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Companion Guide for A Season in Hell

QUESTION 10: HOW PREVALENT ARE EATING DISORDERS?

These days it is common to read about "an epidemic of eating disorders among the nation's high school and college students." However, this characterization is simply not supported by the data. If one selected at random 200 females past the age of 13, the chances are that 1 would have anorexia and 3-6 would have bulimia nervosa. Another 5 would probably have eating problems which do not meet all the criteria listed earlier.

These data, based on a review of various surveys, suggest that at any given time approximately 3-5% of postpubertal females have an eating disorder or borderline variant. This is an alarming situation, but it does not warrant the label "epidemic." This characterization fosters an atmosphere of voyeuristic hysteria which may encourage a morbid fascination with the disorder, a tendency to imitate some of its features (e.g., bingeing and purging), and a ready-made identify as "anorexic" or "bulimic" for certain people seeking notoriety. The focus of teachers, students, and the public must be on the hard work involved in the prevention and alleviation of suffering, not on participation in "an epidemic."

Other facts relevant to the discussion of prevalence are:

(1) Females with eating disorders outnumber males by a ratio of 9:1. Nevertheless, it should be noted that males can develop eating disorders, and when they do, the clinical picture is very similar to that of females.

(2) White, adolescent females from the upper socioeconomic classes are at the greatest risk for eating disorders.

(3) The prevalence of eating disorders is higher in groups which stress the combination of slenderness (low body fat), competition , perfectionism, and fanatical self-discipline. Examples are dancers, models, gymnasts, distance runners, swimmers, and wrestlers.

(4) It appears that the prevalence of eating disorders has increased since the 1960's. However, eating disorders are not a "modern phenomenon. Adolescent girls and young women who starve themselves for various reasons have attracted the attention of doctors and social commentators for hundreds of years.