The Mirror Lies? Eating Disorders on the Barrier Islands

Nearly 20, Mindy’s long face is mostly eyes. Deep brown, they scan constantly, afraid to miss anything. The bony outline of her high cheek bones accentuates the heaviness of the umber pencil straight hair. In a long sleeved shirt and just-the-right jeans, one might overlook how thin she actually is but it is summer and the outline of her midriff peeks from her tank top. At 5’9, Mindy weighs in between 125 and 128: she stuffs herself before she has to weigh in for her doctor, who fears that her eating disorder could, once again, land her in the hospital.
Mindy does not connect with her old therapist, she tells me as I meet with her for the first time, but she has connected with me. She finds my directness freeing. “It helps me open up. I have told you more in one hour than in months with the old therapist.” I contemplated that frightening thought, then said, “Well, we’d best go about finding you a therapist back in Massachusetts because college will restart soon.”
Thoughtful Mindy said, “But I outsmart them all. They focus only on my weight and that is not what drives my problem. I do not believe what I see in the mirror and nobody talks about that. I am OK at 123, but they want me to weigh in at 130 and you can see how much fatter I am through my jeans when I get towards 127.” She patted her thighs as though they were sizable. “I want to talk about what is really, really wrong, and you know how to listen to me. You get it.”
And “get it” I did indeed. I “got” that Mindy had never gotten along with her Mother, so she pretty much raised herself. I “got” that Mindy feigned disinterest in boys, who found her too smart and too intense. I “got” that Mindy was helplessly obsessed with the distorted body image she saw when she looked in the mirror.
“We do need to make sure the medical team helps with this, but you are right: your illness is more complex than focusing on what you eat. How is bikini season for you?” Bikini season and female self-flagellation go together.
“I really don’t like to swim, so it is not a problem,” she offered lamely. Seeing my raised eyebrows, she corrected herself. “It is horrible. I refuse to go shopping for clothes that expose every mistake in my body.” That felt honest to me, and I nodded. We decided to work for the summer and seek adequate help around college. We dug into how to buy a bikini.
After Mindy left, I closed the offices and biked to the beach for a big think. A girl and her boyfriend lay laughing and chatting to my right. Under a turquoise umbrella, a well-endowed woman bustled about a baby to my left. I hoped that, one day, Mindy would be able to enjoy a boyfriend and a baby of her own. If her treatment continues, I concluded that she can become rational about her body.
Ten million plus women suffer from anorexia (self starvation and distorted body image) and bulimia (binge eating and vomiting) and millions more suffer from obesity. Did you know that dentists are often the first to see the ravage caused by eating disorders, which destroy teeth and gums through high acidity in food intake? While treatment philosophies vary greatly about whether to treat the behavior, the attitudes, or the entire person, all of us agree that treatment must be immediate and thorough in order to facilitate a return to health. Women die from eating disorders.
The common-sense guidelines for developing a solid relationship with food are listed on the website for The American Eating Disorders Association. As many of us know, the steps below only sound easy:
1. Eat when you are hungry. Stop when you are full. Eat a modest portion of what you love.
2. Fight against media portrayals of emaciated models that promote ill health to sell fashions.
3. Appreciate the quirks of your body. No two are alike.
Besides these three goals, let me emphasize that the cure for the psychological treatment of an eating disorder is to go beyond body health to find fulfillment in loving relationships with others. Finding love from those who love your body as the vessel of your entire person is what counts. Love of self and others heals eating disorders. I promise.
To consider: The next time you stuff yourself into your shorts or tankini, would you thank your body for always being there for you? And, if you know someone with an eating disorder, would you pass this on? You might just save someone’s life.
(Coche of Stone Harbor educates the public in mental health issues. She can be reached at jmcoche@gmail.com or 215-859-1050.)