16,2015,fromhttp://www.ncbi.nlm.nih.gov/pubmed/18240123

U.S.NavalAcademy.(n.d.).RetrievedNovember16,2015,from
http://www.usna.edu/MDC/EatingDisorders/athletes.php

Winter,D.(2005,June1).CorsetHistory.RetrievedNovember16,2015,from
http://www.denisenadinedesign.com/CinchinUp.htm

22