She steps out of the shower, frigid.
She stands in front of the fogged up mirror, slowly lifting a frail arm to wipe away the steam. She drops her towel, grabs her stomach and turns side to side, her hands touch protruding bone after bone, as finger meets rib with unsettling ease. Hot tears well up in her eyes. Her body is a skeleton, but all she sees is fat–a noun, an adjective, an identifier that keeps her hungry for a thinness that does not exist. She leans over the sink, nauseous from her morning run and another day of restricting. But she has no choice: her master is a toxically magnetic voice promising her unending acceptance and joy that will never come. A little more, it says, just a little more. What she doesn’t know is this: that demon will stop at nothing to see her waste away.
She can’t stop, she’s sucked in.
Her disease? Anorexia nervosa.
It is one of the deadliest of psychological illnesses to date. Unsatisfied with his or her appearance, the sufferer unwittingly uses food and exercise as a way to cope with highly uncomfortable thoughts and feelings. Experiencing one’s body shape unfavorably causes an intense fear of gaining weight and fear of disapproval from others. The motivation to starve oneself is then fueled by the elusive image of a more appealing version of the self: smaller, fitter, thinner. As the body and mind become increasingly malnourished, the sufferer and his or her eating disorder seem to become one entity, manifesting itself into a voice that guides the sufferer to continue down this path of self-destruction, despite severe physical, psychological, emotional, and spiritual suffering.
And these concerns are not limited to anorexia. Other destructive eating behaviors can manifest into psychological illness. Bulimia, binge-eating disorder, orthorexia, EDNOS (eating disorder not otherwise specified) are all powerfully lethal. Right now, thirty million people in the United States suffer from an eating disorder, and every sixty-two minutes, one person dies from an eating disorder.1 If they are so common, why don’t we hear more about awareness and treatment options? According to the National Eating Disorders Association, eating disorders receive inadequate funding when compared to heavily researched diseases: Alzheimer’s affects 5.1 million people and received $450,000,000 from the NIH in 2011; eating disorders affect 30 million people and received only $28,000,000.2 If this money were to be individually allocated, every person with Alzheimer’s would receive $88, while each person with an eating disorder would receive only 93 cents. Alzheimer’s is a neurodegenerative disease in which brain function gradually declines, typically leading to memory loss and other impairments.3 While Alzheimer’s and anorexia differ greatly, both are caused by multiple factors including genetics and one’s environment. However, we are disproportionately investing our resources in research and available treatment options. Why is that? The following stigma is prevalent: that one chooses to have an eating disorder. Perhaps the classification of anorexia as a form of mental illness overshadows the grim reality of its physical manifestations. This public misconception often leads many to unsympathetically dismiss those with eating disorders as vain attention-seekers.
Aside from full-blown eating disorders, general disordered eating behaviors and body image issues prevail in modern American society. Negative self image starts at a young age and peaks during adolescence, continuing into early adulthood and throughout late adulthood as well.4 Forty-two percent of first, second and third grade girls want to be thinner; eighty-one percent of ten-year-olds are afraid of being fat; and over one half of adolescent girls and one third of adolescent boys engage in unhealthy weight control behaviors including fasting, self-induced vomiting, and taking laxatives. The value we place on our bodies predominates, making disordered eating habits increasingly popularized. Disordered eating differs from eating disorders in that there exists a spectrum of unhealthy behaviors that deviate from normal eating and exercise habits; even physically healthy individuals without full-blown eating disorders are pulled into the mentality that their bodies are never fit enough, never thin enough, never good enough.
The reality is that our bodies are now things to consciously manipulate with modern tools, in the name of good health. Through the diet industry, restrictive eating trends, exercise addiction, steroid abuse, and calorie counting applications, we track and record and obsess over nearly every aspect of our health. Eating well and exercising are indispensable habits of maintaining wellness, but there is a fine line between living a balanced lifestyle and chasing an unattainable image of health. The common thread between seemingly disparate disordered eating patterns is an insatiable, pathological need for control. And this desire for control manifests itself in everything from skipping a meal here and there to becoming severely underweight through restrictive eating and excessive exercise. Both extremes are destructive, and behaviors falling in the middle are perhaps the most common. The paramount example is going on a diet. The typical dieter thinks that if he or she finally musters enough willpower to follow this or that restrictive eating plan and “be good” around food, then he or she will achieve that dream body. However, the problem is that diets almost always disappoint: ninety-five percent of all diets fail.5 The deprivation-based mentality inherent to diets only fixates one’s energy on forbidden foods and persistent hunger, a recipe for disaster. Similarly, disordered eating habits don’t work: thirty-five percent of normal dieters progress to pathological dieting, and twenty-five percent of those develop full-blown eating disorders.
But why do diets fail? How can they be potential pathways to mental illness? While eating disorders are complex illnesses that involve many biological and environmental factors, extreme dieting can put someone already at risk for an eating disorder in even greater danger. Eating disorders take over people’s lives by creating a never-ending cycle of obsession and self-harm. As the body is deprived of essential nutrition, the metabolism slows, making it increasingly difficult to lose weight, which only causes the sufferer to restrict eating further and exercise harder. Multi-organ system failure develops as heart rate and blood pressure decrease to conserve energy, bone density is reduced, severe dehydration and electrolyte imbalances develop, and fertility is lost.6 The body essentially falls apart.
Are our bodies incapable of sustaining us? When did the modern world diverge from the more carefree eating patterns of prior generations? Prehistoric humans had none of the resources we use today to manage weight and caloric intake, yet they built the first human civilizations and perpetuated the human race. Our bodies have always taken care of us because that is what they were programmed to do: to hunt, to gather, to run, to build, to grow. We have survived through periods of famine and periods of plenty; we have reproduced, explored, and spread across the globe. Our genetic code provides our bodies with biochemical instructions for how to metabolize food, burning some for energy, and saving some for later. If our bodies were so intelligently designed to sustain life, why are we reluctant to trust them with basic eating and movement today? In the past century or so, societal ideals have shifted from favoring fuller figures (as a sign of one’s good nutrition and ultimately, one’s wealth) to idolizing the ultra-thin female and the extra strong male. Many individuals at normal body weights are now pressured to change their appearance in order to conform to our culture’s standard of attractiveness. Controlling and obsessing over food intake and exercise slows our metabolism and overrides our internal hunger and fullness cues, making trusting our bodies nearly impossible.
We were designed to nourish ourselves appropriately. Our ancestors did so without overly conscious decision-making about what to eat and when to eat. Unfortunately, there’s now a hyper-awareness that many use to manage their health, which often leads to the development of disordered eating habits. But what if we could return to a more relaxed approach? Are our ancestral eating patterns things of the past? We don’t need to look far to realize that, no, this innate skill–of balancing nutrition with movement to maintain individual health–is still very much relevant. In fact, the ability to maintain a medically appropriate fat to muscle mass ratio is one of the many regulatory functions of our brain. Serving as a crossroads for the nervous and endocrine systems, the hypothalamus maintains homeostasis. It is located below the thalamus and receives signals from various sources within the nervous system, and it sends neurohormones that stimulate or inhibit secretion of various pituitary hormones.7 Hypothalamic functions include regulation of heart rate, blood pressure, fluid balance, appetite, body weight, and sleep cycles. In terms of one’s body shape, GHIH, growth hormone-inhibiting hormone, helps determine a healthy body composition in children and in adults, and it maintains a healthy bone density, muscle mass and fat distribution. Food consumption leads to the production of satiety hormones by gastrointestinal endocrine cells. Hindbrain circuits interpret these meal-by-meal signals, while the hypothalamus uses signals from adipose (fat) cells to balance energy and body weight in the long-term.
So, how does this work? Set point weight theory suggests that everyone has an ideal body weight range that has been pre-programmed in their brains since conception.8 Essentially, we do not choose our natural weight; our bodies do. Developed by Bennett and Gurin in 1982 to explain why dieting is not successful in producing long-term change in body weight, set point theory offers the model that we each have “a kind of thermostat for body fat” that differs from person to person. The theory states that the set point keeps weight in a constant range by acting on the conscious mind to change eating and exercise behavior. If one’s weight is under the set point weight range, one is driven to expend fewer calories and consume more; if one’s weight is above the set point weight range, one’s metabolism is increased to burn more calories than those consumed. These adjustments serve to control for any deviation from the body’s ideal weight range for optimal thermoregulation, mood regulation, and nutrient availability. This exceptional homeostatic precision–unique to each individual’s biological needs–seems like strong evidence for an intentional design that has our best interests, beyond just our evolutionary interests, at heart.
Our bodies have been hardwired to maintain this fine balance through intuitively receiving nourishment. Intuitive eating is eating based on physiological hunger and satiety cues rather than situational and emotional cues.9 A study at the Ohio State University found that adoption of the intuitive eating method was predictive of an emphasis on body function and body appreciation in young women. The almost amusing fact is that our bodies know when we are hungry and when we are full, yet we strive to obsessively control what and when we eat because we fear ‘losing control’. However, intuitive eating is not out of the ordinary. Those without disordered eating behaviors, and children especially, retain this ability to regulate their food intake. They do so without the conscious manipulation described at the beginning of this discussion. An American Academy of Pediatrics study discusses the finding that children naturally respond to the energy density of a diet and despite seemingly erratic eating patterns, their twenty-four hour intake is overall relatively well regulated.10 Therefore, early parental interference in a child’s diet can negatively impact future eating habits (i.e., disrupting their natural responsiveness to internal hunger and satiety cues). Children are meant to be intuitive eaters, and so are the rest of us. Along with listening to one’s internal cues, intuitive eating involves unconditional acceptance of one’s body shape, understanding its functions and appreciating what the body does rather than focusing on what it looks like. A similar analogy belongs to the realm of religion: a temple. A temple is a place of worship, a physical location that houses the spiritual essence of the divine as well as the followers of the particular religion. While the temple is a holy and revered place, its function is to bring honor to a deity; it is not an idol to be worshiped. We can use that same thought pattern to consider our bodies: their functions are essential and admirable, but the physical shell itself does not need to be placed on a pedestal. This alternative mindset appreciates the value in each human’s original design while recognizing our inability to control how we were created. But what if there was more? What if our bodies have more value than we dare ascribe them?
According to the Judeo-Christian tradition, God created each of us uniquely in His image. The Book of Genesis describes a God who created the heavens and the Earth in six days, the last of which culminated in the creation of mankind. Every little detail of our bodies and minds were planned with brilliantly intentional purpose. In Luke Chapter 12, Verse 7, it is understood that “… the very hairs of your head are all numbered …” by God, who chose and remembers every aspect of our being.11 No one person was created the same; nearly all of us have a set of DNA entirely specific to us. Comparison is therefore futile and frankly, exhausting. When we compare our bodies to others’, we waste brain power fixating on our physical selves when we could be caring for our whole selves, not bits and pieces. God initially warned His people to have no other gods but Him.12 While idolatry takes different forms for the individual person and is highly dependent on the time period under consideration, stories of the Israelites worshipping a golden calf and Americans worshipping their appearance are both examples worth mentioning. The story is found in the Book of Exodus Chapters 32 and tells of the time when Moses went up Mount Sinai to speak with God. While they waited for their leader to return, the Israelites grew impatient and asked Aaron, the brother of Moses, to make them a god that would follow through on its promises in the timeframe that the Israelites wanted. Aaron listened and instructed them to bring him all of their gold jewelry so that he could fashion the pieces into an idol. The resulting golden calf was placed on an altar and worshipped with sacrificial offerings.13 Just as the Israelites failed to trust that God would follow through on His promise to lead them to the Promised Land, so do we often fail to trust Him with the very bodies He created. It is one thing to genuinely care about how you treat your body and another to micromanage your health, exhausting time, energy, and resources into a cause that quickly becomes a faulty god.
Our bodies have an earthly reality–they are physical, tangible entities. The Christian worldview says that our bodies are physical shells with which we are endowed to glorify God through fulfilling our purpose on Earth. According to the Bible, God wants us to treat our bodies as temples of the Holy Spirit because the ways in which we treat our bodies in this life directly impact the ways in which we fulfill our purpose on Earth. Essentially, our corporeal existence has lasting significance. For instance, 1 Corinthians 10:31 reads that “Whatever you eat or drink or whatever you do, do it all for the glory of God”.14 The kinds of foods we put into our bodies and the ways we speak to ourselves have lasting significance. Society holds our bodies to standards radically different from those described in the Bible. While culture may measure women’s bodies by the scale and men’s bodies by muscle mass, the Christian God does not measure people by any numbers. He loves everyone the exact same amount, not the tall people more than the short people, or the thin people more than the average person. If we viewed ourselves from this perspective, we would treat our bodies with the care and respect (read: not obsession and harm) that they deserve. To take care of our bodies is to allow them to become strong and healthy. It’s not a diet, a cleanse, or a seven-day slimdown. It’s a lifestyle of nourishment and movement that glorifies a God who created us with both incredible precision and unfathomable love. By treating our bodies as temples and therefore residences of the divine, we joyfully prepare them for the work that we are called to do, whatever that may be. Just as a temple is not to be worshipped itself, we are not to worship our bodies. Instead, we are to allow our bodies to be mediums of purpose and vessels with which we bring glory to God.
Accepting this model would radically change the way we think about and treat our ephemeral selves. Christians believe that God intentionally designed the human body to be well nourished and to maintain our natural weight, all with the purpose of preparing our bodies for eternity with Him. It is a holy act to take care of ourselves in a way that is reflective of the freedom found in accepting Christ as Lord and Savior. This action can be understood to mean intuitively feeding and moving our bodies and allowing them to maintain our set point weight. He created us for lives rid of destructive coping mechanisms. Synthesizing the biological and spiritual realities of our bodies would bring peace and purpose to the millions who struggle with disordered eating and negative self-image.
References
1 Eating Disorder Statistics. National Association of Anorexia Nervosa and Associated Disorders. Retrieved from http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/
2 Anorexia: Overview and Statistics. Retrieved from http://www.nationaleatingdisorders.org/anorexia-nervosa
3 Alzheimer’s & Dementia Causes, Risk Factors | Research Center. Retrieved from
4 Anorexia: Overview and Statistics.
5 Eating Disorder Statistics.
6 Anorexia: Overview and Statistics.
7 An Overview of the Hypothalamus. Retrieved from https://www.endocrineweb.com/endocrinology/overview-hypothalamus
8 Harris, R. B. (1990, December 01). Role of set-point theory in regulation of body weight. Retrieved from http://www.fasebj.org/content/4/15/3310.short
9 Avalos, L. C., & Tylka, T. L. Exploring a Model of Intuitive Eating Among College Women. PsycEXTRA Dataset. doi:10.1037/e527492007-001
10 Birch, L. L., & Fisher, J. O. (1998, March 01). Development of Eating Behaviors Among Children and Adolescents. Retrieved from http://pediatrics.aappublications.org/content/101/Supplement_2/539.short
11 Luke 12:7. NIV
12 Exodus 20:3. NIV
13 Exodus 32:1-8. NIV
14 1 Corinthians 10:31. NIV