ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, February 13, 1996 TAG: 9602130055
SECTION: EXTRA PAGE: 3 EDITION: METRO
COLUMN: Personal Health|
SOURCE: JANE BRODY
Donna Boguslav, a registered nurse who specializes in eating disorders, was working at St. Vincent's Hospital in New York when a young woman who resembled a concentration camp victim was brought in by ambulance.
Emergency medical technicians had found the 24-year-old woman, a former model, lying barely conscious on the floor of her apartment. They had been summoned by her out-of-town parents.
Hospital personnel connected her to an intravenous feeding tube. But the severely anorexic woman looked up at the bottle of liquid and exclaimed ``Dextrose - that's sugar!'' and, with her last bit of energy, she ripped out the IV needle.
``We had to tie her down to get some nutrients into her, but despite our efforts, she died of kidney failure as a result of her self-induced starvation,'' recalled Boguslav, who is now assistant director of health services at New York University.
Boguslav has great empathy for those afflicted with eating disorders. ``Before I was a nurse,'' she said, ``I was a dancer. And like many, maybe most, dancers, I have a history of eating disorders myself. If there's something weird that can be done with food, I've done it.''
While everyone is bombarded by images of slender, shapely bodies that only 1 percent of the population can achieve, most people do not develop eating disorders as a result. Why, then, do some fall into the trap, even to the point of destroying their health or losing their lives?
``If your self-esteem depends on your parents, peers or anyone but yourself,'' Ms. Boguslav says, ``you're in trouble. You're vulnerable if your identity is defined through someone else's eyes. Your sense of self-worth must come from within and not rely upon external appearances.''
Certain pursuits that overemphasize external appearances often foster eating disorders. Modeling is one, dancing another, acting still another. Many models, dancers and actresses have notoriously bizarre eating habits, often subsisting on one or more candy bars to get through the day.
Penelope Tree has confessed that she was anorexic when she modeled her waif-like body in the 1960s.
Jane Fonda, the actress, has said she suffered from bulimia for 20 years before turning her attention to fitness. Gelsey Kirkland, a former Balanchine ballerina, recalled in her autobiography, ``Dancing on My Grave,'' that although she weighed less than 100 pounds at the time, Balanchine was not satisfied. He stopped a class to inspect her body, thumped on the bones of her chest and said: ``Must see the bones. Eat nothing.''
Athletic endeavors that involve judging, among them gymnastics, diving and figure skating, also commonly spawn eating disorders.
But for most people who develop eating disorders, it is not the demands of a particular endeavor that lead them to adopt extreme measures to lose weight.
Rather, experts say, it is a ``negative body image'' - and often an unrealistic one - that underlies their obsession with weight. A few therapists have begun to focus, not just on the sources of damaging body images but on how to change those images, even when the body remains the same.
For example, Dr. James C. Rosen, a psychologist at the University of Vermont in Burlington, has developed an effective ``body image therapy'' program that teaches obese people, among others, to shed a negative self-image and learn to feel good about themselves, even without losing a pound. The program reports a 70 percent success rate, maintained for at least six months.
Rosen insists that ``too much emphasis has been given to weight loss alone as the cure for self-image problems,'' adding, ``These problems cannot necessarily be eliminated by eliminating pounds.''
In his eight-week program, he helps people restructure the messages they give themselves. Among the steps he teaches are these:
Do not bad-mouth your body: Instead of negative thoughts like ``I'm such a pig,'' practice more forgiving, nonjudgmental self-descriptions like ``Gee, don't I look healthy!''
Learn to take a compliment: Other people are likely to be more objective and positive about your appearance; listen to what they say.
Take in your whole being: Study yourself in a full-length mirror until you can calmly look at the whole picture, not just your perceived flaws.
Put appearance in its place: You are far more than a body. Give more ``air time'' to your other attributes: your intelligence, your social self, your ability to work.
Develop more positive image behaviors: Stop checking your reflection or your weight at every opportunity or hiding your body behind baggy clothes. Dress smartly, experiment with hair styles and makeup and learn to act self-confident.
``Gradually,'' Rosen said, ``we teach them to stop hiding their bodies - to wear more revealing clothing, including shorts and bathing suits, to stop undressing in the dark, to exercise in public - by desensitizing them to the negative reactions they have to their bodies.''
LENGTH: Medium: 91 linesby CNB