Women Hold The Key How violence in India would decrease with women in power
Long Distance Marriage Economy problems increase the number of commuter marriages
One Small Step An intimate interview with Karen Nyman, the 50th woman in space
Are You Eating? Researchers see increase in eating disorders in women ages 30-60
What's in this issue Eating Disorders on the rise for women ages 30-60 Are you at risk? Read about women who have been affected by disorders and take the quiz to see if you should be concerned. By Jenny Deam Page 55
Why Does This Shirt Cost More To Clean Than That One? How women get charged more than men for everything from laundry to health insurace — and how you can do to stop it. By Joy Condie Page 25
"Shadow Americans" Go Public With Their Status As more of the nation's 11.5 million undocumented workers go public with their status, their stories will change the citizenship debate. By Marian Conan Page 28
The Syrian Cyberwar The U.S. isn't arming the rebels, but it is sending Internet technology. Can searing video docs help dethrone Assad? By Hariet Jones Page 49
Cover Credits// Art Director MaryAnn Moore Photographer James Carmichael Lighting & Props Bob Jones
Women Hold The Key How violence in India would decrease with women in power
Long Distance Marriage Economy problems increase the number of commuter marriages
One Small Step An intimate interview with Karen Nyman, the 50th woman in space
Are You Eating? Researchers see increase in eating disorders in women ages 30-60
DEPARTMENTS India Needs Feminine Political Influence A country torn by gender discrimination and crimes such as rape, child marriage and female foeticid — India is in desperate need of female leaders. By Karly Granada Page 17
Long Distance Marriage Many couples must resort to living apart in order to make ends meet during a rough economy. By Nicole C. Brambila Page 37
One Giant Leap For (Wo)Mankind Karen Nyburg becomes the 50th woman in space, achieving her child hood dreams of space travel. By Richard L. Knight Page 47
CULTURE Fiona Apple's New Album An interview with Fiona — what influenced this album, her life, and what's next. By Charly Thomas Page 69
New Culinary Seal Of Approval A new restaurant certification aims to ensure fine dining is haute — and healthy. By James Dashner Page 59
Room On The Road For Everyone? The perils of pedaling againts urban "bikelash." Can bicyclists and motorists share the road peacefully? By Maria Ambrose Page 66
Women who paved the way
An indepth look at the state of women's rights and the women who got us there By Paige Charlston Page 69
In Charge
Geeta Zurini
Violence Increase in India More women in political positions could be key to stopping violence By Karly Granada Giving women more voice in India's political arena will help end rampant gender discrimination and crimes such as rape, child marriage and female foeticide in the largely patriarchal country, the head of UN Women said. Some of the most powerful figures in India's political history are women, such as former Prime Minister Indira Gandhi and her daughter-in-law, Sonia Gandhi, who heads the ruling Congress-led coalition
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government and there are over one million female politicians represented in village councils. Yet the country's women continue to face a plethora of threats - from female foeticide, child marriage, dowry and honour killings to discrimination in health and education and crimes such as rape, domestic violence and human trafficking. "Facts are facts. There are challenges we know that India has and we have been speaking to authorities about
that," Michele Bachelet, former Chilean president and now head of UN Women, told TrustLaw late on Friday at the end of a three-day visit to India. "But I truly believe that political participation is a means to empower women to confront all kinds of challenges that they face. When women are not powerful enough and their voices are not heard, they are not prioritised." According to poll conducted by the Thomson Reuters
In Charge
Foundation in June, women in India are discriminated against, abused and even killed on a scale unparalleled in the top 19 economies of the world. Based on parameters such as quality of health services, threat of physical and sexual violence and access to property and land rights, the poll of around 400 experts found Canada to be the best place to be a woman amongst G20 nations, excluding the European Union economic grouping. Empowerment ends abuse Bachelet - who was in India to speak at various conferences on women in politics and meet female leaders - said while more women are entering village councils thanks to a law reserving a third of seats for women, they need support to make governance decisions and are still often influenced by men. She said UN Women was supporting schemes to help
women campaign in elections, share their problems and challenges in making decisions through a new virtual knowledge hub, and by providing training in budgeting and governance — all of which would help them tackle wider issues. Gender equality in politics will result in the empowerment of women, she said, adding that increased political voice at the top will have a trickle-down effect, helping women to not only fight abuse and injustice, but also change male mindsets which have for years kept them subservient. "When you see women playing an important role, you not only change the mindset of girls who see that there is another possible future, but you also change the mindset of men," she said. Many of the crimes against women are in India's heavily
populated northern plains, where, in parts, there is a deep-rooted mindset that women are inferior and must be restricted to being homemakers and childbearers. In addition, age-old customs such as payment of hefty dowries at the time of marriage and beliefs linking female sexual behaviour to family honour have made girls seem a burden. As a result of such views, 12 million girls have been illegally aborted over the last three decades, according to a 2011 study by The Lancet. One bride is murdered every hour over dowry demands, says the National Crime Records Bureau, while over 20,000 rapes were recorded last year. Bachelet said she had discussed the issue of violence against women during her meetings with President Pranab Mukherjee as well as with Sonia Gandhi.
"I have spoken everywhere I have been about how much progress has happened here in India, but also about how much needs to be done. The UN will continue to raise our voice to ensure that women's rights are really secure," she said. "But our job is not only advocacy, it is also to promote concrete initiatives that can deal with the issue. We need to speak loud and will continue to speak loud, but we also need to ensure that we walk the talk."
Child Marriage Rates Statistics provided by UNICEF
47% 18% Gethin Chamberlain
of girls are married by age 18
of girls are married by age 15
October 2012 ¡ Page 18
Bank It
Santiago Alvarez
Long Distance Marriage A struggling economy makes work hard to find, many couples move apart to make ends meet By Nicole C. Brambila David and Candice Knox have been married for 13 years and spend about half the year together with a few weeks together followed by a few working apart. Now married 13 years, the couple jokes they had to go through customs just to date. Little did they know four years ago when the economy tanked and Candice Knox got
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a job offer in Palm Desert, that the anniversary luggage he gave her years ago would come in handy. Candice Knox lives in Rancho Mirage and works as a sales director with Cambria. David Knox lives in Minnesota, where he owns a real estate training business. More than 1,900 miles and two time zones typically separate the couple.
"People think that we're weird," David Knox said. "When you're married, you're supposed to live together." They're not alone. A growing number of married couples are living apart. It's called the commuter marriage, and more than 3.5 million couples in the United States are doing it. That number has more than doubled since
Bank It 1990, when the U.S. Census Bureau estimated that 1.7 million married couples were living apart for reasons other than a legal separation. The commuter marriage isn't really that new. Traveling salesmen, migrant workers, the incarcerated and soldiers on deployment have always been in long-distance relationships. In the past two decades, a relaxing of social norms around marriage and the prevalence of online dating, which allows singles to cast a wider net, have likely contributed to the increasing number of couples who choose to live apart, sociologists say. But the biggest factor is probably economic, with the rise in dual-income households and the worst recession in postwar era U.S. history. A recent study found nearly three in five couples who live apart do so because of work or financial reasons. "We know it's growing, partly since the economy took a dive," said Karla Bergen, a communication professor at College of Saint Mary. She has studied long-distance relationships. "People are just happy to have a job wherever." Take Arlene and Mike Van Parys, who live in Desert Hot Springs. But in 2001, the job market meant the Van Parys lived in different cities -- she in Oak View, he in Cathedral City. For two years, the couple saw each other every other weekend. "It's like the best of both worlds, I think," said Arlene Van Parys, 46. "We got to spend our time together and then also apart. You appreciate the other person more when they come back." About 3.1 percent of married couples live apart, according to the Census Bureau. Information on couples who live apart is limited. Research about these couples in the U.S. is still emerging. Those who are likely to live in dual residences frequently live in urban areas, are better-educated and tend to be younger, a 2009 UCLA study found. The AARP estimates the number of married couples 50+ years who live apart tripled between
2001 and 2005. "The older you are when you do a long-distance relationship, the less it seems to matter because you're not changing as much," said Laura Stafford, University of Kentucky professor and author of "Maintaining Long-Distance and Cross-Residential Relationships." The commuter marriage does challenge the social norm that says being a couple means sharing an address. And while living separately once meant the relationship was on the rocks, studies show these couples are no more likely to split than those who live in the same ZIP code and under the same roof. Today's technology is partly the reason. Unlimited cellphone minutes and video chats via FaceTime or Skype mean being apart doesn't have to feel so isolating and lonely. "It can keep you together while you're apart," Stafford said. "It keeps you connected." But even the best technology is a poor substitute for being together. Linda Young is a Texas psychologist that does relationship coaching, has lived apart from her husband for several years. She recommends that couples: Resist the urge to shelve unpleasant feelings out of fear of ruining the time together. Keep in touch in old-fashioned ways like writing notes and letters. Get creative, like watching the same movie so you can talk about it. Living apart is not all chocolate and flowers and I-miss-yous. Having separate homes often means lonely weekends and having to show up solo at get-togethers with friends and family. And that can wear on a relationship over time. "We've always said at the point that this affects the marriage, someone has to say, 'Uncle,'" Candice Knox said. "If it's not going to work, then something's got to give."
"People think that we're weird," David Knox said. "When you're married, you're supposed to live together. It just freaks them out."
47% of couples work ouside of their town
18%
of couples live in different cities
11% of couples live in different states
Couples affected by distance Statistics provided by UNICEF
October 2012 路 Page 38
Study Up
Photo Courtesy of Nasa
Reaching Beyond the Stars Karen Nyberg becomes 50th woman in space By Richard L. Knight Karen Nyberg, ’94, is proof that childhood dreams do come true. She recently became the 50th woman in space. It was a goal she kept at her fingertips for years, knowing one day she would make it happen. The May launch of the space Shuttle Discovery carrying UND alumna Karen Nyberg was thrilling, patriotic, emotional, and a proud moment for all privileged to attend. My wife, Becky, and I were honored to be invited to the launch with then president Charles Kupchella and his
October 2012 · Page 47
wife, Adele, and representatives from the UND School of Engineering and Mines. We were fortunate to spend the day before and the day of the launch with Karen’s family and close friends. The Kennedy Space Center is the sixth most visited tourist site in Florida, a testimony to the interest many have in the unknown space represents. Admittedly, I was surprised at the overwhelming feeling of accomplishment and pride the Center itself generates, with its IMAX theatre, shuttle simulator,
historical exhibits, and various displays. The contributions our explorations into space have made on everyday life are remarkable. May 30 was the prelaunch, and the families of the six astronauts and interlopers like the O’Keefes and Kupchellas were treated to a special tour of the Space Center. Karen and fellow astronauts had been in quarantined in preparation for the flight. As such, they stayed about 20 feet on the other side of a roped-in area where their families and
Study Up friends saw them for the last time before they returned on June 14. That evening Karen treated her invited guests to a prelaunch party that was great fun — though the guest of honor was still in quarantine and couldn’t attend. It was an opportunity to visit with the Nyberg family and many of Karen’s friends who are also UND graduates. Her parents, Ken and Phyllis, were surrounded by her siblings and family from all over the country, terrific people who proved they know how to have a bit of Midwest fun, Florida style! Saturday, May 31, was launch day. As Karen’s family and friends gathered for the bus ride to our viewing site about three miles from the launch pad, you could feel the anticipation in the air. It was a beautiful, warm
and humid Florida day, and as we arrived about three hours before the launch, I was determined to withstand the heat and stay outside to take in as much of the activities as possible. Each family had an astronaut assigned to their group, and during the countdown they talked us through all the technical chatter between the shuttle crew and the Space Center. Five minutes before the launch, a Space Center employee sang the Star Spangled Banner, perhaps one of the most meaningful and stirring renditions I’ve heard or felt. Anyone who has experienced a launch will tell you words cannot do it justice. It was an incredible life experience and Becky and I will always be grateful Karen invited us.
Karen’s crew performed their flight flawlessly, in what has been described as one of the most perfect flights in the shuttle history. Karen operated the three robotic arms involved in various stages of her mission, joining a very small sorority of astronauts who jokingly call themselves the “Robo-chics.” As Dr. Kupchella said to me after the launch, “We’ve always told our students to reach for the stars, and now one is literally among them!” -----Karen Nyberg, ’94, can do a lot of things. Some of them are typical – like playing with her dogs, Sydney and Charlie. Others are a bit more unique – like running nine marathons. But, what sets Nyberg apart from almost everyone she meets is her all-impressive career. As of May 31, she became the 50th woman in space.
Nyberg realized her calling when she was in elementary school. Most of the girls in her class wanted to be nurses or teachers. Not Karen; she had her sights set on a dream she and others called “far-fetched” up until about a year ago when she found out she was picked for her first spaceflight aboard the space Shuttle Discovery. “It’s one of those things I kept in the back of my mind, like this is what I want to do. I’m just going to keep pushing toward it,” Karen said from her office at the Johnson Space Center. Our phone conversation took place in early July, less than one month since
Nyberg and the rest of the crew landed safely back on Earth following a 14-day NASA mission. Blasted into space at speeds of up to 17,500 miles per hour, the team’s goal was to deliver the Japanese Pressurized Module to the International Space Station. Nyberg was tasked with operating all three robotic arms that were on the Station at the time – the shuttle robotic arm, the Space Station robotic arm and the new Japanese robotic arm. “It was just so fun, it seemed natural to me,” Nyberg casually commented of the experience. “I would say it was as good as or better,” she added.
She had her sights set on a dream she and others called “far-fetched.”
Photo Courtesy of Nasa October 2012 · Page 48
Fun Facts
All About Lemons Lemon is said to be a "flavor catalyst," meaning that it interacts with the taste buds so that the flavors that follow are more pronounced.
After salt and pepper, lemon may be the most commonly used flavoring ingredient in the culinary arts.
The average lemon contains three tablespoons of juice. To get the maximum amount of juice, roll a room-temperaturelemon on the counter before cutting it open.
Cooking with lemons Used in everything from baking to sauce making to meat and vegetable cookery, lemons bring their own tangy flavor and bright aroma, while actually enhancing a dish's other flavors.
Storage
Lemons are highly acidic, and this acid will react with different foods in different ways. For example, the acid will help dissolve connective tissues in meat, which is why lemon juice is commonly used in marinades — it helps tenderize tougher cuts of meat. But be careful not to overdo it: too much acid, or marinating
for too long, can have the opposite effect, causing the muscle fibers to get tougher. The acid in lemon juice can also curdle milk, and while it can cause green vegetables to turn a drab olive color, it will help vegetables such as potatoes and turnips maintain their white color.
Lemons will keep for several days at room temperature, and interestingly, a room temperature lemon will yield more juice than one that is cold. However, lemons left at room temperature for too long are susceptible to mold. The best way to store lemons is in the refrigerator, either in one of the crisper drawers or in a plastic bag. Applying light pressure with your hand as you roll it. This bursts the tiny juice-filled cells, extracting more juice
While the fruits themselves do not do well when frozen, the lemon peel can be removed and frozen, then used later in recipes that call for lemon zest.
Lemon Varieties Eureka & Lisbon The most common lemon variety is the Eureka lemon. Its slightly smaller, smoother cousin, called the Lisbon, is more likely to be available in the winter. Flavorwise, there's not much difference between them.
Meyer Another variety, called the Meyer lemon, is quite small and significantly sweeter than the ordinary lemon varieties.
What the zest? Zest is the shiny, yellow outermost layer of the peel, which contains powerful flavor compounds. The white part of the peel just beneath the zest is quite bitter and shouldn't be used.
Try Something New Lemon Brownies
Ingredients The Brownies
3/4 cup all-purpose flour 3/4 cup granulated sugar 1/4 teaspoon salt 1/2 cup unsalted butter, softened 2 large eggs 2 tablespoons lemon zest 2 tablespoons lemon juice
The Glaze
1 rounded cup powdered sugar 4 tablespoon lemon juice 8 teaspoons lemon zest
Directions Preheat oven to 350째F. Spray an 8-by-8-inch baking dish with cooking spray and set aside. Zest and juice two large lemons; set aside. In the bowl of an electric mixture fitted with the paddle attachment, beat the flour, sugar, salt, and softened butter until combined. In a separate bowl, whisk together the eggs, lemon zest, and lemon juice until combined. Pour into the flour mixture and beat at medium speed until smooth and creamy, about 2 minutes. Pour into baking dish and bake for 23-25 minutes, or until just starting to turn golden around the edges and a toothpick inserted into the center of the brownies comes out clean. Allow to cool completely before glazing. When brownies are cooled completely, make the glaze...sift the powdered sugar, add lemon zest and juice, and whisk together all three ingredients. Spread 1/2 the glaze over the brownies with a rubber spatula. Let glaze set. Spread the remaining glaze over the bars, and let it set. This glaze does not harden like most. Cut into bars, and serve!
Are You Eating? Adult eating disorders on the rise
More grown women are suffering from anorexia, bulimia, and other dangerous eating behaviors By Jenny Deam Usually she just had a cup or two of plain pasta. Sometimes, as a treat, a diet soda. But whatever she ate or drank, Susan* kept it to around 500 calories a day. A year passed, and anytime she tried to eat more, her stomach would clench until she vomited. Her skin turned blotchy, her eyes became sunken, her hair started falling out. Yet, she felt numb. Susan had overcome a turbulent upbringing, married a great guy, and set up house in a small, idyllic Pacific Northwest town. Life was good...until two years ago, when her out-of-control, alcoholic father ended up in the hospital. Once again, his crises cast a dark shadow on her life, and Susan's old emotional demons returned. Her insides twisted every time the phone rang—would it be the doctor? the police?—and little by little, the constant drama of dealing with her dad squelched her normally healthy appetite. By June 2011, the 5'4" Susan had lost over 40 pounds and weighed in at less than 100. She found excuses not to join her family at the dinner table, focusing instead on privately planning out every morsel that went into her mouth. Her husband grew frantic until, finally, Susan went to a doctor, who was at a loss. He ruled out a series of gastrointestinal conditions, then said, "And you're too old for anorexia." Susan was 43.
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Eating disorders leaped into the national conscience in the 1970s and '80s, when the number of diagnosed cases exploded. The patients were adolescent girls, many of whom became anorexic or bulimic as a means of controlling their bodies— and, by extension, their lives—as they made their way through puberty. So many girls fell victim that eating disorders were branded a teenage disease. (And experts continue to see a troubling number of cases among teen girls, says Ovidio Bermudez, M.D., board member of the National Eating Disorders Association.) Yet lately doctors have noticed a disturbing spike among a different group: women in their late twenties, thirties, and forties. At the Renfrew Center's 11 treatment locations, the number of patients over age 35 has skyrocketed 42 percent in the past decade. Likewise, a couple of years ago at the Eating Recovery Center in Denver, an estimated 10 percent of patients were over age 25; today, a whopping 46 percent are over 30. And when it opened in 2003, the University of North Carolina's Eating Disorders Program was designed for adolescents—now half of its patients are over 30 years old. Just like their younger counterparts, adult eating disorders deliver a mind-body punch that kills more people than any other mental illness. Patients of all
ages can suffer impaired brain function, infertility, dental decay, or even kidney failure or cardiac arrest. But while the teen and adult diseases share physical symptoms, and both can be tied to deep psychological roots, their catalysts are quite different, says psychotherapist Jessica LeRoy, of the Center for the Psychology of Women in Los Angeles. "As women get older and their lives evolve, so do their stressors and triggers," she says. These can nudge the door open for an eating disorder. But research on the adult-onset versions is lacking—and without sufficient tools and awareness, women like Susan are being misdiagnosed. When her physician failed to pinpoint a cause, Susan and her husband sought several more opinions about her ever-shrinking size. The other doctors also ignored the possibility of an eating disorder, though one did suggest she seek psychiatric care. Susan went back home, where she lived in fear and confusion, her health rapidly deteriorating. Finally, a friend whose teenage daughter was anorexic recognized her symptoms and urged the family to consult an eating disorder specialist. After two years of starving herself, Susan checked into a clinic, where she needed to be hooked up to a feeding tube to survive. For decades, the eating disorder lexicon had two main entries: anorexia and bulimia. But modern research reveals that these fall woefully short of encompassing the many facets of disordered eating. In the early '90s, the American Psychiatric Association introduced a new diagnostic category: eating disorders not otherwise specified (EDNOS). A catch-all label that includes dozens of subdiagnoses, EDNOS applies to patients who don't meet the exact criteria for anorexia or bulimia but still have very troubled relationships with food or distorted body images. Today, EDNOS diagnoses significantly outnumber anorexia and bulimia cases. "The atypical has become the typical," says Ovidio Bermudez, M.D. On any given day, nearly 40 percent of American women are on a diet. The weight-worry gun is loaded early: By the time they reach age 10, 80 percent of girls fret that they're fat. Their main "thinspiration," according to experts: the ultra-slim starlets glorified in popular culture. It seems unlikely, though, that women who make it into adulthood with healthy eating habits would suddenly become swayed by such images. "Grown women used to be allowed to have curves," says LeRoy. "As they got older, their bodies were supposed to change, especially after having kids." But times have changed. The
Photo Courtesy of Nasa
3 out of 10 Women ages 30-60 are affected by eating disorders Statistics provided by UNICEF
October 2012 · Page 95
emergence of the MILF meme has spawned a novel form of pressure for an older age-group. And though LeRoy point outs that appearing svelte post-pregnancy isn't a bad thing, "the problem is when mothers try to turn back the clock and look like they're 18 by starving themselves." Of course, celeb scapegoats are not the only cultural influence at play. Ironically, a growing national impetus on super-healthy living might be fueling some adult eating disorders, says Emmett Bishop, M.D., director of adult services at the Eating Recovery Center in Denver. While the message itself (smart food choices, reduced portion sizes, ample exercise) is justified—and necessary in fighting America's obesity epidemic—"some women who are prone to eating disorders might take that message and run too far with it," says Bishop, using it to validate food restriction or as an excuse not to eat at all. Particularly at risk are women with extreme personalities (i.e., those who lean toward all-or-nothing behavior), says eating disorder nutritionist Sondra Kronberg, R.D., director of the Eating Disorder Treatment Collaborative in New York. "When a woman like this hears that red meat has a higher fat content, she might really hear 'All meat is bad and loaded with fat; I can't eat it,' " she explains. And cutting out entire food groups can snowball into a full-fledged disorder. Contributing to these catalysts is the growing fervor over food sensitivities and allergies, says Kronberg. What starts out as necessary restriction—say, nixing wheat due to a gluten allergy—could ignite larger restrictive-eating behavior, leading to a seriously dialed-down diet that excludes critical nutrients. But experts also note that adult eating disorders aren't all driven by the need to look young or eat extra healthfully. Restriction or purging can also be outward manifestations of much deeper emotional turmoil, says Cheryl Kerrigan, a recovered adult anorexic and author of Telling ED No! "For some women, it's not about the food," she says. "It's about the feelings." Katy was 26 the first time she stuck a finger down her throat. A Detroit native, she'd grown up happy and with healthy eating habits. But as she climbed the proverbial ladder at her public relations firm, her stress level also rose (frustratingly, her salary stayed on the bottom rung). One day, after dinner with her husband, Katy slipped into the bathroom. "It was like I had pressure inside me that I needed to release," she says. "Afterward, I felt much better." She flushed the toilet and went downstairs to watch TV. Before long, Katy was purging up to eight times a day. At work, she'd vomit, wash up, and return to her desk without anyone noticing. "I was like a closet smoker," she says. Unlike many bulimia patients, Katy wasn't trying to erase calories or shed dress sizes; she rarely ever binged and throughout her sickness she remained a size 14. Rather, she came to feel that throwing up was evidence that she ran her own life. The desire for control is common among adult eating disorder patients, says Kronberg. Women are loaded with more responsibilities,
such as paying the mortgage or caring for aging parents. They're also navigating big life transitions—career changes, marriage, pregnancies, divorce—that can leave even a steady person feeling off-kilter. "As early as age 30, many women hit a point at which they feel there are certain things they should have accomplished," says Kronberg. "They evaluate their lives, and if they see a void, they look for something that will make them feel good." In essence, a perceived lack of success can morph into a feeling of failure and become an eating disorder catalyst. But emerging research shows that yet another factor could turn an innocent desire for self-improvement into an unstoppable compulsion. If two women with the same background have similar careers and diets, why might just one develop an eating disorder? Scientists now believe that some people carry an inherited vulnerability and that the illness can run in families. The developing picture is complex: One specific gene does not spawn the disease. Inherited eating issues are likely due to a combination of genetic factors, ones that may skip a generation, lie dormant for decades, or never become active at all, says Sari Shepphird, Ph.D., author of 100 Questions and Answers About Anorexia Nervosa. What experts do know is that "something has to come in from the outside to turn the eating disorder on," says psychologist and genetic researcher Craig Johnson, Ph.D., former president of the National Eating Disorders Association. Dieting and exercise are often the initial switches. Whenever any woman does either, she's actually changing her brain's neurochemistry. (For most people, this is necessary to create new healthy habits.) To wit, studies show that women with anorexia or bulimia have abnormal levels of several neurotransmitters, chemicals that affect anxiety and appetite. It's possible that something deep in their DNA was triggered to mess with the stuff. Currently, there's no genetic test for an eating disorder, but just because your mom or sister struggles with food doesn't mean you're doomed to follow suit. Instead, women with a family history should be cautious about throwing themselves into hard-core diets or workout regimens, especially if they also have anorexia-related behavioral traits such as perfectionism or anxiety, or bulimia-related traits like impulsivity and restlessness. The encouraging news is that adult women with lateonset eating disorders often have an easier time healing than adolescents do. About 50 percent of patients will
Unlike many bulimia patients, Katy wasn't trying to erase calories or shed dress sizes; she rarely ever binged and throughout her sickness she remained a size 14. Rather, she came to feel that throwing up was evidence that she ran her own life.
October 2012 · Page 97
Photo Courtesy of Nasa October 2012 路 Page 96
fully recover, says Shepphird, likely because many women over 30 have the maturity needed to recognize that they need help. Most seek treatment because they want to get better—as opposed to teens, who are usually pushed into therapy by their parents or doctors, says Johnson. (Take Katy's case: She knew that purging was dangerous. After tearfully confessing to her husband, she entered counseling.) In the past, however, older women have felt out of place in treatment programs geared toward teenagers, says Laurie Glass, a recovered adult anorexic and the author of Journey to Freedom from Eating Disorders. Glass fell ill in 2003 when she was 32 but resisted entering a recovery center because of her age. "The guilt and the shame were overwhelming. I thought, I'm an adult, I should know better," she says. Instead, she sought out a dietitian for counseling. Of course, had she become sick in 2012, Glass would
treatment centers have seen a significant increase in the number of patients over age 30.” One prominent treatment center, the Renfrew Center (with 11 locations across the country), reported in 2005 that as many as 20 percent of their adult eating disorder patients said they were age 30 or older when they first encountered symptoms. Why the upsurge in adult anorexia? It’s simple, says Dr. Shepphird: an increasing and intense social pressure to be thin. “The pressure on adult women to equate thinness with attractiveness has increased in recent years, now resulting in 80 percent—four out of five—women reporting dissatisfaction with their appearance,” she says. “More women today feel like they are not ‘successful’ as women unless they are thin, which leads to increased eating disordered behavior.” Looking back on the road that led Lackey to anorexia, she says she “developed a strong fear of gaining any of the weight back.” And, in a vicious cycle, she began using food restriction as a way of controlling those fears and anxieties as well as job-related stress. By November 2007, she had her eating down to a shockingly strict regimen: a cup of yogurt for breakfast, two slices of deli turkey for lunch and one-third cup of rice for dinner. In January 2008, Lackey dropped below 100 pounds. In the end, after a few frightening emergency room visits for heart problems, it was a photo taken by a friend that helped her see that she, indeed, had a problem. “There was a picture of me that showed me stripped to the bone—my arms, my skull, my neck—there was no body fat anywhere. I was shocked and asked my husband, “Is that what I look like?” For the first time, I felt frightened for my life and agreed to get help. In the end, it took several visits to treatment centers and meetings with eating disorder specialists before she began gaining weight again and beginning her recovery. “I am working on being comfortable with change, which feels threatening to a lot of people with anorexia and other eating disorders,” says Lackey, who is now in recovery. While societal pressures continue to be a factor contributing to eating disorders in women, Dr. Shepphird offers up another possible culprit: Stress. “We know that anorexia is also often precipitated by, or triggered by, an emotional life event or period of significant stress,” she says. “Significant stress, when coupled with inadequate coping resources, can combine with other risk factors to increase a person’s vulnerability to illness.” Common stressful life events that are known to trigger anorexia, and other eating disorders in some women, include divorce, childbirth, widowhood and menopause. “Additionally, eating disorder experts believe that chronic dieting may pose a particular risk for anorexia and other eating disorders in women as they age,” she adds. Blake Hill, a resident of Marina del Ray, California, was 19 years old when his mother, then in her 40s, began struggling with severe anorexia. “My mom was a beautiful person inside and out,” he says. But he watched as his 5'10" mom succumbed to anorexia. In the years that followed, she shrunk to a mere 71 pounds. The disease, he says, caused a lot of grief for his family and complicated his relationship with his mom. “Anorexia nervosa is an illness that can devastate the whole family,” says Dr. Shepphird. “The mood and personality changes that result from anorexiarelated starvation can wreak havoc on close personal relationships and family ties.”
“There was a picture of me that showed me stripped to the bone— my arms, my skull, my neck—there was no body fat anywhere. I was shocked and asked my husband, “Is that what I look like?” For the first time, I felt frightened for my life and agreed to get help." likely have found plenty of patients her age at eating disorder treatment centers all around the country. As the larger medical community slowly becomes aware t hat eating issues don't disappear with adolescence, grown women have a better chance of being properly diagnosed. Still, says Johnson, if you suspect you have a problem, seek out an eating disorder specialist. That's what Susan wishes she had done, back when she couldn't bring herself to eat. Now in intensive treatment, she's learning that the best way to shrink her anxieties is to deal with her emotions and rebuild a strong, healthy body. For the majority of her life, 44-year-old Angela Lackey, a writer from Midland, Michigan, says she rarely fussed about her weight or worried about eating. She had a normal body image and, at 125 pounds, was healthy and fit. But shortly after being diagnosed with a thyroid illness that contributed to a sudden weight loss, she says friends began to notice her thinning figure. “Many people had complimented me on how ‘tiny’ and ‘good’ I looked,” she says. She didn’t know it then, but those comments would fuel unhealthy eating behaviors that would lead to full-fledged anorexia in a downward spiral that nearly cost Lackey her life. While anorexia can hit at all ages, most people assume that it’s an adolescent disorder. “The most common cases of anorexia in women are among those who had some eating disorder symptoms when they were teens,” says Sari Shepphird, PhD, a clinical psychologist and eating disorders specialist in Los Angeles and author of 100 Questions & Answers About Anorexia Nervosa. “But the most current scientific literature suggests a vulnerability to developing eating disorders throughout the lifespan. Recent studies, in fact, indicate that older patients are being seen in increasing numbers and eating disorders
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How do you know if you need help? Take this quiz to figure out if you need to talk to someone about your eating habits. In her book, 100 Questions & Answers About Anorexia Nervosa, Dr. Shepphird offers a list of key questions. “If you answer ‘yes’ to any of these questions, regardless of whether you fit the diagnostic criteria for an eating disorder, your attitudes and behaviors about food and weight may need to be addressed,” she says.
Do you... Use laxatives or diuretics to keep your weight down? Berate yourself if you eat a “forbidden” food and compensate by skipping your next meal? Vomit after eating? Label foods as “good” and “bad”?
Obsess that your stomach, hips, thighs or buttocks are too big? Feel that the number on your scale determines your mood for the day? Punish yourself with more exercise or restrictions if you don’t like the number on the scale?
Exercise more than an hour Weigh yourself several every day to burn calories? times daily? Count calories whenever you eat or drink?
Constantly think about your food, weight or body image?
Still feel fat when others tell you that you are thin? Have difficulty concentrating because of Worry about what your last those thoughts? meal is doing to your body? Exercise to lose weight, even if you are ill or Severely limit your food injured? intake?
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