When pop singer Karen Carpenter died in 1983 from heart failure at age 32, not much was known about the eating disorder that caused her early demise: anorexia nervosa. Today, Malibu resident and licensed marriage and family therapist Erica Ives has released a new book on her study specialty, “Eating Disorders: Decode the Controlled Chaos.”
“I used the word ‘controlled’ in the title for a reason,” Ives said of her book. “People with eating disorders are exercising control over their lives in a certain weird way. They might feel that ‘Hey, this is something I am good at. Controlling my caloric intake is the one thing I am exceptional at.’ But it creates chaos in their lives.”
Unfortunately, long-term effects of this kind of disorder can be serious. People with bulimia (characterized by binge eating and then purging through vomiting and/or laxatives) can suffer potassium loss, severe dental problems and depression. People with anorexia can suffer from osteopenia (precursor to osteoporosis), vital mineral loss, organ failure and death. An estimated 10 million women and one million men suffer eating disorders nationally.
Ives said that many of the medical complications from eating disorders can be reversed, if therapy starts early enough.
Ives, who suffered from an eating disorder herself for years, said that such disorders can start as young as five and are frequently accompanied by anxiety and depression; but that the question is, which came first?
Secrecy usually surrounds someone with an eating disorder. They hide purging or hide food. They will binge in private and avoid eating in public. Food as nutrition takes last place to food as metaphor, Ives said.
“Someone who restricts their caloric intake might be expressing belief that they don’t deserve love, so they ‘disappear,’” Ives said. “Or purging might be a metaphor for discarding themselves as a burden to others. The psychological roots are deep.”
So Ives usually begins her therapy with a new patient with a “team approach”—pediatrician, labs, a psychiatrist if necessary. She said that parents will bring their children to her with a request, basically, to “fix them,” without taking into consideration the import of family dynamics. Some parents will withdraw if she recommends family therapy.
Unfortunately, Ives said, the public school system is little equipped to deal with the problem, which she believes is pervasive in upper-income communities.
“Schools’ budgets are being cut all the time, reducing counseling staff and nutrition programs,” Ives said. “This is a shame because schools are the best venue to address this issue. Eating disorders are very isolating for those suffering from it. By the time I get a patient in her 40s, it’s very hard to reach her because her relationship with food has defined who she is for a very long time.”
Dr. Juliette Boewe is staff psychologist at Malibu High School. She said that she doesn’t see that MHS has a significant problem with eating disorders.
“We’re really no different from other typical campuses,” Boewe said. “Every high school will have some problem there, but we’re not different because of our zip code. Our kids are people just like anyone else.”
Luke Sferra, high school counselor at MHS, said that eating disorders are discussed as part of the 9th grade health curriculum.
“Our teens are subject to the same pressures as any teens,” he said. “Students that are identified as struggling with an eating disorder are referred to outside therapeutic experts.”
Malibu-area mental health experts believe eating disorders are a bigger problem, though. Dr. Bruce Lockwood practices general psychiatry and said he believes the issue is troublesome in Malibu. Carolyn Costin is a family therapist and national expert on eating disorders. She said that in the current social media-driven universe of teens, the pressure to “brand” oneself is intense.
“I don’t know if Malibu High has a ‘greater’ problem, but it is big and growing,” Costin said. “There is so much pressure on kids to look ‘right’ or get into the ‘right’ school. For every girl diagnosed with anorexia, I’m sure there are 100 others unhappy with their bodies on a barely sub-clinical level.”
Ives said that parents are the first bulwark against a child falling into an eating disorder. Sudden dramatic weight loss should result in immediate medical assessment, but behavior that raises flags would include food and caloric obsession, over-emphasis on exercising, ritualistic behavior like cutting food into tiny pieces, or even bloodshot eyes after visiting the bathroom (which could indicate efforts to vomit).
“Let a professional assess any problem you think your child might have,” Ives said. “Eating disorders can be treated effectively and the result is improved health, improved relationships with others and, most importantly, improved self esteem...You are so much more than your body!”