February is nearly here, and by now your New Year’s resolutions have begun to lose their first bloom. Those diligent promises to yourself about working out more, eating less and giving up junk food altogether — have they begun to seem just a little … extreme?
It’s just too cold and dark to jog on winter mornings, right? And, besides, can’t a healthy life include an occasional stop for fast food without alerting the diet police?
When it comes to diet and exercise, backsliding is normal, and carrying a few extra pounds at this time of year is standard. But it’s not universal. Some people are psychologically unable to stop dieting, even as their already slender frames become dangerously emaciated. Other dangerously overweight people are never able to begin.
Then there are the normal-sized but neurotic, like the perfectly ordinary-sized woman who eyes her wardrobe fearfully while dressing for work, wondering if she can still fit into her pencil skirt after having dessert the night before.
Scientists tell us that over half of American adults are overweight, and it sometimes seems as if all of us are obsessed with food and body images.
Eating should be so simple and pleasurable. Instead it’s become a minefield of negative attitudes and self-destructive behavior.
For some unfortunates, it becomes an agonizing, never-ending war between temptation and self-denial, where the battlefield is the human body itself and the only victor is despair or even, sometimes, death.
And that’s where the rapidly growing Emily Program comes in. Founded in 1993 by psychologist Dirk Miller, the program is named for his sister, a woman who successfully recovered from an eating disorder 15 years ago. The Emily Program runs four metro-area clinics, each offering a full menu of treatment options for eating disorders that range from anorexia nervosa to binge eating.
In September, the Emily Program purchased the building at 2265 Como Ave. with plans to convert it to the organization’s headquarters. They hope to complete the remodeling process later this month and relocate administrators and about 25 therapists and other clinical workers to the site. The formal opening is scheduled for March.
Lindsay Brown, director of business development, said the new location meshes well with the program’s goal of offering treatment in a “warm, noninstitutional setting where clients will like to come for treatment and where they will feel safe.”
But first there’s something she wants to make clear.
“We are not a weight loss program in any way,” cautioned Brown.
Instead, the goal of the program is to restore to clients “a healthy relationship with food and their bodies,” said Dr. Jillian Croll, director for education, research and program development. They do that with a variety of treatment options, from nutritional counseling to yoga to psychiatric and therapeutic services.
There are programs tailored to anorexic teenagers, but Croll pointed out that eating disorders are hardly confined to stereotypical overachieving, affluent, young white girls with control problems.
“We have those patients, of course,” she said, “but there are also 45-year-old men, ethnic minorities and people on public assistance.”
Nor can you spot clients by their skeletal appearance.
“With a lot of our clients,” said Croll, “you don’t just look at them and say to yourself, ‘You have a problem.’ They may look normal in weight, but maybe they’re exercising three or four hours a day.”
Croll said that 1 in 10 women have some sort of eating disorder but that only about 10 percent of affected women ever receive treatment. When it comes to eating problems, women out number men 9 to 1.
Perhaps the gender imbalance is a reflection of society’s obsession with the youthfully slender female form, but Croll said that the news for men is not good either. Eating disorders among men are rising, as is a willingness to accept a painfully thin ideal of beauty.
“Fifteen years ago when I would do presentations at colleges about anorexia, the young men thought that the images I showed of extra-thin women were gross,” she said. “Now they don’t. There is a really strong societal prejudice against women of normal weight, not just overweight.”
Combating eating disorders presents a variety of challenges. For starters, eating — like breathing — is one of those fundamental activities that keep us alive. Alcoholics at least have the possibility of total abstinence. “But you can’t just stop eating,” said Croll, to cure an eating disorder.
Sometimes an eating dis-order is exacerbated by personal qualities that are admirable — even sought after — in other contexts.
“Perfectionism is a good trait in a tax accountant,” said Croll, “but not so good in your relationship to food and exercise.”
Then there’s a problem that adolescent anorexics in particular must face. Thanks to our society’s sometimes warped notions of feminine beauty, said Croll, “the girls feel that they are coping well. They fulfill society’s ideals, they’re thin, they’re wearing size 00. They don’t want to be here.”
In psychological terms, she said, anorexia is an “egosyntonic” disorder, meaning that “it’s internalized and synonymous with a person’s belief system. It’s part of who they are.” And that can make anorexia especially difficult to treat.
Fortunately, even the most unwilling patient can be helped. When asked by the therapist what her treatment goals are, a girl may respond, “I want to get my parents off my back.”
That gives Croll the kind of opening she’s looking for. “I ask, ‘Well, how can you get to that result?’”
Even the most resistant young patient knows that the answer to that one involves eating.
Programs like Emily do not come cheap. Intensive outpatient programs that meet daily can run as high as $1200 a week. Fortunately, insurance often picks up much of the tab.
Eating disorders are tough problems but they’re not intractable. Croll said that up to 75 percent of their clients recover. Which is not to say that all (or any) of them achieve the weightless elegance of fashionably “ideal” bodies. Instead, they gain something simpler but much more important.
“We define success as being able to eat according to the body’s needs,” said Croll. “It’s joyful movement, positive coping skills and the ability to maintain healthy relationships with others.”