Unfortunately, this battle is all too common among teen girls. It’s the war of eating disorders. Girls, it can kill you!

Because the Brio staff receives so many heartbreaking letters from our Sisses who are struggling with this, we’ve been wracking our brains trying to figure out how to help. We could give you a bunch of statistics. Or preach at you. Or try to scare you.

But we care about you too much. We decided instead, to visit Remuda Ranch — one of the top treatment centers for eating disorders in North America. We chose Remuda because several of their teen patients are Brio girls.

Nestled outside the desert in Wickenburg, Ariz., this Christian organization was founded by Mr. and Mrs. Ward Keller when they realized their own teen daughter was battling an eating disorder.

Marty McCormack, Brio’s assistant editor, and I visited the section of Remuda that housed and treated only teen girls. I spoke in their chapel, and a few of the girls agreed to talk openly with us concerning the battle they’re fighting.

Because Remuda wants to protect the girls’ privacy, we’re not allowed to show you any photos of who we talked with — nor can we use their last names. But to give you an insider’s view of what the food battle is all about, the girls said you could eavesdrop on our conversation.

Why would they do this? Because they care about you. We Brio Sisses are one big family. Please girls, listen carefully.

Brio: What are some of the reasons teen girls develop eating disorders?
Caroline: For me, it’s something I can control. I’m 16 years old, and I feel like everything else in my life is being controlled by others. I have a twin sister, and she had an eating disorder when we were in fifth grade. I felt like second-best. I also have to admit that this has been something to get attention as well as control.

Mindy: My eating disorder started because I’d always been known as the perfect little girl who’d never do anything wrong — someone who had no problems. My family was the “perfect family.” So this was kind of my way of going, “Ha, Ha! I’m not perfect. Look at me! If you think I’m perfect, just look — I’m not!” It was major rebellion on my part.

Shayla: When I was in the third grade, kids called me “fat girl” and teased me relentlessly. So I started feeling ashamed of my body. I’d go home and stand in front of my mirror, telling myself that I wasn’t good enough.

My brother and I went through a chunky stage at the same time. But when he entered high school, and got involved in sports, he lost weight and got a lot of recognition for it. Since no one was complimenting me on anything, the feeling that I wasn’t good enough was multiplied.

I started dieting, lost the weight and finally got the recognition I wanted. I was about 13 years old then, and that’s when I slipped into the anorexia part. At this point the doctors were telling me I had to do this and that to gain weight, so I still felt as though I wasn’t good enough. So then I slipped into compulsive eating, started getting teased again and became bulimic. I’m 16 now and just want to be well.

Megan: For me, it was perfectionism — trying to be the perfect little girl. I’ve always been known as the bouncy, friendly girl of the high school, and I felt like I had to live up not only to my expectations and my high standards, but I’m such a people-pleaser that I’d do anything to make people happy.

I felt like I had to have the perfect body to go along with the perfect personality. I’d never show people how I really felt. Even if I was having the worst day, I’d put on that friendly, “I’m okay” mask.

You kind of lose your identity when you have an eating disorder, because when you start getting into recovery, you start seeing how you really are. You become yourself again. When you’re in the eating disorder, it becomes your identity. It becomes who you are. That’s why it’s hard to give it up when you’ve had it for so long.

Mindy: Yeah. When I’m back at home, I’m known as “Mindy, the anorexic.” That’s my identity.

Megan: Whenever I get home, I’m afraid that I’ll be seen as “the anorexic coming home,” and I don’t want to be treated like that, because things are better now. Life is better now.

How do others react to you, knowing you have an eating disorder?
Olivia: We receive so many “get well” cards in the mail. You know, stuff that says, “Get better soon.” It’s not like we’re ill. Sometimes they’ll say, “It’s so sad when people come down with illnesses. It’s a good thing yours is curable.” But it’s much deeper than that.

Mindy: And it really makes you feel a lot of guilt. It’s like there are so many people with horrible, untreatable diseases. Then here we are with eating disorders — and it is curable — but it’s not that easy. It really is deeper than that.

Caroline: Yeah. I get letters from friends who say, “I can’t wait till you get back and we can go out and eat all three meals.”

Mindy: This is my second term at Remuda. When I went home last time, everyone expected me to be all healed and just be the old Mindy. You know what the first thing we did was? Right when I got home, my whole family went out to eat. It was so scary! They expect it to be all gone, and it’s not. I’ll be fighting this the rest of my life. It’s something I have to learn to deal with — but I can definitely fight it.

What’s the best way a teen friend can really help?
Shayla: I think the most important thing friends need to realize is that eating disorders are generally not all about food. It’s usually an emotional problem. Somewhere along the line we’ve thought we’ve been rejected or hurt, and we think it was our fault. So we want to make ourselves better and perfect.

With society the way it is — and even with our peers at school — we tend to think that the perfect body will make us accepted, which means we won’t have to feel the hurt. So we fight the food. It may look physical, but it’s actually an emotional problem.

Caroline: Friends need to realize that it’s not, “Let’s go get something to eat, and that’ll make it all better.” Even if we do start eating, we still have the whole emotional thing to deal with.

Instead of a friend approaching me with, “Hey, let’s go get a chocolate shake!” it would help so much more for that friend to simply come up and hug me.

Mindy: Last time when I got home, people were assuming I was all better and they’d say, “Okay, Mindy! Let’s go out and eat!” Sure. I’d go eat with them, but as soon as we ate, I’d just go to the bathroom and throw up.

They thought since I was eating, everything was okay. But I was still hurting so bad inside, and nobody was asking about the hurt. No one really cared about my emotional side, because my physical side appeared to be okay.

Friends who truly listen, and friends who are just there, are really helpful. But I’d want to smack the people who’d come up to me saying, “You’ve got to get some meat on your bones now!”

Olivia: I think the most important thing a friend can do to help is to simply spend time with us — letting us know they care. We need to know that we don’t have to live up to certain expectations. Comments like, “Your hair looks nice,” is encouraging and helpful. Not, “Your hair looks nice today.” That makes me wonder what it looked like yesterday!

Megan: A lot of us tend to judge ourselves on our looks and our body, and you know what? We’re really cheating ourselves. I’m learning that what’s on my insides is so much more important than what my outside looks like.

But society focuses so much on looks. It’s everywhere. Instead of being complimented on what we’re wearing or what we look like, it would be so much easier on us if friends would compliment us on a characteristic. For instance, instead of commenting on our jeans, hair or shoes, why not mention friendly, caring or sensitive? That’s what’s really important.

Mindy: Another thing that helps is just having friends who stick with you. I’ve had an eating disorder for three years, and I’ve lost so many friends. I barely have any friends at home anymore.

Caroline: Yeah. It’s easy to become isolated. When you lose your friends because you’re not doing anything fun with them anymore, you kind of just want to sit at home.

Mindy: All you do is lie around the house thinking about what you’re going to eat next or what you’re not going to eat and how you’re going to burn the calories.

Megan: Even when I was with my friends, mentally I wasn’t there. I wouldn’t really be interacting with the group. I’d be thinking, What am I going to order for dinner now that I’m here with 10 girls? Or if we were all at a slumber party and they’re eating pizza, I’d just be sitting there worrying over what I could eat and not be noticeable.

Mindy: It’s like you’re sitting in a room and there’s a window that’s separating you from everybody else. You can see them and touch them, but there’s this imaginary wall. You can’t level with them because you’re not there. It’s like you’re just watching everybody else.

For so long I felt like I was invisible. You’re there watching everyone else, and you can’t live.

What are some signals that a friend is in danger?
Megan: Withdrawal. Even all my friends would say, “Megan, you’re just not Megan anymore.”

Caroline: Even my sister started telling me I wasn’t the same. You act different. Your whole personality changes. You’re not as fun as you used to be. You’re also not as talkative or interactive with others.

Mindy: Another warning sign is going to the bathroom right after eating. Chances are, we’re throwing up what we just ate. Denial is also a sign. Saying, “I’ve already eaten” is a huge cop out.

We’re also very manipulative. Don’t assume simply because we’re eating and not going to the bathroom immediately afterward that everything’s okay. I’d be eating with my parents and stuff the food under the table at a restaurant or drop it on the floor.

Olivia: Another sign that your friend may have an eating disorder is her bra size will drop.

Shayla: And another thing to watch for is mood swings.

Mindy: Malnutrition really affects your brain. You become very tired and irritable. It’s hard to even concentrate. At school, I’d just sit in my desk and stare at the teacher, trying so hard to understand, but I just couldn’t do it. I finally had to quit going to school because it was pointless. I couldn’t sit still for an hour and a half. I couldn’t do my work. I couldn’t even think. It was horrible!

Talk about the danger of eating disorders.
Shayla: Eating disorders can be slow suicide or instant death. With anorexics, they can have heart failure when they get to a low enough weight. With bulimics, they can rupture their esophagus when they’re purging. That can be instant death.

Mindy: It’s not only dangerous, it’s really selfish. I have a lot of guilt, because for the past three years my brother’s been denied so many things he’s wanted because half of our money has been devoted to “Mindy in treatment,” “Mindy in counseling” and “Mindy’s hospital bills.”

Right before I went to my first treatment center, he yelled, “Why do you have to be so selfish? Mindy, you’re taking all these things that we need just because you’re stubborn!”

It really hurt. I’m not a selfish person, but what he said made sense.

I was hospitalized for calcium [deficiency], because I had almost hit rock bottom from purging. I was hooked up to IVs, and the doctors told my parents that I could die. My brother called and said he had gone to the bookstore and picked out a poem to read at my eulogy.

That scared me — but the funny thing is, when you’re in an eating disorder so thick, you don’t realize how serious or dangerous or selfish it is. It’s easy to rationalize and convince yourself that it’s no big deal.

Is counseling always necessary to survive an eating disorder?
Olivia, Megan, Caroline, Shayla, Mindy: YES! Definitely!

Olivia: But you have to be at the point where you want to get well.

Again, these are not professionals talking. These are real girls — your age. Your Brio Sisses. Because eating disorders are so complex, we decided to use a portion of Brio magazine for three consecutive months (November, December and January) to continue our discussion with these girls. So meet us right here next month, and we’ll go a little farther, okay?

Read Part Two

Eating Disorders: The Shocking Truth!
• A female who diets before age 14 is eight times more likely to develop an eating disorder than a female who does not.
• Sixty percent of ballerinas and other athletes whose fields require leanness practice disordered eating and dieting.
• Any sport or career that requires thinness or weight control is a setup for disordered eating.
• One of 10 people with an eating disorder is male.
• The average woman today is 5 feet 4 inches tall and weighs 142 pounds. The average model is 5 feet 10 inches tall and weighs 112 pounds.
• One percent of teenage girls and 5 percent of college-age women become anorexic or bulimic.

What Is Anorexia?
The diagnostic criteria for anorexia nervosa are: • Intense fear of gaining weight or becoming fat, even though underweight.
• Dissatisfaction with one’s body weight, size or shape. For example, a person claims to “feel fat” even when emaciated or believes that one area of the body is “too fat” even when tremendously underweight.
• In females, absence of at least three consecutive menstrual cycles when otherwise expected to occur.< P>

What Is Bulimia?
The diagnostic criteria for bulimia nervosa are: • Recurrent episodes of binge eating (rapid consumption of a large amount of food in a limited period of time).< br> • A feeling of lack of control over eating behavior during the eating binges.
• Regular self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise in order to prevent weight gain.
• An average of two binge episodes a week for at least three months.
• Persistent obsession with body shape and weight.

Symptoms of Eating Disorders
1. Preoccupation with food, weight, calories and body image.
2. Constantly thinking about “feeling fat.”
3. Bingeing.
4. Purging.
5. Skipping meals, eating alone and making unusual food choices.
6. Laxative, emetic and/or diuretic abuse.
7. Compulsive exercising.
8. Withdrawal from family or friends.
9. Self-esteem determined by weight.
10. Frequent weigh-ins.
11. Constant eating beyond normal appetite.
12. Denial and defensive behavior about changes in weight, appearance or eating habits.
13. Rapid weight loss.
14. Eliminating meat from the diet.
15. Changes in menstrual cycle.
16. Low body temperature.
17. Malnutrition.
18. Dehydration.
19. Electrolyte imbalances.

Side Effects of Anorexia and Bulimia
1. Damage to the heart.
2. Changes in or loss of menstrual cycle.
3. Erosion of the teeth and gums.
4. Kidney problems.
5. Intestinal ulcers.
6. Constipation.
7. Deteriorating hair and nail quality.
8. Insomnia.
9. Skin rash or dry skin.
10. Memory loss, slowness of thought.
11. Moodiness.
12. Depression.
13. Indecisiveness, lack of concentration.

Questions To Ask Yourself or a Friend
1. Are you frightened at the thought of eating situations where you will have to eat a normal meal?
2. Do you have food rituals such as eating food in rigid sequence, keeping foods from touching each other, eating a very limited variety of foods,
cutting food into small pieces, and blotting food with napkins to remove fat?
3. Do you feel good or bad according to how much you eat, how much you weigh or how much exercise you get?
4. Does weighing too much make you keep to yourself and feel lonely?
5. Do you spend most of your time thinking about how much food you have eaten or will be eating during the day?
6. Do you use laxatives, vomiting, diet pills, excessive exercise or water pills to help you lose weight or feel in control of your weight?
7. Would you eat more than others if you didn’t control yourself?
8. Do you sometimes feel out of control when eating and frequently eat beyond the point of fullness?
9. Are you frequently depressed because you feel overweight?
10. Do you diet or fast (for other than biblical purposes) weekly or monthly?
11. Do you feel that if you could lose weight you could achieve all your other goals?
12. Do you restrict your eating or overeat when you are stressed and feel unhappy?
13. Do you weigh yourself several times a day?

Issues That May Cause an Eating Disorder
• Low self-esteem, inadequacy, anxiety.
• Definition of self in terms of appearance.
• Actually being overweight.
• Helplessness and need for control.
• Difficulty in managing emotions.
• Social anxiety and lack of social skills.
• Fear of growing up.
• Dysfunctional home life.
• Lack of love or acceptance.

Hotlines:
Remuda Ranch Programs for Anorexia and Bulimia
1 E. Apache
Wickenburg, AZ 85390
(800) 445-1900
http://www.remuda-ranch.com

Eating Disorders Awareness and Prevention (EDAP)
603 Stewart St., Suite 803
Seattle, WA 98101
(206) 382-3587
http://members.aol.com/edapinc

National Association of Anorexia Nervosa and Associated Disorders
P.O. Box 7
Highland Park, IL 60035
(847) 831-3438
http://members.aol.com/anad20/index.html

Read Part Two