Eating Disorders in Young Adult Literature

by Emily Klausing

            No matter where we look, what we read, watch, or listen to, it seems the battle with food is everywhere.  On one end of the spectrum there are restaurants serving and advertising huge, unhealthy portions of food to a society that has reached its peak in obesity and on the other side of the spectrum is a culture fixated on dieting, dieting, dieting, and worshiping hauntingly thin celebrities.  Who is most at risk to this battle?  The answer is adolescents, who are at their prime for soaking up everything around them, especially in the media.  While the government is taking a stand on trying to prevent the spread of obesity among our nation’s children, we must not forget the opposite adolescents, who are ultimately dying to be thin.  Eating disorders are becoming an epidemic among adolescents in the United States, and numbers are continuing to rise.  As a future teacher, I believe it is my responsibility to take a better look at how I, as an English teacher, can prevent eating disorders among my future students.  I believe it is important to use young adult literature to gain a better understanding of eating disorders.

In order to understand eating disorders in young adult literature it is critical to understand some basic definitions.  An eating disorder may be defined as a “persistent disturbance of eating behavior or a behavior intended to control weight that significantly impairs physical health or psychological functioning, and is not secondary to a general medical condition or another psychiatric disorder” (Fairburn).

The two main eating disorders among adolescents are anorexia nervosa and bulimia nervosa.  Anorexia nervosa, or anorexia, is a “condition characterized by food denial, marked weight loss and amenorrhea, and is most commonly found in young women” (Lee 42).  Some common characteristics found in anorexics are:  emaciated look, physically active, profound weight loss, loss of menstrual cycle, body image distortion, and fear of weight gain.  Some medical complications that can occur due to anorexia are:  general health, cardiovascular compromise, osteoporosis, metabolic slowdown, multiple organ compromise, suicide, growth retardation, pubertal delay, and peak bone mass reduction (Ice).

Bulimia nervosa, or bulimia, is an “eating disorder characterized by episodes of secretive excessive eating (binge eating) followed by inappropriate methods of weight control, such as self-induced vomiting (purging) abuse of laxatives and diuretics, or excessive exercise.  The insatiable appetite of bulimia is often interrupted by periods of anorexia” (Stoppler 1).  Some common characteristics found in bulimics are:  the individual “looks normal,” binging and purging behaviors, individual overly concerned about his or her body, and the individual being secretive.  Some medical complications that can occur due to bulimia are:  dehydration, heart problems, electrolyte disturbances, and gastrointestinal problems (Ice).

The following statistics will also help to understand the severity of eating disorders among adolescents.  One out of every one hundred teenagers suffers from an eating disorder (DeTommaso).  Eighty-six percent of eating disorders begin before the age of twenty (DeTommaso).  Eating disorders have the highest mortality rate of any mental illness, which is twenty percent (Ice).  More than ten percent of the people with eating disorders are males (Fairburn).  In the United States, as many as ten million females and one million males are fighting a life and death battle with an eating disorder (Fairburn).  Forty-two percent of first to third grade girls want to be thinner (Maine).  Eighty-one percent of ten year olds are afraid of being fat (Maine).  Without treatment, up to twenty percent of those affected die from the disorders (Ice).  It is estimated that seven million females and one million males suffer from eating disorders.

Through the above information it is evident that preventing eating disorders in a school system is vital.  However, will using young adult literature in which characters have eating disorders improve or worsen adolescents’ views on body image?  Some critics believe that works of fiction dealing with eating disorders will increase the chance of eating disorders among adolescents.  These critics believe that these books are putting ideas into the minds of adolescents.  However, opposing critics believe that young adult literature concerning eating disorders offers real consequences to the characters’ actions and will help adolescents see the danger behind eating disorders.

Adolescents are already being bombarded with thinness and unrealistic body images from the media.  For example, the average American woman is five feet four inches and weighs 140 pounds, whereas the average American model is five feet eleven inches and 117 pounds.  Meaning most fashion models are thinner than ninety-eight percent of American women.  Many of these celebrities and fashion models in the media are suffering from eating disorders, but adolescents do not see the consequences some of these celebrities are experiencing from their extreme thinness.  Instead adolescents see that thinness seems to lead to a life of glamour.  Thus in the mind of an adolescent in order to be famous and glamorous, one must be extremely thin.  In order to be thin, one must have a strict eating regimen, which in most cases develops into an eating disorder. 

A recent study found that “dissatisfaction with weight and shapes was very common among pre-adolescent and adolescent girls.  The frequency of reading fashion magazines was positively and independently associated with dieting and exercising to achieve the perfect body” (Eating Disorders Information Sheet).  It can be concluded that adolescents are very much engrossed with messages from the media; and the message of thinness equaling beauty is very prevalent.  Therefore, by providing adolescents fictional characters with eating disorders, it is enabling adolescents to see the whole picture of the life of someone suffering from an eating disorder.  Young adult literature with characters that have eating disorders show the life-threatening consequences that their eating behaviors can have.

Diary of an Anorexic Girl by Morgan Menzie, Lovesick by Jake Coburn, and Insatiable by Eve Elliot, are three phenomenal pieces of young adult literature, dealing with real life episodes of adolescents experiencing eating disorders.  I believe the three books would be great individual reads for adolescents who are suffering from eating disorders, adolescents who have a friend with an eating disorder, and I truly believe all adolescents could benefit from these stories. 

Diary of an Anorexic Girl is the true story of Morgan Menzie with some added fiction, and she also changes her name to Blythe in the story.  Blythe is an average teenager girl who goes to a private, suburban high school and is growing up in a Christian family.  When Blythe’s classmate and teammate Laurie begins to lose weight, Blythe notices that Laurie is gaining attention from all the boys.  Blythe then decides that she will watch Laurie’s eating habits, and try to model Laurie’s food intake.  At first Blythe finds it difficult to cut the calories, but soon enough she is consuming only four hundred calories a day.  Blythe becomes very competitive and determined to lose more weight than Laurie.  In Blythe’s mind the more weight she loses, the more it seems the boys are noticing her.  However, when Blythe hits a scary eighty-nine pounds her parents send her to a therapist.

Blythe hates therapy, but decides that if she gets back up to a healthy weight her parents will stop watching her every bite and she will be allowed to exercise more again.  After a few months Blythe get back up to 120 pounds.  However, when she goes away to a college session for advanced students, her self-starvation and extreme exercising start back up.  Blythe misses her family and home, and her depression and feelings toward food worsen deeply.  Aside from school, her life only seems to consist of thinking about limiting calories and exercising, and most of the time Blythe is fatigue.  When working on a project a lady talks about the extreme living conditions in her country and how everyone looks deathly thin, the lady points to Blythe, and says, “like that girl.”  This causes Blythe to sink deeper into her depression, but her food habits do not change.  When her parents finally come to pick up her up it is evident that she needs a lot of help.  It finally hits Blythe that she is wasting away in mind, body, and spirit, and she truly does not want to live like this anymore.  Blythe decides she is the only one who can save her self.

Throughout the story Blythe has two supportive friends, Oliver and Diane, who try to help her find confidence in herself.  The books also includes Blythe’s daily eating schedule, journal entries, prayers to God, poems, and what she wished she’d known all the time.  On the back of the book, there is a quote that says that Diary of an Anorexic Girl is the “true story of a victory over a disease that is killing America’s youth:” which indeed the book truly is.

I found Diary of an Anorexic Girl to be very realistic and relatable to young adults.  Blythe’s consequences of her anorexia are very forward and scary, providing the horror of how trying to be too thin can ultimately be life threatening.  I believe it is crucial that the book be this straightforward, so adolescents can see how harsh the consequences of eating disorders can be and that life itself is more important than one’s body size.  The other aspect of the book that I found to be of value was that the story did not just deal with Blythe’s anorexia.  Rather, the book dealt with Blythe’s relationships, friends, family, boys, and school.  It showed how all of these aspects of her life suffered because of her anorexia.  The book also showed that the underlying problem behind Blythe’s anorexia truly was her depression and unhappiness with herself.  The book showed that with therapy and faith in her self, Blythe could be happy and content with herself.  I would rate this book a ten out of ten, for its brilliance in speaking to young adolescents about the dangers of anorexia.

In Lovesick, Jake Coburn tells the story of two adolescents facing serious diseases, alcoholism and bulimia.  The one thing about this book that is different from other books concerning eat disorders is that although bulimia is significant to the plot, it is more of a love story of two adolescents’ relationship as they battle through difficult points in their lives.  The book starts out with Ted York losing his basketball scholarship to New York University because of a drinking and driving incident that hurt his knee.  However, Ted is unexpectedly given the opportunity to have his tuition paid for at New York University if he keeps an eye on billionaire Charles Pracker’s daughter Erica.  The reason Charles wants to have someone watch Erica is because she suffers from bulimia.  Although she is seeing a therapist, she is really making no progress and her father is scared that her condition will only worsen when she goes away to college.  Ted, who comes from a poor family and has no hopes of going to college otherwise, hesitantly takes the deal in agreement that he will spy on Erica. 

Ted and Erica are placed on the same floor in a dorm at New York University.  Erica and Ted quickly become friends and it is not because of Ted’s secretive deal to spy on Erica, but because both feel like outsiders in the college world.  Ted does not want to go to parties because he is in Alcoholic’s Anonymous for his drinking problem, and has been sober for ninety days.  Erica is disgusted with the fraternity boys and does not want to be at their parties.  Nonetheless, Erica is continuing to get sick, but Ted does not let her father know because Ted knows that the cold-hearted Charles will pull Erica out of New York University, which will only depress her more.  Ted tries to be supportive of Erica, and brings her to one of his Alcoholic’s Anonymous meetings so she can see that it is okay to get help. 

Through their struggles the two end up falling in love, but Ted feels compelled to tell Erica about the deal he made with her father.  After Ted’s secret comes out Erica runs away feeling depressed and like everyone is out to get her.  She calls her therapist and asks if he had anything to do with this.  When she realizes he did not, she decides she has no one to turn to and she decides the best option for her is to go away and get help.  Ted at first drinks an ungodly amount of alcohol in disgust of his lie to Erica.  The next question remains if Erica and Ted can ever be friends again.  After Erica gets out of rehab for her bulimia she goes to visit Ted.  Erica forgives Ted, and the reader can see that their love and care for one another ultimately outweighs the spying and their diseases.

In evaluating Lovesick the whole concept of Ted getting his tuition paid for by a total stranger is a little far-fetched.  However, once one can get over that aspect of the novel a great story of two adolescents struggling to stay afloat exists.  One of the best things Lovesick does is relate eating disorders with other disorders, such as alcoholism.  In most cases adolescents who suffer from eating disorders are female, and it can be hard for their male peers to understand why they would ever want to do something so harmful to themselves.  However, by relating Erica’s bulimia to Ted’s alcoholism it allows the reader to see that both are disorders that can be overcome with help from others.  I think the book is a great read because although the book does involve Erica’s bulimia, it also revolves are the relationship of two adolescents; which ultimately makes the book more realistic and interesting to adolescents.  It is a book adolescents would enjoy, and then ultimately realize the harsh consequences behind two scary diseases that a great percent of teenagers experience.  For all of these reasons I would rate Lovesick a ten out of ten.

Eve Elliot’s Insatiable tells the story of four high school teenagers whose lives have been consumed with weight and food.  There is Samantha, a beautiful cheerleader/”ice princess,” who is obsessive compulsive with every aspect other life, especially her body and her food.  Samantha finds people who are overweight to be disgusting and barley eats anything.  She also cleans her room at least five times a day, thinking if she does not clean it the messiness will overflow into her life, which will make her fat.  Her worries about weight cause her to lose her boyfriend, which makes Samantha cut herself as punishment.  She also cuts herself if she eats anything fattening or does anything “dumb.”  Samantha’s mother eventually gives her the ultimatum to get help for her anorexia or be hospitalized.  Samantha decides to get help from Dr. Gale.

There is also Hannah, who is feeling tremendous grief over the death of her mother.  Hannah’s mother had cancer, but doctors believe that she died as a result of anorexia.  Hannah in return eats large amounts of food to comfort her self, then immediately purges the mass quantities of food.  Another aspect contributing to Hannah’s negative image of herself is that she believes she is a lesbian.  Hannah, however, does not think she has a true problem until she starts to vomit blood.  She too goes to Dr. Gale for help.

Another character is Jessica, the artsy rebel who starves herself in order to deal with her father’s death and the lack of loves she receives from her mother.  Jessica eats nothing and becomes so thin she can hardly stand up.  One afternoon while fixing her little brother lunch, Jessica falls and hits her head on the counter.  Her friend Phoebe finds her, and Jessica is then hospitalized because she has fractured her skull.  Seeing the condition Jessica is in the doctors hook her up to feeding tubes, and want to send her to a rehabilitation center.  However, Jessica’s mother, who is a thin model, thinks Jessica is just fine the way she is.  Tragically, Jessica dies from her battle with anorexia.

Lastly there is Phoebe, who is Jessica’s friend.  Unlike Jessica, Phoebe is overweight.  Although she is the smartest girl in her school and has a lot going for her, she overeats to compensate from the pain she receives from her father.  Her father is a photographer and is constantly around models.  He pushes Phoebe to lose weight, and almost seems ashamed of her.  Phoebe decides to get help so she can lose weight and hopefully please her perfectionist of a father.  Phoebe too goes to Dr. Gale for help in her battle with food.

Samantha, Hannah, and Phoebe meet in group therapy and work with Dr. Gale to overcome their eating disorders.  Although the three girls suffer from three different diseases, all three disorders revolve around food and the deeper issues that lie underneath the food itself.  The book shows the realistic thoughts, feelings, and actions of four very different adolescents trying to overcome their battles with food and family.

Insatiable is very realistic and lets the reader really go into the thoughts of four girls.  The book shows that many times food is not the issue; rather there is some underlying problem that needs therapy to be solved.  One of the most significant aspects of the story is its ability to be very powerful and straightforward.  Jessica’s death shows the painful reality of the desire to become too thin.  Insatiable allows adolescents to see that eating disorders are a constant struggle for those who suffer, but therapy is the best way to overcome them.  Insatiable would be good for someone who suffers from an eating disorder because it would allow them to see the serious consequences, but would also show them there is help.  The book would also be good for all adolescents, by helping them understand what some of their peers with eating disorders may be going though.  I would rate Insatiable a nine out of ten.

Although Diary of an Anorexic Girl, Lovesick, and Insatiable are three great works of young adult literature dealing with eating disorders that would be fantastic individual reads, I do not necessarily know if they would be great reads for an entire class.  However, in my research I came across a great lesson plan on PBS entitled When Food Becomes a Problem.  The summary of the lesson plan states:

Eating disorders affect many young people.  Anorexia, bulimia, and binge eating are all disorders that are symptomatic of other issues.  The media often delivers the message that being beautiful and thin is the solution to all problems.  Many of today’s teens are influenced by this and attempt to emulate what they see.  Today, 1 out of every 100 teenagers will suffer from an eating disorder.  The onset of most eating disorders occurs before the age of 20.  Eating disorders left untreated can be life threatening. (DeTommaso)

The objectives of this lesson plan are: 

Students will be able to evaluate the signs and symptoms of eating disorders.  Students will be able to explain why it is important to speak with a trusted adult about himself or herself or someone they may be concerned has an eating disorder.  Students will be able to evaluate the short-term and long-term effects of eating disorders on the body and emotions.  Students will describe anorexia, bulimia and binge eating.  Students will be able to identify the signs and symptoms of an eating disorder.  Students will be able to explain the statement: “What’s inside is more important than what is outside.  Students will explain why teens choose to use food as vehicle to control things they feel they cannot control themselves. (DeTommaso)

The materials needed for the lesson plan include a computer with Internet access, “Wanted” poster worksheet and “Gone On Too Long” worksheet (which can be found on the website).  First the students will read Jessica’s Anorexia.  The story is about an intelligent, athletic, popular adolescent girl, who just has too much on her plate.  One day at a family reunion an aunt teasingly says her cheeks have baby fat.  However, Jessica takes it to heart and decides to go on a diet.  Soon the diet turns into limitation of calories and extreme weight loss.  Even though the scale says Jessica is weighing less and less, when she looks in the mirror she still feels dissatisfied with herself.  Jessica has developed anorexia nervosa.  After reading this it is important to ask students why they thought Jessica started starving herself, but also what the deeper issues behind just the food are.  It is also important to ask students about what they think Jessica should do for help. 

The next step in the lesson plan is to have students answer questions about what they think they know about eating disorders.  Then hold a discussion with their answers, and then reveal the correct answers.  After this step there are two more stories to read entitled Stephen’s Problem, in which Mike watches his older brother Stephen starve himself before his wrestling meets, but then binge after the meet is over.  The other story, A Model’s Bulimia deals with Magali Amadei, a celebrity who has hit it big, but for many years has been suffering from bulimia.  After her brother was in a bad motorcycle accident Magali turned to food for coping.  When she became a model and would be depressed and homesick, she returned to her binging and purging.  However, after passing out at a photo shoot she received help.  Now she is speaking to schools about her experience.

The lesson plan also consists on making a “Wanted” poster that concentrates on counteracting our culture’s obsession with being thin, and looking past the physical appearance of others.  The posters will also list ways eating disorders can be prevented.  The lesson plan also consists of giving students the symptoms of eating disorders and discussing whom they should speak with if they or someone they know could have an eating disorder.  Next, the lesson plan allows students to see the physical and emotional effects if eating disorders are left untreated.  The lesson plan ends by having students write a reflection on the statement, “It’s on the inside that counts.”  This lesson plant also meets seven relevant national standards.

It is significant and evident that all departments in a school system must come together to help promote healthy eating and prevent eating disorders.  In North Salem, Guidance Counselor Dr. Guberman came to the English Department chair concerned with the number of girls in his school system suffering from eating disorders.  Dr. Guberman asked the English Chair if they could come together to come up with a way to help decrease the rising epidemic of eating disorders within their school system.  Dr. Guberman asked the English chair to find a piece of literature or short stories to present to the Senior English classes about eating disorders.  The foundation of a great program began with just an interdisciplinary workshop between the two departments.  However, before long the word spread among all the departments and The Eating Disorders Program at North Salem was created.

To understand the program, a brief overview can be of assistance.  On day one of the program the school nurse and the physical education teacher presented a better understanding of eating disorders by discussing definitions, warning signs, causes, treatment, prognosis, and body types.  On day two, the art teacher and history teacher talked about the changing images of beauty through the ages of time.  The slides depicted the change in body image through the ages to allow adolescents to see how “beauty” had changed over the course of centuries.  On the third and fourth day of the program the guidance counselor and the English teacher discussed My Mother’s Daughter:  Stories By Women edited by Irene Zahava.  In the story a fictional single parent family is almost destroyed by the daughter’s eating disorder.  After the story a set of questions were presented to understand the girl’s eating disorder, her family, and the media.  It was also emphasized that eating disorders can happen in any family setting, not just a single-parent-family (Sagan).

It is significant for teachers to know what they can do to prevent eating disorders among their students.  It is important for teachers to “discourage dieting” The National Eating Disorders Association asks teachers to adopt the slogan, “Don’t Weight Your Self-Esteem – It’s What’s Inside That Counts.”  Secondly, it is important for teachers to “practice what you preach.”  Meaning it is important for a teacher to eat well-balanced meals, and avoid talking about “being fat.”  Thirdly, it is vital to “find out what kids are eating” and to promote a school food program that provides a wide range of meal options for students.  Also, “encourage healthy exercise” by helping one’s school system to develop a physical education programs that all students can enjoy.  It is very important for teachers to “teach respect” and institute a zero tolerance policy on negative talk about children’s bodies in school.  It is also important to “teach media literacy” to one’s students.  Finally, it is important for teachers to “write letters and make phone calls” in order to ensure one’s school system promotes healthy eating habits and body image for all students (What Teachers Can Do).

It is also significant to teach adolescents what to do if they know someone who has an eating disorder.  If an adolescent knows of someone with an eating disorder some things not to do are:  be judgmental, focus primarily on eating behaviors, gossip about him/her, follow her/him around to check eating and/or purging behavior, ignore her/him, reject her/him, tell her/him to stop the behavior, nor feel compelled to solve the problem.  If an adolescent knows someone with an eating disorder some important things to do are:  express your concerns in a caring way, listen to her/him with understanding, learn more about eating disorders, offer support and be available, provide encouragement with regard to recovery, inform her/him that help is available and provide a list of resources, prepare yourself for your friend to be in a denial and behave defensively, and consult with a professional if you feel you need guidance on how to approach your friend (Getting Help For An Eating Disorder).

Eating disorders are a serious disease facing many adolescents everyday.  As teachers it is our job to help prevent and educate students on the dangers of issues they, or their peers, will encounter.  I believe that by studying eating disorders in young adult literature, if only for a day or two, teachers can provide a lifetime of information and hopefully prevention to adolescents.

Works Cited

DeTommaso-Kleinert, Donna.  “When Food Becomes A Problem.”  PBS 2005.  20 July

2006.  <http://pbskids.org/itsmylife/parents/lesson_plans/when_food_is_a_problem.html>.

“Eating Disorders Information Sheet.”  Classroom Teachers.

Fairburn, C. G. and K. D. Brownell, eds.  Eating Disorders and Obesity:  A

Comprehensive Textbook.  Second Edition.  New York:  Guilford Press, 2001.

“Getting Help For An Eating Disorder.”  2004 Emory University:  July 21 2006. 

<http://www.emory.edu/SCOUNSEL/eating-help.htm>.

Ice, Susan, M.D.  “Statistics.”  Eating Disorders Coalition.  Journal of the American

Academy of Child and Adolescent Psychiatry.  20 July 2006.  <http://www.eatingdisorderscoalition.org/reports/statistics.html>.

Lee, S.  Social Science and Medicine.  1996:  42.

Maine, Margo, Ph.D.  Body Wars:  Making Peace with Women’s Bodies.  Gurze Books,

2000.

Sagan, Dr. Catherine.  “Eating Disorders.”  Teachers.Net Gazette  May 2003:  Volume 4,

Number 5.  24 July 2006.  <http://www.teachers.net/gazettee/MAY03/sagan.htm>.

Stoppler, Melissa Conrad, M.D.  “What is Bulimia?”  Medicine.Net.  Ed. William C.

Shiel.  26 January 2006.  ePublications.  23 July 2006. <http://www.medterms.com/script/main/art.asp?articlekey=2546>.

“What Teachers Can Do.”  <http://www.healthywithin.com/for_teachers.htm>.