Original article from the Bozeman Daily Chronicle February 15, 2015
Does Southwest Montana’s health-focused culture play a part in putting some of its young women — and men — at risk of debilitating mental illness?
For Paige Reddan, a dietitian with the Eating Disorder Center of Montana, the answer is yes.
While statistics specific to Montana or Bozeman aren’t available, the National Eating Disorders Association estimates that 20 million women and 10 million men nationally suffer from a clinically significant eating disorder at some point in their life. Those numbers translate into incidence rates of about 1 in 8 for women and 1 in 16 for men.
The association also points to research that found anorexia nervosa has the highest mortality rate of any psychiatric disorder, in part because of its connection to starvation, substance abuse and suicide.
“An eating disorder is a mental illness,” said Reddan, noting that the cause is typically a combination of factors including stress, social pressures and genetic susceptibility.
“There’s puzzle pieces to it that have to come together,” she said. “That part of the brain can click.”
Bozeman’s culture, she added, is a “perfect storm” for the disorder with its focus on fitness and healthy eating.
“There’s this huge focus on athleticism,” she said, pointing to the pressure that’s often placed on high school kids through sports, sometimes with the idea that athletic performance can improve their college prospects.
Obsessive exercise and an unhealthy relationship with food can become intertwined, Reddan said — for example, when someone only allows themselves to eat on days they’ve exercised.
“We see a lot of high school girls,” she said, noting the pressure they often feel to be “beautiful and thin.”
“A lot of people feel like they’re just being healthy,” said Sara Bennin, now a 23-year-old studying at MSU. “It’s really easy for a sport to turn into an obsession.”
Bennin’s own struggles with an eating disorder through parts of high school and college began innocently, she said.
Growing up in Orlando, Florida, she spent years competing in gymnastics, she said. She found an identity through the sport — but it took a mental toll.
“I was definitely not the smallest girl on the team,” she said. “They made a few comments about my body.”
When she quit the sport and its intensive workouts at 16, she began to gain weight, then started dieting. She was healthy about it at first, but eventually became more rigid.
The following year, she transferred to Park High when her family moved to Livingston. Adjusting to a small town, as well as from a strict private school to a public high school, she had a hard time making friends.
“It made it really easy to isolate myself,” she said. Instead, she ate lunch, typically an apple and a yogurt, alone in her car — and exercised. She lost tens of pounds.
Her transition to college at MSU, paired with ongoing family issues, added to the stress.
“I used my eating disorder as a way to dissociate,” she said. “I restricted like crazy in the dorms.”
She over-exercised, as well, running in her dorm’s gym for an hour in the morning before working out again at the main campus fitness center in the afternoon.
A straight-A student who had enrolled in MSU’s honors college, her grades dropped because she couldn’t concentrate.
“All you think about when you’re starving is food,” she said.
Her family, she said, responded by telling her she needed to gain weight or they’d stop paying for school.
“You just need a good steak,” her dad told her. “It will remind you how much you like food.”
She started binging.
“I felt super-out-of-control,” she said. “I was terrified of food.”
After struggling for another year, she was ultimately referred to an eating disorder center therapist by an MSU dietician, where she began a slow recovery.
There she was placed in hours of weekly therapy sessions, both individually with therapists and dietitians, as well as a support group.
At one point, while her therapy group was working on an eating challenge, Bennin recalled, she found herself having “a complete meltdown over a cupcake.”
Bennin was in the program for a year, making gradual progress. Like depression, an eating disorder isn’t the sort of thing someone can just snap out of, she said, and it’s common for recovery to be an uneven process.
“It was tough,” she said, saying that it took her a long time to relax enough to “go on living a normal life.”
“It was really weird for me to start feeling emotions again,” she said.
Reddan also said that “orthorexia,” or a fixation on consuming only organic or local foods, can play a role in some cases. She noted that she sees some patients become obsessed with “eating perfectly.”
“For some people that works,” she said. But, for others, it can spur the mental snap into an eating disorder as a “holier than thou” attitude about food becomes a way to rationalize eating too little.
It becomes a problem, Reddan noted, when a cookie or a cupcake elicits the same emotional reaction as a bowl full of spiders.
“My role is to change their relationship with food,” she said.
Both Reddan and Bennin compared eating disorders to alcoholism or other substance abuse disorders — though the difference, Reddan noted, is that food isn’t something you can cut out of your life entirely.
“It’s just a bad way of coping, honestly,” said Bennin. “A way to get your mind off hard things.
“Some people have better coping mechanisms than others,” she said.
It’s important, Bennin added, that adults understand the impact their words have on kids. She once had a dance teacher tell her that “I looked like I had swallowed a water melon,” she said.
She’s now doing better in school, holds down a job, and notes she “can eat desserts without guilt.” Studying dietetics, she hopes to ultimately get into therapy so, like Reddan, she can work with people suffering from eating disorders.
Bennin regrets that she wasn’t more honest with her family, and that she missed out on the life experiences she lost to her illness. More than two years past her 21st birthday, she can count the number of times she’s had a drink on one hand.
“I missed out on so much,” she said. “My first two years of college were just miserable.”
“I just wish,” she said, “I would have felt like it was OK to ask for help.”
Reddan is set to discuss disordered eating along with several other Bozeman women at a pair of events at the Bozeman Library at 7 p.m. Feb. 17 and Feb. 26.