Health
Web sites support eating disorders

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By Katherine Nichols
Advertiser Staff Writer

Some who are afflicted with bulimia or anorexia are proud of it. Now they and fellow enthusiasts have their own Web presence. Illustration by Jon Orque • The Honolulu Advertiser Where to get help Eating Disorder Clinic at Kapiolani Counseling Center: 983-8368 Kristen Lindsey-Dudley, nutritional therapist: 983-8420 Kahi Mohala: 671-8511 Anorexia and Bulimia Center of Hawaii: 262-7922 Ai Pono: 540-1001

Are the new Web sites a real issue or predominantly buzz?

"Both," said Kelly Vitousek, a University of Hawai'i associate professor of psychology who has been researching eating disorders for 20 years. "Vulnerable kids are getting the message. But the message is all around them in any case. It's more alarming as a marker as far as what the widespread attitudes are."

Kristen Lindsey-Dudley, a nutrition therapist who assists eating-disorder patients in the counseling center at Kapiolani Medical Center for Women and Children, agreed that these types of Web sites can sometimes "give desperate kids ideas."

In some cases, ideas turn to action. And with this kind of influence, those actions become easier to justify. Denying the presence of a problem is a typical feature in the early stages of the disease. "Perhaps the most worrisome aspect of these Web sites is that ... (eating-disorder victims) get a little added support for that stance," Vitousek said. In what experts call the honeymoon phase, people "are often quite exhilarated about their ability to control their eating and their weight," she added. "The adverse side effects have not kicked in yet. It's hard to get through to people in the early stages that this is a really serious problem."

According to Vitousek, many people with anorexia are pleased to have the label associated with them. The Web sites can be especially damaging in making the person feel like a member of some sort of elite club.

Can any benefit be derived from these disturbing sites? Vitousek thinks the personal information may help some clinicians who deal with people launching into an eating disorder "to understand the way patients see the problem early on." Obsessive behavior and self-flagellation are on full display in nearly every posting.

"The self-loathing and despair are absolutely genuine, and the essence of what makes them vulnerable," Vitousek said. "Most of them view the attempt at control and weight as the solution, not the expression of those problems." Instead, they think, 'this is the one area of my life I have got together' — an intoxicating high within the context of the abject misery in the rest of their lives.

After all, the whole world tries unsuccessfully to control eating and weight, and they can do it. If a little is good, more is better, and the extremity becomes a supreme achievement in the disordered eater's eyes.

The Web sites contain much truth, said Vitousek. But some is the result of a defensive stance, of the mentality that others are jealous of their "control." Vitousek noted that when they let down their guard, they admit that all is not well. Disordered eaters know their lives are slipping out of control and that "they are not calling all of the shots."

After the honeymoon period of roughly 6-12 months, said Vitousek, severe psychological and biological consequences set in. Depression is almost inevitable and universal.

So what can parents do to solve and prevent this problem? Lindsey-Dudley said that as a society, we've "lost that connection with food and normal eating." She requires her patients to eat four meals a week with their parents. Often, teenagers are so rarely around their parents, it's impossible for adults to know if a problem exists.

Parents can also help by not talking about their own weight issues within hearing distance of their children. "It has a large influence," said Lindsey-Dudley. "... (Kids) absorb the pressure. In general, this society needs to stop talking about people's bodies like they're pieces of fish." Home is the one place that should be an escape. Parents should preach healthy eating by example. And speak about their bodies with words they hope their children will use when looking in the mirror. And seek professional help when they suspect bulimia or anorexia nervosa.

Anorexia has a death rate of up to 20 percent. However, Lindsey-Dudley indicated this is not a deterrent. "I've had patients tell me, 'I'll take the 20 percent. I'll take the risk,'" she said. "There's another emotional situation going on, but they don't know how to deal with it. That's how scary (an eating disorder) is. It makes them irrational."