Print Issue: May 2, 2002

For Teens Struggling With Eating Disorders, Coming To Terms With Self-Image Requires Counseling And Spiritual Guidance

Megan McMahon is a junior at Lassiter High School, Marietta, and she plays right defensive wing on the school's lacrosse team. (Photos by Michael Alexander)

By Erika Anderson, Staff Writer

ATLANTA-At first it was no big deal, she thought. She just threw up once.

But soon, it was after every meal. Every day.

Like millions of teens, Megan McMahon was counting calories. Then she began obsessing about her weight. And when she looked in the mirror and saw her barely 100-pound self as fat, things got out of hand quickly.

"I had a fear of getting fat. I had a distorted image," she said. "I saw fat when I looked in the mirror. It didn't matter what anyone else told me. I would find little things on my body that I didn't like . . ."

Megan wasn't alone.

A recent study from the National Association of Anorexia Nervosa and Associated Disorders (ANAD) shows that 86 percent of those with an eating disorder, such as anorexia, bulimia or binge eating, develop their illness between the ages of 10 and 20.

Gail Phillips, LCSW, a Buckhead-based counselor who has specialized in counseling patients with eating disorders since 1988, calls eating disorders among teenagers an epidemic.

"There is huge cultural pressure for thinness and for perfect bodies. One of the prime examples that I give is that (cultural pressure to be thin) is like sunburn-everyone is exposed to it," she said. "And some people are more susceptible to sunburn than others."

Phillips said that in addition to distorted images of ideal bodies in the media, there can be psychological, biological and genetic causes, as well as developmental, spiritual, medical and relational causes, that can lead to an eating disorder. However, she said, almost all eating disorders start out the same way.

"Eating disorders begin as a coping mechanism," she said. "They help us cope with depression or anxiety or loneliness."

Megan, 16, a junior in high school and a parishioner of the Church of St. Ann in Marietta, said her problems with her self-esteem and body image began in the eighth grade, when she and her boyfriend of five months ended their relationship.

"We were talking on the computer and he said all this stuff-he called me ugly and fat and said I had no friends," she said. "I was all of about 98 pounds at that time. I had never been fat in my life. But when someone tells you that eventually you start to believe it."

As she began high school, she also began watching her weight. During the summer after her freshman year at Lassiter High School in Cobb County, Megan began throwing up after meals regularly.

"The first time I did it, I cried my eyes out," she said. "But then I figured it was no big deal-it was just that one time."

That one time led to it being a "habit of once a day," and eventually Megan was purging everything she ate.

An afternoon jog with a friend changed everything.

"We were jogging and my friend asked me, 'How do you stay so skinny?'" she said. "I said 'Oh, I throw up.' My friend just said 'oh' like it was no big deal."

But it was a big deal, and Megan's friend told her school counselor, who called her parents. With the help of her older sister, Megan sought counseling, which she said helped her to see herself in a new light.

Above, On the grounds of her parish, the Church of St. Ann, Marietta, Megan McMahon, 16, is joined by one of her supportive siblings, older sister Jennifer, 23. Megan is the youngest of three girls.

"I saw things differently. I had to write down my thoughts every day," she said. "I realized that when I felt fat or when I felt like throwing up was mostly in the morning when I was putting on my clothes. (Counseling) made me change my way of thinking."

At first, though she was in counseling, Megan was still purging.

"I wasn't really trying at first. I was not eating, and if I did eat, I would throw it up. It just got to be too much," she said. "I was too tired to stand up and I didn't even want to get out of bed. I wanted to get better."

Phillips said that counseling those with an eating disorder involves working to change the unhealthy behaviors and relationship with food.

"We give different tools to help you cope . . . it's called cognitive behavioral therapy," she said.

But eating disorder patients also undergo general counseling, Phillips said, because chances are, those with an unhealthy relationship with food "haven't learned how to manage their feelings," she said.

Phillips said she also "strongly recommends" family therapy for those with an eating disorder.

"There's that saying that it takes a village to raise a child," she said. "Well it takes a village to help someone recover from an eating disorder."

Recovery is essential to those who are suffering from an eating disorder, but how can these illnesses be prevented?

"The most important thing you can do to prevent an eating disorder is to get educated," Phillips said, adding that there is a wealth of information available in books and on the Internet.

Phillips also encourages young people to "get away from teen magazines," citing a study where two groups of women were sent into a waiting room. In one of the waiting rooms, magazines with models on the covers were placed, where in the other room, other magazines, such as news magazines, without models on the covers, were placed. The women who had been in the waiting room with the model magazines felt worse about themselves after just 10 minutes.

"We need to get angry at the messages of our culture, rather than buy into it," Phillips said.

Spirituality can play a big role in the way a young person looks at himself or herself.

"Everyone needs to feel they have a place to question their faith, but at the same time, we need to pray for faith and guidance-even Jesus did that," Phillips said.

Jenny Karns, coordinator of campus ministry at St. Pius X High School in Atlanta, said she believes that personal contact with the students is essential. At St. Pius, members of the administration, campus ministry, guidance and athletic departments, as well as the school nurse, meet regularly to discuss student issues.

"The bigger issues can get missed, especially in a school with 1,000 students," she said, but when various members of the faculty meet, "everyone has contact with someone," she said. 'We need to make sure these kids are known by name."

Karns said that if a student is dealing with a serious issue, such as an eating disorder, the school will refer the student to a counselor. But Karns hopes that the counselor will incorporate the spiritual aspect of a teen's life into the therapy.

"It's a constant prayer of mine that there are more counselors who can integrate faith and science," she said.

Affirming a student who struggles with her self-esteem begins with God, Karns said.

"You can never talk enough about how you are created by God and loved by God and sustained by God, and that he has a great plan for your life," she said. "Everything starts there. That comes from no amount of secular counseling. You can only find that answer in Christ. This school is unique in that it offers opportunities for kids to explore their faith in Christ and their hope in Christ. But it has to be personal. You have to realize for yourself that you are loved by God. We have to take those personal steps toward Christ and that's where this community has to step up and help."

Gloria George-Patrick, youth minister at Sts. Peter and Paul Church in Decatur, said that it is essential for teens to remember that they are God's children.

"You have to know who you are and whose you are," she said. "It's important to know that I am created and beautifully made and everything about me is created by a perfect God . . . The spiritual dimension of a person must be fully developed along with other aspects of the human being."

She recalled one teen who struggled with food issues who was helped by other members of the youth group.

"The youth themselves helped her without me even intervening," she said. "She found acceptance through them. They put no emphasis on her size."

Phillips said that this acceptance can be important for preventing and healing eating disorders.

"One of the primary symptoms of an eating disorder is isolation. There is so much shame involved with an eating disorder," she said. "Being in an accepting group can help to break through that shame."

Megan said that having a group of friends with whom she can truly be herself, such as those she's found through the Life Teen program at St. Ann's, has been an important part of her recovery.

"It's definitely helped me knowing I have a group of friends who accept me for who I am. At school it can be so incredibly hard because of criticism and always having to look good and be perfect and feeling you can't show your emotions," she said. "None of that is at Life Teen. At Life Teen I can cry for an hour in adoration if I want to. And if I do, there are people who want to know what's wrong and want to be there for you. It's really comforting. It's like a safety net."

Megan said she "hasn't thrown up in six months."

"I know I will always struggle with it," she said. "And sometimes I do have those thoughts, but I try to push them away. I know now that bulimia is a problem I have, but now I want to get rid of it and just give it up to God."

EATING DISORDER Statistics*

1. 5-10 million adolescent girls and women in the United States struggle with eating disorders and borderline conditions.
    
2. One million boys and men in the United States struggle with eating disorders and borderline conditions.
    
3. The number of people with eating disorders and borderline conditions is triple the number of people living with AIDS in the United States.
    

Pressures of the Media

1. The average American woman is 5 feet four inches tall and weighs 140 pounds. The average American model is 5 feet 11 inches tall and weighs 117 pounds.
    
2. Most fashion models are thinner than 98 percent of American women.
    
3. Almost half of American elementary school students between the first and third grade want to be thinner.
    
4. Four out of five children at the age of 10 are afraid of being fat.
    
5. Four out of five American women are dissatisfied with their appearance.
    

The Dieting Culture

1. Almost half of American women are on a diet on any given day.
    
2. One in four American men are on a diet on any given day.
    
3. Half of 9- and 10-year-old girls feel better about themselves if they are on a diet.
    
4. 35 percent of "normal dieters" progress to pathological dieting. Of these, one in four will progress to partial or full syndrome eating disorders.
    
5. Americans spend over $40 billion on dieting and diet-related products each year.
    

* Information from www.edap.org/edinfo.