BY AMANDA SAUDER

EALTH ISN'T A PICTURE; it's a painting--the beautiful strokes of mental, physical, and spiritual wellness all intertwined. Health is not a one-dimensional physical portrait of perfection. No. True, godly driven health is total-person balance in the grace and mercy of Christ. Health isn't a picture; it's a painting.

The Statistics
Unfortunately, it is estimated that 70 million people worldwide are missing this point. At least 50,000 will die as a direct result.

It's a vicious, all-consuming cycle that haunts an estimated one of every five college-age women and one of every 20 college-age men. Approximately one of every 10 high school students also suffers from this disease. Ten percent of victims are younger than 10 at the onset of this disease; 33 percent are between the ages of 11 and 15, and 43 percent between 16 and 20. Nearly nine out of 10 are consumed by this illness by the time they reach the age of 20.¹

It's the number one cause of death among young women. Five to 10 percent will die within 10 years; 18 to 20 percent will die within 20 years.

Think Adventists are immune? Think again.

According to a February 2002 poll on the Something Fishy Web Site on Eating Disorders, 66 percent of eating disorder victim respondents said they were Christian.²

The Disease
According to the American Psychiatric Association (APA), there are two recognized categories of eating disorders. The first, anorexia nervosa, is "characterized by refusal to maintain a minimally normal body weight." The second, bulimia nervosa, is "characterized by repeated episodes of binge eating followed by inappropriate compensatory behaviors such as self-induced vomiting; misuse of laxatives, diuretics, and other medications; fasting; or excessive exercise."

Also according to the APA, other signals of anorexia include an intense fear of gaining weight, a skewed perception of body shape or size, and in postmenarcheal females, discontinuance of menstruation. There are two acknowledged categories of anorexics: the restricting type (weight loss is accomplished primarily through dieting, fasting, or excessive exercise) and the binge-eating/purging type (binge-eating and purging through self-induced vomiting or misuse of laxatives, diuretics, or enemas).³

The APA also outlines additional symptoms of bulimia nervosa: self-evaluation is excessively influenced by body shape and weight, sense of lack of control during binges, and a frequent binge and purge cycle that occurs at least twice a week for three months. There are also two categories of bulimics: the purging type (purges through self-induced vomiting or misuse of laxatives, diuretics, or enemas) and the nonpurging type (individual uses of other inappropriate compensatory behaviors, such as fasting or excessive exercise).

"The primary distinguishing feature between anorexia nervosa and bulimia nervosa is body weight. Bulimics have normal to high-normal weight and thus do not suffer from the effects of starvation," states a chapter on eating disorders in the book Becoming Vegan, by Brenda Davis (R.D.) and Vesanto Melina (M.S., R.D.).⁴

A third broad category of eating disorders is acknowledged by the APA: eating disorders not otherwise specified (EDNOS).⁵ Individuals suffering from EDNOS exhibit some of the characteristics of anorexics and/or bulimics, but not enough to meet the full diagnosis.

According to the National Eating Disorders Association, such disordered eating occurs "when a person's attitudes about food, weight, and body size lead to very rigid eating and exercise habits that jeopardize one's health, happiness, and safety." An estimated 15 percent of young women suffer from disordered eating (National Eating Disorder Screening Program).

Do You See What I See?
It is important to note that while the behavior patterns of eating disorders are physical, these diseases are almost never about food.

According to Linda Wysong, vice president of student services at Union College in Lincoln, Nebraska, eating disorders are almost always "an indication of deep internal pain."

"When people hear the words 'eating disorder' they generally think of young women with anorexia nervosa or bulimia nervosa," states Becoming Vegan. "However, eating disorders are determined not by body weight or gender, but rather by state of mind."⁶

In fact, it is extremely difficult to diagnose an individual with an eating disorder based on looks or weight alone. Statistically, among women with bulimia nervosa, approximately 70 percent are of normal weight and 15 percent are overweight. Just 15 percent of bulimic women are underweight.

It is also difficult to perform a weight-only diagnosis on those with disordered eating habits. "The body weights of people suffering from EDNOS can range from seriously underweight to morbidly obese," states Becoming Vegan.⁷

Besides physical behavior patterns, those with eating disorders often exhibit similar psychological traits. Kirk Brown, student counselor at Union College, has seen several students suffering from eating disorders. Among them, he says, almost always present "is a distortion in the way they see themselves physically. Sometimes their body image is so distorted that it really becomes delusional. People who are the skinniest see themselves as the fattest girl in town."

"Often the root of an eating disorder is low self-esteem," agrees Debbie Goble, clinical dietitian at Shawnee Mission Medical Center in Shawnee, Kansas. "It's the very first thing."

"It'd be like Miss America seeing herself as the ugliest woman on earth," adds Brown.

Along with this self-hatred is a fierce panic of being fat. "Affected individuals go to great lengths to achieve weight loss, often building strange rituals around food, eating, and exercise. They have an intense fear of gaining weight and see themselves as fat, even when they are dangerously thin," states Becoming Vegan.⁸

A Snowball Effect
So how does this nightmarish cycle start? How does the ingrained fear of food, fat, and failure overtake so many lives?

For many eating disorder victims, it all began with a simple diet.

Such was the case for Brooke Whited, according to her testimony in the September 1997 issue of Brio magazine. "It began as a harmless diet simply to shed a few pounds, but soon it became my entire life," says Brooke. "The only thing I accepted from myself was perfection, and to be perfect I had to weigh 100 pounds. I achieved that goal and felt great. Everyone complimented me on my figure, so I decided to lose more weight.

"After a while, losing weight became an obsession," Brooke continues. "It made me feel powerful to step on the scale and see the number decrease daily. Every day I counted each calorie I ate and measured every morsel of food I swallowed."

Brooke became a victim of anorexia nervosa, her weight reaching a dangerous low of 78 pounds. She was eventually hospitalized to combat the disease.

Debbie Goble has seen many cases of diet-triggered eating disorders. "I did see an emaciated older women. She came into the hospital, had lost 100 or 150 pounds. She had been diabetic for five years, and when she was diagnosed with diabetes, she followed the diet they gave her very strictly. [When I saw her], she weighed less than 100 pounds. She realized she had gotten carried away with it, but . . . it was [now] hard to revert back.

"That is often the root of an eating disorder--a simple diet," continues Goble. "You get so caught up in that and you get so accustomed to that way of eating that it is very hard to shift into maintenance. There's that fear of reverting back and gaining the weight. I see that quite a bit."

In Perfect Control
There are numerous other roots for the development of eating disorders. One discovered root is displayed in certain personality types.

"Among the most common [psychological factors] are perfectionism and an obsessive/compulsive personality," states Becoming Vegan. "Those at highest risk for eating disorders tend to be very concerned about how others perceive them. In spite of their intelligence, work ethic, and notable achievements, they see themselves as inadequate, even worthless. . . . Their eating disorder may provide a sense of being in control of their own lives."⁹

Brown also sees the issue of control as a major contributing factor to eating disorders. "It's not uncommon for [eating disorder victims] to feel they have no control in life. It's not uncommon for them to come from rigid, controlling, demanding, scheduled families, where they are measured by their performance. Their life is planned--they don't have freedom. In that environment the one thing they can be in control of is what goes in their mouth. For some it's the only vestige to have power and the ability to make decisions for themselves."

Popular culture and the media also play a major role in promoting eating disorders. The Web site of Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED), discussed the results of a 1999 study on the media's unhealthy affect on women's self-esteem and body awareness. "In 1995, before television came to their island, the people of Fiji thought that the ideal body was round, plump, and soft. Then, after 38 months of Melrose Place, Beverly Hills 90210, and similar Western shows, Fiji teenage girls showed serious signs of eating disorders."

Indeed, according to a recent article in Health magazine, 32 percent of female TV network characters are underweight, compared to just 5 percent of U.S. females. Also, only 3 percent of female TV network characters are obese, compared to 25 percent of U.S. females.

Triggers
For women and men vulnerable to eating disorders, there are many different triggers that set them on the downward path of an eating disorder.

According to ANRED, "triggers often happen at times of transition, shock, or loss where increased demands are made on people who already are unsure of their ability to meet expectations." Triggers might include major life changes, such as puberty, moving, graduation, beginning college, starting a new job, death, divorce, marriage, family problems, or the breakup of an important relationship.

However, the onset of an eating disorder is not always categorized by something dramatic.

"For those who are predisposed, a full-blown eating disorder can be initiated by a seemingly insignificant trigger, such as a thoughtless comment from a family member or friend about weight or shape," states Becoming Vegan. "The disorder is usually precipitated by a period of increasing challenges or responsibilities that the individual feels ill-equipped to handle."¹⁰

Other triggers can be found in the social scene.

"The way a lot of men meet and act and relate with women [can promote eating disorders]," says Brown. "[Some men] look at the media's ideal woman and say, 'Hey, if a women falls into that category, they'll catch my eye.' But if they don't, if they're maybe big-boned, they won't. That is reinforcing to women already struggling [with predispositions to eating disorders]. They see who the guys are dating and think, I need to look like her. Then they get into dieting."

"Many women find value in how men see them," says Wysong. "For many people, all it can take [to onset an eating disorder] is a comment from their dad, 'Hey, you look really good since you lost 10 pounds.' That could be a tipping point. Girls need to know their dad's love and acceptance. When they don't get it, these things--body image--become important."

Health as a Painting
As Adventists, we have enjoyed a God-given health message since our church's early years. Because of our dedication to good health, we may feel we are untouched by eating disorders. However, just the opposite may be true.

"I think within Adventistm," says Wysong, "my hunch is that we have higher than the national average of eating disorders. I wish I had data to back that up. But what we know about eating disorders is that they are largely about low self-esteem and being perfect. If we think our value is based on doing good or being good people, then when we mess up, our value diminishes."

"As Adventists we have a lot of rules about diets and foods," says Brown. "[Those with leanings toward perfectionism] can become focused on and obsessed with these rules. Sometimes people who struggle are those who are obsessive altogether. They're kind of uptight--almost phobic--about food and fat. It gets obsessive instead of healthful."

Ellen White agreed. In Counsels on Diet and Foods she wrote, "Health reform becomes health deform, a health destroyer, when it is carried to extremes" (p. 202).

In The Ministry of Healing Mrs. White also reflected this sentiment: "Those who understand the laws of health and who are governed by principle will shun the extremes, both of indulgence and of restriction" (p. 319).

"Family health really affects this," continues Wysong. "We need to give every child a sense of their value in God's eyes--that is what gives them value. Seeing God's love as total and unconditional and understanding--what that really means is a huge piece of helping our sons and daughters to have good self-esteem."

"It's so much about overall perspective, keeping your life in perspective, in balance," says Brown. "Change your life by changing your thinking . . . how you see yourself and others and God."

The Not-So-Narrow Way
Society tells us we need to lose weight; we need to be beautiful and handsome and muscle-bound--no matter what the cost.

The media tells us we're nothing unless we look like their actors, pose like their models, play like their athletes, conform to their unrealistic standards.

But Jesus said, "What good will it be for a man if he gains the whole world, yet forfeits his soul?" (Matt. 16:26, NIV).

Our Savior loves us--just the way we are. He doesn't ask for perfection; He wants our love. And it's His grace that will transform us.

Paul said, "Do not conform any longer to the pattern of this world, but be transformed by the renewing of your mind" (Rom. 12:2, NIV). And in Romans 5:8 and 8:32 he reminds us how important we are to God just as we are.

Popular culture publishes the picture of health.
God shows us that health is a painting.
And luckily, my God isn't just a photographer; He's an artist.

_________________________
¹ About.com.
² www.something-fishy.org/news/poll_february2002.php.
³ www.psych.org/psych_pract/treatg/pg/eating_revisebook_4.cfm.
⁴ Brenda Davis and Vesanto Melina, "Eating Disorders," Becoming Vegan (Burke Pub. Co., 2000), chap. 14, p. 221.
⁵ www.psych.org/psych_pract/treatg/pg/eating_revisebook_6.cfm
⁶ Davis and Melina, p. 220.
⁷ Ibid., p. 222.
⁸ Ibid., p. 220.
⁹ Ibid., p. 222.
¹⁰ Ibid., p. 224.

_________________________
Amanda Sauder is a senior public relations/journalism major at Union College in Lincoln, Nebraska.