As I was walking through a life one morning the sun was out, the air was warm, but oh I was cold, and though I must’ve looked a half a person, to tell the truth in my own version, it was only then that I felt whole.
Ted Leo and the Pharmacists
Me and Mia
Long time readers of The Alder Fork Blog will know that I don’t always write about music, art, film, and theatre because my mind likes to wander. I wrote my Master’s thesis on the connections between Anorexia Nervosa and religious belief, with an aim towards exploring pastoral options for treatment and prevention. Many people asked to read it, and some have. The second and third chapters of my thesis (when I was discussing the pastoral elements) are not as well written as I would have liked. I kind of tired of the process and allowed myself to make some leaps in the writing. In the end it was good enough to pass, but could have been better. The first chapter, however, is one of my proudest pieces of writing. In that chapter I reviewed the relevant literature and drew some conclusions of my own about the existing and potential roles for religious interventions, and poastoral education. Over the next little while I will be featuring that chapter in its entirety,obviously broken up into smaller parts. It begins today with the Part I. Please don’t hesitate to contact me about it, I love to discuss my research. If you or someone you know might have an eating disorder please seek professional help.
Anorexia Nervosa and the “Thin Ideal”
The purpose of this chapter is to present research on the relationship between anorexia and religion. It will focus on defining anorexia nervosa, and on research about religion and anorexia. Although there are few empirical studies related to this topic, some hypotheses can be drawn from the available literature. Notably, the evidence suggests that a religious worldview can influence an individual’s relationship with his/her body. For example, fasting and the valuing of spirit above body have been correlated with poor body image. As well, spiritual interventions have been useful in the treatment of anorexia nervosa.
Anorexia nervosa is an eating disorder characterized by an individual’s efforts to control her body weight through eating, exercise and other means. The Diagnostic and Statistical Manual of Eating Disorders IV presents the following four criteria for a diagnosis of anorexia:
A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
B. Intense fear of gaining weight or becoming fat, even though underweight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
D. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles.
(A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)
Based on the clinical criteria for a diagnosis of anorexia nervosa, it is apparent that the condition is a mix of psychological (B, C) and physiological (A, D) concerns.
There are two subtypes of anorexia, “restricting type,” and “binge eating/purging type,” which reflect two different methods of controlling food intake and body size. Restricting anorexia could be considered the extreme dieting model where the individual limits her food intake to the point that she starves herself. Binge eating/purging type is similar to bulimia nervosa in that the individual eats large quantities of food and then attempts to expunge them through vomiting, or laxative abuse. When a person stops eating, her body first reacts by storing as much energy as possible, entering what is called starvation mode. Without enough food energy the body shuts down organs and wastes away. For anorexics this extreme weight loss is considered a mark of achievement of body control. If untreated, anorexia can lead to death.
Although persons of any age are at risk for developing anorexia nervosa, this eating disorder is most common among young females between 12 and 25 years of age. It is estimated that 1 out of every 8 adolescent girls displays eating disorder symptoms (including bulimia and eating disorders not otherwise specified). The prevalence of anorexia, specifically, ranges between 0.5% and 3.7% in females, and 0.05% and 0.37% in males, with the number of new cases continuing to increase. Up to 20% of all patients diagnosed with anorexia will eventually die from their condition.
Those who suffer from anorexia come from a wide range of socio-economic backgrounds. Anorexia occurs most often in industrialized nations that have an abundance of available food. Eating disorders are common in North America, Europe, Australia and New Zealand, and Japan, although research in other areas of the world is currently limited.
As this eating disorder affects a diverse population, the root causes of anorexia are complex. There is evidence to suggest that certain psychological stresses, such as dysfunctional family life, a sense of helplessness, or even genetics have a role in many cases. There are two prominent explanations for the proliferation of eating disorders in North America. The first can be termed controlling the body, and relates specifically to personality variables such as perfectionism, low self esteem, fear of maturation, and familial/cultural variables that leave an individual feeling out of control or dominated (primarily known as the psychodynamic explanation). The second explanation deals with cultural and peer pressure to achieve and maintain a certain appearance, a misunderstanding of the concepts of body type and development, and fear of obesity.
A negative consequence of the social stigma associated with anorexia is the proliferation of “pro-Ana” (short for anorexia) movements among teenage girls that promote anorexia as a lifestyle choice and ideal. This situation is perhaps the most extreme outcome of a society that values physical beauty, in the form of thinness, as a high ideal. The glamourization of anorexia as a celebrity disease and a path to acceptance can be seen in the content of these sites. This type of online community provides anonymous support for girls that they cannot find in the “real world,” partly due to the fact that anorexics do not speak openly about their condition, as well as the stigma associated with the illness. The community fostered on these sites is dangerous for those at risk of developing an eating disorder. This issue will be addressed as part of the discussion of the theology of the body because it relates to the community of those at risk.