Dying to Be Thin

Nov. 16, 2006 — -- The documentary "Thin" by Lauren Greenfield, which debuted Tuesday on HBO, only shows an uncomfortable slice of treatment for eating disorders, and is not a true picture of anorexia nervosa, or of any eating disorder.

The film also does not illustrate that treatment is possible and is available.

"Thin" shows us only a narrow snapshot of eating disorders. Anorexia nervosa and bulimia nervosa exist on a spectrum of severity. The film looks at patients with more serious cases. An eating disorder isn't always easy to recognize by someone's skeletal frame.

By focusing on these difficult cases, "Thin" creates the feeling that treatment for eating disorders is futile and that there is little hope for recovery. But there is real science behind treatment for eating disorders, and people with eating disorders can and do get better.

Patients and families who are seeking help for eating disorders have the right to know that the treatment program they are entering is a solid one.

So in real life, off the documentary screen, how can we understand what it's like to have an eating disorder?

Some studies suggest that more than one in 10 women suffer from some form of an eating disorder. But it's not a strictly females-only disease. Men also suffer from these disorders, and it appears that they are now becoming more common in men and boys.

Anorexia nervosa has the highest mortality rate of any psychiatric disorder. That means, more patients die from anorexia than from depression, or schizophrenia, or any other mental disorder.

People with anorexia have low body weight and are afraid of gaining weight.

They often can't see their bodies the way other people do, and they don't think their eating disorder is a big deal, even though their entire self-esteem rests upon their body weight.

Many anorexic women stop having their periods.

Cynthia M. Bulik, Ph.D., is the director of the UNC Eating Disorders Program at the University of North Carolina at Chapel Hill; a professor of eating disorders in the department of psychiatry at the UNC School of Medicine; and a professor of nutrition at the UNC School of Public Health.