About a year ago SELF magazine approached me to ask whether the UNC Eating Disorders Program would be interested in collaborating with the publication in developing and conducting a national survey of women designed to produce an unfiltered snapshot of disordered eating behaviors in American women.The first thoughts that went through my head were really images -- images of SELF covers with thin women, diet headlines, recipes, rapid weight loss promises. At the same time, they promised dissemination of accurate information to 50.8 million readers, which was many more than we could ever reach through academic outlets.So I remained open-minded and met with the editors of SELF in New York. The Conde Nast building, at first glance, was a caricature. If you've seen "The Devil Wears Prada," you get the picture: young women teetering in their heels and short skirts, makeup and perfect hair everywhere. Once I walked through the doors of the SELF offices, the atmosphere was more relaxed. The women looked more down to earth, more like the rest of us. They told me that Vogue and several other magazines were headquartered in the same building and you could almost tell which magazine someone worked for by a single glance.As the meeting progressed, I felt that the SELF author and editors truly wanted to explore that gray area between healthy eating and actual eating disorders. I described it as flying under the diagnostic radar and suspected that the numbers of women who occupied this gray territory was likely to be very high.So we developed a working plan. UNC would be the brains behind the operation. SELF would finance the survey, which would focus on women between the ages of 25 and 45. UNC would be able to look at actual eating disorders, and SELF was interested in getting our help developing questions that would get at some of the common unhealthy profiles their readers talk about online -- behaviors such as secretive eating, chronic dieting, over-exercising, and being a prisoner to calorie counting.What's important about this survey is that it was conducted online. People were invited to participate via an e-mail blast. So there is a bias in there that only people with e-mail would be eligible to participate, but current data suggest that a high percentage of women in this age bracket are online. At no point were SELF or UNC ever mentioned in the survey. We did not want to have an over-representation of SELF readers or Tar Heel fans who completed the questionnaire.
What we found was astonishing and busted some traditional myths about disordered eating behavior. Sixty-five percent of American women between the ages of 25 and 45 reported having disordered eating behaviors and an additional 10 percent of women reported symptoms consistent with eating disorders such as anorexia, bulimia nervosa and binge eating disorder. Unhealthy eating and weight control practices are rampant among women in our society. One of the myths that we busted was that disordered eating is somehow limited to white upper middle class young women. This couldn't be farther from the truth. Disordered eating behaviors cut across racial, ethnic, age, and socioeconomic lines. Women who identified their ethnic backgrounds as Hispanic or Latina, white, black or African American and Asian were all represented among the women who reported unhealthy eating behaviors.An eye-opener for me was the high number of women who reported engaging in unhealthy purging activities. More than 31 percent of women in the survey reported that in an attempt to lose weight they had induced vomiting or had taken laxatives, diuretics or diet pills at some point in their life. Among these women, more than 50 percent engaged in purging activities at least a few times a week and many did so every day. Since the majority of the women were overweight, this tells me that women are resorting to desperate and potentially dangerous means to try to keep their weight under control. Unfortunately, these methods are entirely ineffective.
I fear that many of these behaviors have become normative. It is almost expected that a woman -- any woman -- is dissatisfied with her body and is trying to lose weight. When's the last time you heard a woman (especially a maturing woman) say, "I am really proud of how I look and who I am." Even supermodels are expected to point out their flaws. Body dissatisfaction is the cultural norm. If a woman were to proclaim satisfaction with her appearance, women around her would doubt her veracity or wonder what she's hiding. Yet, we have to work as a team so that we can model appropriate body acceptance to the girls in our life. When they hear us harping on our flaws, complaining about the size of our various body parts, saying how clothes always make us look fat, we are the role models who teach them how to talk about their own bodies. We all want our children to have more respect for their bodies than we did, to treat them better and speak more kindly about them. We often talk about our bodies in ways we would never think of talking to another person -- it would be too disrespectful and rude. The next time you hear yourself dissing your body, ask yourself whether you would ever speak to someone else that way and why it should be OK to speak to yourself in such a disrespectful manner.The UNC-SELF team developed several tips to help women change their behavior. Some of the most important are: Adopt a moderate approach to eating, eat a healthy breakfast every day, separate food from mood (this means learning new skills to deal with emotions rather than turning to food every time uncomfortable emotions arise), and find realistic body role models. Finally, we encouraged every woman to work on making these positive changes and to do it for the girls in your life!Women can take a version of the survey at www.self.com to see how their answers compare with other readers' answers and share their thoughts in the Hot Topics section of the magazine's Web site.For information about the UNC Eating Disorders Program, visit www.unceatingdisorders.org . For general facts about eating disorders visit the Academy for Eating Disorders Web site at www.aedweb.org .