Eating disorders are very serious. Anorexia and bulimia primarily affect people starting in their teens and twenties, but studies report both disorders in children as young as six and in individuals as old as seventy-six. In my practice as a psychologist, I have met with girls who have started their eating disorder at age nine and have worked with women who still struggle with binging and purging going into their sixties.

An Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED) report shows that more than half of teenage girls are on, or think they should be on, diets. Without treatment, up to 20 percent of people with serious eating disorders die. With treatment, that number falls to 2–3 percent.

I remember being amazed at hearing my daughter and her friends picking apart their bodies while only in the first grade. Self image, body image, and the need to be perfect or the fear of our imperfection starts very young. It starts in our disordered thinking, just as it did for Eve when the serpent tempted her that shecould be perfect like God. We all are like Eve.

In my work with girls and women of all ages who struggle with all forms of eating disorders, I am hopeful, as eating disorders don’t have to be lifelong. Sadly, not all end well, and my heart is grieved for those I have known or heard about who have died from these disorders. No one can abuse her body for long and expect to not suffer adverse consequences.  

Eating disorders have often been called the “good girl” disorder, because they often affect respectable girls who are pleasing and cooperative, who are not acting out with defiant behavior. Instead they are really acting-in against themselves, and for all of their outward pleasantries, they are inwardly self-loathing and filled with emotion.

Girls often get into eating disorder behaviors out of curiosity, or when fears about themselves or growing up are triggered. They see how others have gotten thin or hear about purging tactics. Initial triggers might be about their bodies, looks, perfection, fear of not being good enough, being teased by peers, or a life that generally feels out of control.

Stacy writes about teasing between girls who already are self-conscience about their bodies and appearance.

Girls are definitely in an awkward stage when they’re teenagers, and now body image is key. Trying to look good, girls may be experimenting with makeup and don’t fully understand how to apply it. They may put on the wrong shade (which makes them look orange) or too much (which makes it look really thick). As a result, they get teased or called names.

Teenagers are always growing and will lose and gain weight at different times and rates.  Some girls tend to have bigger breasts—and the guys give more attention to those girls. Then other girls will be mean and make up rumors about the girls with larger breasts being “sluts,” because they don’t get the same attention as the bigger-breasted girls. All girls are awkward about their bodies at this age. And girls will make mean stuff up about other girls to make themselves feel better. All of us girls do all we can to avoid being the target of such ridicule, even if it means hurting ourselves.

Those who struggle with anorexia sometimes want to keep their bodies looking like little girls’ bodies, so they create rigidity in their lives to maintain control. Restrictive eating and behavior gives them a feeling of mastery or success. Or they think that if they can survive on little and have few needs, they can reach a life of perfect self-control. If they achieve this, they believe they can keep bad things from happening to them.

Anorexia tends to be hard to keep secret over time. Some girls who start with anorexia flip into bulimia, using a combination of binging, restricting, fasting, and purging behaviors. Bulimia also can destroy a female’s body with the inconsistent and extreme binge-purge cycle.  I’ve heard girls and women say things like, “I used to have to stick my finger or my toothbrush down my throat, but now as soon as I lean over the toilet it just comes up,” or “Food is always there like a best friend. I eat even in the middle of the night. But then I feel sick and hate myself for eating and have to get it out. The vomiting makes me dizzy and it’s painful, but I know I have to do it to get relief. Afterward, I am wrung out, and I hate myself even more.”