The Pressure To Be Thin As Supermodels Gain Fame, Society Measures All Women On Their Impossible Standard

One evening early in her modeling career, Kim Alexis was nibbling on a head of lettuce when her roommate Kelly Emberg walked in.

“You’re eating a whole head of lettuce?” Emberg scolded. “How could you?”

For Alexis, struggling to lose 15 pounds that the Elite Modeling Agency forbid, that 50-calorie head of lettuce was her only meal of the day. She broke down crying. By pursuing a high-profile modeling career, she had entered a world of nightmare diets and constant hunger, ultimately becoming so deprived that she went without a menstrual period for two whole years.

This story, recounted in Kaz Cooke’s new book, “Real Gorgeous: The Truth About Body and Beauty,” gives chilling insight into the pressures for extreme thinness on American adolescent girls and women today.

When the models they see in magazines embrace dangerous eating patterns and a bizarre preoccupation with thinness, many ordinary girls and women feel forced to match this ideal.

Since the days when Alexis began modeling, the pressures have only grown more intense. By 1993, British model Kate Moss, at 5-foot-7 and 100 pounds, had made the emaciated prisoner-of-war look chic.

Adolescents and women in the Inland Northwest have not fared much better.

Dr. Jim States, a Spokane physician who specializes in adolescent and young adult medicine, has treated 1,000 teens and young adults for eating disorders since 1978.

Out of every 10 adolescent girls taking gymnastics, track or ballet in this city, he estimates three are likely to be suffering from an eating disorder. Further, he believes he’s probably treating two of them and the third is refusing help.

According to the National Institute of Mental Health, eating disorders affect more than 5 million Americans every year. Five percent of adolescent and adult women and 1 percent of men have anorexia nervosa, bulimia or binge-eating disorder. An estimated 1,000 women die each year of anorexia.

The causes of eating disorders are complex. They range from the effects of this country’s $246 billion fashion industry, to the pressure of overzealous athletic coaches, to the emotional disconnection of overworked, divorced or addicted parents.

Local experts agree, however, that an eating disorder is only a symptom. The larger problem is a damaged sense of self.

“If one has a high sense of self, the likelihood of a preoccupation with weight is lowered,” says Stacey Mainer, a Spokane therapist who specializes in eating disorders.

States believes that at critical transition times, when all teens struggle for a sense of self-identity and autonomy, kids with a weak inner core suffer most.

Whether they turn to alcohol or drugs, sink into anxiety or depression, or develop an eating disorder, many are faltering in a task he calls “self-activation.” This task requires a strong self capable of expressing the person’s authentic needs and wants.

This passage echoes the “terrible twos” when children first begin establishing a separate sense of themselves. If parents don’t adequately help kids through this early stage, problems often resurface in adolescence.

Healing for some, States says, requires extensive therapy.

These kids are particularly vulnerable to the messages of the culture because they look to external sources - their parents, friends, the media - for self-definition.

Which messages are these vulnerable kids hearing?

According to the experts, dangerously unhealthy ones.

In 1968 the average fashion model was 8 percent thinner than the average American woman. Today, the average model is 23 percent thinner than the average woman.

These statistics were cited in Kathryn Zerbe’s book, “The Body Betrayed.”

In 1960, Marilyn Monroe was considered the epitome of the sexy American. The little black dress she wore in “Some Like It Hot” was a size 14.

Today, actress Andie MacDowell says, “They only want you if you have a voice like a woman, a body like a girl and a mind like a man. … If one more person asks me to lose 5 pounds, I’m going to be sick. I don’t want to go through it anymore, and I don’t want my daughter to go through it, either.”

The motivation for remaining thin doesn’t come solely from the fashion and entertainment industries. Today’s kids may glimpse a grown-up world of violence, drug use and AIDS, and run scared.

“Kids are saying to me, ‘I don’t want to grow up,”’ says States. “This is epidemic since 1978.”

Some anorexic kids are from fairly healthy, loving families. They enter seventh grade and discover their ninth-grade peers are drinking, using drugs and having sex.

They begin to diet simply to stay childlike and safe.

“Why would anyone want to go out into this non-safe world?” States says. “I’ve seen anorexia happen with kids 9, 10, 11 years old.”

Others come from families where the parents have been absent through overwork, addiction or divorce. They may have parents who are rigid and perfectionist.

They may live in families that believe that being agreeable and avoiding conflict leads to friendships and tranquility.

“That myth means the individual suppresses the true self and develops a false self,” States says. “As we develop a false self, it makes it hard to esteem ourselves.”

Still other kids are seemingly doing well, earning A’s and competing at the top of various sports. But as they progress, so does pressure from their coaches.

Dr. Wendy Repovich, director of Eastern Washington University’s Exercise Science Program, gives lectures on a phenomenon called “the female athlete triad.” It’s made up of disordered eating, amenorrhea (the absence of menstrual periods) and osteoporosis.

Studies of driven young female athletes - long-distance runners, gymnasts, dancers and figure skaters, for example - have shown that by the age of 18, 19 or 20, many of them have the bone densities of 70-year-old women.

Their disordered eating has stopped their periods and shut down estrogen production, feigning menopause and leaching calcium from their bones. They wind up, like post-menopausal women, with osteoporosis.

They experience recurring fractures, often in the spine, that never heal. The outer bone structure remains strong, but the inner core has been weakened by the loss of calcium that ordinarily serves to cement the fibrous material together.

“It’s like a brick wall,” says Repovich. “You start taking out brick after brick, and the structure just crumbles.”

Twenty-year-olds wind up with dowager’s humps and disabling fractures.

Other medical implications of food restriction are the shrinkage of the brain and other organs, stress on the heart, a slow-down in digestion and elimination, a drop in body temperature, and, in the most critical cases, starvation and death.

States often teams with Spokane dietitian Vivienne Dutzar and therapists Stacey Mainer and Rick Graff to coordinate a patient’s treatment. Success hinges on more than simply changing the person’s eating patterns.

Though complex, the work is often gratifying.

“When their self starts to emerge,” says Dutzar, “it’s like watching flowers blossom.”

, DataTimes ILLUSTRATION: Staff illustration by A. Heitner

MEMO: Two sidebars appeared with the story: 1. WARNING SIGNS OF EATING DISORDERS Anorexia nervosa Large weight loss, with no medical illness. Refusal to gain weight. Denying being hungry and eating only small amounts of low-calorie food. Expressing anxiety about being fat, even as more and more weight is lost. Skipping school-lunch periods and avoiding other situations where people are eating. Talking about food, collecting recipes, and/or cooking for others but rarely eating. Being highly active, including excessive exercising; may withdraw from friends to immerse herself in highly physical activities like dance. Developing strange rituals at meals (for example, a piece of lettuce must be cut into five pieces, of which four can be eaten and one must be left on the right-hand side of the plate.) Rigidly and compulsively insisting on certain routines; becoming very upset over unexpected changes in routine. Often cold; dressing in layers of clothing that seem inappropriate during warm weather.

Bulimia Evidence of binge-eating, such as appearing to eat huge amounts of high-calorie food without gaining weight. Evidence of self-induced vomiting. Vomiting at school. Often leaving the table right after a meal and going directly to the bathroom. Bathroom messes or smells of vomit. Buying drugs that induce vomiting. Glands under the jaw are swollen, giving a “chipmunk” appearance. Unusual and expensive dental bills. Owning lots of laxatives and/ or diuretics. Unexplainable paleness and complaints of dizziness. Unexplainable muscle cramps, heart or kidney problems that are unusual for teenagers.

Source: National Anorexic Aid Society of Harding Hospital Jamie Tobias Neely

2. INFORMATION ABOUT DISORDERS AVAILABLE For more information on women and eating disorders, check out the following resources:

Books “Surviving An Eating Disorder: Strategies for Family and Friends” by Michele Siegel, Judith Brisman and Margot Weinsheil ($12.50, HarperPerennial). “Reviving Ophelia: Saving the Selves of Adolescent Girls” by Mary Pipher ($12.50, Ballantine Books). “Real Gorgeous: The Truth About Body & Beauty” by Kaz Cooke ($16.99, Norton).

Sources Dr. Jim States, physician who specializes in adolescent and young adult medicine, 327-7203. Vivienne Dutzar, registered dietitian who specializes in eating disorders, 455-3220. Stacey Mainer and Rick Graff, therapists in private practice who treat people with eating disorders, 838-5244. Wendy Repovich, director of the Eastern Washington University Exercise Science Program, provides lectures and slides on eating disorders and female athletes, 359-7960. Jamie Tobias Neely

The following fields overflowed: CREDIT = Jamie Tobias Neeley Staff writer