By Dr. Marcy Forta
My name is Marcy Forta, and I am an eating disorder survivor, advocate, educator, and lecturer. I had anorexia when I was in my teens and was fortunate enough to overcome it. I have gone on to lead a fulfilling life, and my eating disorder, while not definitive of who I am today, is still a part of how I got here. It is a part of who I am. I am not ashamed of it, nor of my struggle. Thank G-d, I went on to graduate business school, get married, have a beautiful family, open a women’s and girls’ clothing store, and then close that store to go back to school in order to learn more about how I can assist in heading off these devastating disorders. I have spent the last six years studying disordered eating and eating disorders, all types of risk factors for them, how they manifest, the onset of them, their consequences, and the struggle of the adolescent female in particular. Currently I implement education and awareness programs. And while I do work with the girls themselves, it is particularly meaningful to speak with parents and school educators about the prevalence and dangers of eating disorders. There is simply too much misunderstanding and misinformation surrounding eating disorder risk and onset. People who are not affected by them or less experienced with them simply do not have a clear idea of what they are and what they are really about. I work to help them better understand these things as well as how we can support those affected by them.
When I owned my women’s and girls’ clothing store, I was especially struck by the difficulties girls had in shopping, trying on, and buying their clothes. The number in the top or the size in the skirt caused real, almost tangible, anguish for them. There was a lot of frustration both for women and girls with this process. It was disheartening to see, and frustrating to realize, that so much of how we feel about ourselves is tied to how we perceive our physical appearance. I really wanted to figure out how I could help people and change this situation.
One of the things I learned early on while studying eating disorders was how well-intentioned teachers and principals are so often in the dark, neither understanding the diseases, nor the prevalence of them in their schools. Yes, this was a clear, documented phenomenon in several empirical studies I read, but since I was studying small, local, parochial schools, I was certain that this would not be the case here in our close-knit community. Not only was I wrong but actually shocked to learn there was almost this deniability that eating disorders exist in their schools along with an almost complete obliviousness as to what they are and how they manifest. This realization made me even more determined to dispel the myths about them as well as educate and raise awareness for them. There is just so much misinformation out there.
Eating disorders are sadly often misunderstood and sometimes even considered a lifestyle choice. The reality, however, is that eating disorders are severe psychiatric illnesses with a complex etiology along with numerous physical and emotional consequences, thought to be triggered by a complicated interplay of biological, psychological, and environmental factors. The number of clinically diagnosed eating disorder cases worldwide is between 0.5% and 3% of the general population with some experts putting the number closer to 12%.
Adolescence, the age when eating disorders tend to emerge, is a time of particular vulnerability and stress, leading to increased propensity for both disordered eating, eating disorders, and the development of mental health issues overall. Teenagers are undergoing many biological, emotional, and physical changes as they struggle to assert and solidify their independence. In fact, studies have found that habits, attitudes, and perceptions regarding food are developed in children as young as 6 and that they also struggle with body image and weight issues, openly expressing their desire for a thinner and leaner body. This is such an unnecessary and harmful burden for them to bear. In fact, studies have found that over 80 percent of 10-year-olds are afraid of being fat, 80% of children who are only 10 years old! This same study also noted that between 35% and 57% of adolescent girls engage in dangerous dieting behaviors, including fasting, diet pill use, laxative abuse, and more*.
Eating disorders are often chronic and debilitating, and result in a significant reduction to the affected person’s quality of life. Eating disorders have high co-morbidity with other mental disorders and significant treatment resistance. And, after all our years of studying their causes and onset, there is still not a clear understanding of them. People affected by them often don’t know how to differentiate between themselves and the disorder. And while eating disorders are all about food – whether that means controlling what you eat, bingeing, purging, or dieting chronically, the actual causes and onset of them are really not about the food. Rather, (editor’s note, for some) food becomes a strategy to manage some inner turmoil or severe stress that someone is experiencing. And as each eating disorder is unique, it needs to be managed and treated as such, which is why they are so insidious (and complicated to treat).
While there are many potential risk factors for the development of eating disorders, there is no single issue that can be pinpointed as a sure-fire cause. Rather it is the combination of multiple risk factors and how a person internalizes and/or perceives them, that creates the risk for them. There are those who may have numerous potential risk factors but will never develop an eating disorder, whereas for others, being affected by only one or two of the risk factors, may impact them far more seriously.
As Helen Keller put it so eloquently, “Alone, we can do so little; together, we can do so much”. We are all needed in the fight for our affected family and community members against eating disorders. We must continue to advocate, educate, and increase awareness about these devastating and dangerous illnesses. This is my passion.
*Boutelle, K., Neumark-Sztainer, D.,Story, M., &Resnick, M. (2002).Weight control behaviors among obese, overweight, and nonoverweight adolescents. Journal of Pediatric Psychology,27, 531-540.
Neumark-Sztainer, D., &Hannan, P. (2001). Weight-related behaviors among adolescent girls and boys: A national survey. Archives of Pediatric and Adolescent Medicine, 154, 569-577.
Wertheim, E., Paxton, S., &Blaney, S. (2009).Body image in girls.In L. Smolak & J. K. Thompson (Eds.), Body image, eating disorders, and obesity in youth: Assessment, prevention, and treatment (2nd ed.) (pp. 47-76). Washington, D.C.: American Psychological Association.