Ethics and Eating Disorders
More than 10 million women in this country are suffering from some form of eating disorder. Although we tend to think of anorexia and bulimia nervosa as adolescent and young adult problems, more women are suffering from these conditions in mid-life or later. From today’s New York Times:
Cynthia M. Bulik, director of the Eating Disorders Program at the University of North Carolina, Chapel Hill, says that though it was initially aimed at adolescents, since 2003 half of its patients have been adults.
“We’re hearing from women, no matter how old they are, that they still have to achieve this societal ideal of thinness and perfection,” she said. “Even in their 50s and 60s — and, believe it or not, beyond — women are engaging in extreme weight- and shape-control behaviors.”
For middle-aged and older folks, eating disorders often begin with a desire to “get healthy” which becomes an excessive habit of self-starvation and exercise:
A 58-year-old yoga instructor in St. Louis, Ms. Shaw says she was nearing 40 when she decided to “get healthy” after having children. Soon, diet and exercise became an obsession.
“I was looking for something to validate myself,” she told me. “Somehow, the weight loss, and getting harder and firmer and trimmer and fitter, and then getting recognized for that, was fulfilling a need.”
. . .
And though one doctor suggested that Ms. Shaw looked as if she needed to “eat a cheeseburger,” most praised her efforts to keep her weight down and her commitment to exercise.
“One of the things we’re working very hard to do is to make sure this stays on physicians’ radar screens so they can recognize and distinguish between menopause-related changes, real health problems and eating disorders,” Dr. Bulik said. “Often they don’t ask the question because they have in their mind this stereotypical picture of eating disorders as a problem of white, middle-class teenagers.”
For Ms. Shaw, diet and exercise overtook her life. She spent more and more hours at the gym — even on family vacations, when she would skip ski outings with her husband and sons in favor of workout time.
“None of my friends, my ex-husband, no one ever said anything,” she said. “It was no one’s job to fix me, but I wish someone had said to me: ‘I miss you. You’re gone. You’re so obsessed.’ ”
While eating disorders are complex bio-psycho-social phenomena, the article from today’s Times reminds us that there is a moral dimension to eating disorders as well. Although there is a major problem in this country today with obesity (in fact, yesterday’s Times had an article on fighting obesity in schools), our societal acceptance and perpetuation of a very thin ideal for women is having detrimental effects.
My own research in this area focuses especially on the role of thin-ideal images as playing a major role in the onset and maintenance of eating disorders. Research shows that girls and women are significantly more dissatisfied with their bodies after viewing thin-ideal images, especially in fashion magazines, and are significantly more likely to develop symptoms of an eating disorder. While some eating disorders seem to have an underlying biomedical cause, many develop overtime as a result of certain habits that become obsessive like dieting, working out, and criticizing one’s body.
In his book Moral Wisdom, James Keenan, SJ emphasizes how little everyday actions that we might not think of as morally significant (like exercising or reading fashion magazines) play a major role in determining our moral character. Drawing on the moral theology of Thomas Aquinas, Keenan writes,
Thomas believed that we become what we do. What does this mean? Thomas appreciated that anything that we intentionally do (and he always meant intentionality in the broad sense) makes us become what we are doing. If we were rude in getting to work this morning, we are becoming more rude people. If we were able to laugh at some problems that affected us today, we are developing a sense of humor. If we stopped to help a person in need, we are growing in compassion; if we did not, we are becoming more callous (143).
This pertains especially to the consumption of thin-ideal images and the development of eating disorders. The more we look at and strive to conform to images of women we see in magazines, movies, and television, the more dissatisfied we become with our bodies. This does not mean that we should not try to cultivate healthy eating and exercise habits, nor does it mean that we should blame women who do develop eating disorders, but it does mean that we should be aware (and help those around us be aware) of when those seemingly healthy habits become excessive, and may be forming us into the sort of person we do not want to be.