On July 8th, 2009 The Oregonian ran an article about eating disorders featuring a large, glamorous photo of a “recovered patient”: a beautiful young woman in a slim dark dress and long blondish hair leaning against a leather couch in a well-appointed home.

Were her parents proud of her? You bet! Should they have been? Absolutely!

Is it a good idea for her and for their readers for the newspaper to have run this huge photo and for the article to explicitly state weight she had lost and that she now “wants to get a nursing degree and counsel others with similar problems?”

No. It’s not a good idea. In fact, it’s a terrible one. A bad idea for her and a bad idea for young patients with anorexia nervosa or other eating disorders who picked up the paper that day.

Let’s start with those who picked up the paper that day. They read how the young woman featured was sent to a residential treatment center and saw the ?frighteningly skinny’ women around her and thought she was in the wrong place. And then how one of the girls came up to her and said “you’re one of the skinniest girls I’ve seen.” Her response: “that’s when I thought ?Oh my gosh, I belong here’.

What’s the message? All people with serious eating disorders are terribly skinny? This is patently false. Consider those with bulimia nervosa or those with severe anorexia nervosa but who have been weight restored. Not to mention the wildly inaccurate and delusional perception of people with anorexia nervosa who think that everyone is skinnier than they are.

Not only was this article unreflective but it was silent about the real symptoms of anorexia nervosa and made no mention of what Dr. Ken Nunn, professor of neuropsychiatry in Newcastle, Australia, reports as “like the delusions and hallucinations of a person trapped in the completely dominating world of psychosis, the world of anorexia nervosa is a prison tightly bound by walls of distress at every turn.”

Psychosis… delusions… suffering… bad teeth, bad breath, weak bones… this is the real world of anorexia nervosa, a world that makes the comments in Andy Dworkin’s piece such as “sufferers usually are beautiful, talented, amazing, gifted girls” seem to me trivializing and beside the point. No, in fact, they aren’t. These are normal kids: some beautiful, some not, some very smart, some average, some gifted some not; at Kartini Clinic we have treated mentally retarded children, children with autism and children with cerebral palsy who also had anorexia nervosa. Oh and they are not all girls. Boys get eating disorders, too.

This relentless glamorizing of a terrible illness does not serve the patients well.

Any experienced eating disorder doctor or therapist knows that if you mention weight loss or very low weight numbers in an article like this people with anorexia nervosa will read it and – far from being appalled – will experience envy. How helpful is that?

In the book Eating Disorders in Childhood and Adolescence Dr. Nunn goes on to say: “anorexia nervosa is not a trivial side effect of an over-indulged Western society. It is a malignant disease of children with parents trying to do more than could be expected of any parent—damned if they do and damned if they don’t” He goes on to say that the young person with AN may be unaware that the disease is destroying them and unaware of the threats the illness poses for them personally and for their family. “This inability to personally register anorexia nervosa is one of the most perplexing aspects of the illness and increasingly appears to be medically (brain based) rather than psychologically based.”

Brain based rather than psychologically based…….. yet no breath of this information (once revolutionary and new, now hard for even those who live under a professional rock to ignore) merits a mention in the Oregonian’s article. It could have been written in 1975 or even earlier, so little does it acknowledge how the science has evolved. In the 1970’s it would have then been showcased along with articles presenting autism as being caused by “refrigerator mothers” (i.e. cold-hearted) and schizophrenia as a response to the traumas and conflicts of modern life.

A (not-so-recent) article in USA Today cites but one of many studies contributing to the mounting scientific evidence of the biological origins of anorexia nervosa: “[r]esearchers studying anorexia in twins conclude that more than half a person’s risk for developing the sometimes fatal eating disorder is determined by genes. Most experts already believe there is a strong genetic component to the disorder, which mostly affects girls and women.” Dr. Cynthia Bulik, professor and clinical psychologist at the University of North Carolina, Chapel Hill, and lead author of the study puts it more bluntly: [the new study] “hammers home the fact that these are biologically based disorders. We need to stop viewing them as a choice… The patients feel guilty, the providers tell them things like they should just eat, parents are blamed, the insurance companies won’t fund treatment because they think it’s a choice. It’s held us back for decades.”

But my greatest concern of all is for the young woman who was featured in the large picture in the article. If indeed she has been healed, let her family rejoice and let her move on with her life. At the Kartini Clinic we say: no “professional” anorexics! Do not encourage these children to make anorexia their life’s crusade and continue to dominate their thoughts and their self-identification. I would much rather one of our patients go on to be an astronaut than an eating disorder doctor or nurse or therapist.

Parents are understandably proud of their child’s healing, thrilled to see it, but they must beware: over-identification with the eating disorder virtually assures that they will never leave it behind, psychologically.

This article is one of many lay pieces that capitalizes on a fascination with pictures of beautiful, thin young women. The (mistaken) aura of beauty that surrounds this severe mental illness and the (mistaken) belief that the patient chooses to have it haunts us and keeps us chained to the psychiatric myths of the previous century. We need to move on!