Tuesday, August 22, 2006

A Girl Can Dream

(written to the editor of Star magazine)

Dear Editor:

I am writing in regard to your recent (August 28th) feature about Nicole Ritchie, entitled, "Bare Bones!" As Pearson, Clark, and Levine note, Ms. Ritchie is grossly underweight.

My concern is that anorexia, a serious (and often lethal) physical and psychological condition is not represented properly in the article. The writers quote Christine Bybee, a "nutritionist and fitness expert" regarding Nicole's condition: "'A true anorexic looks like a walking skeleton. . . . At that point, a person needs to be hospitalized. Nicole isn't there yet."

Unfortunately, Bybee's statement is wholly untrue. First, it is impossible to judge whether someone is anorexic simply based on her appearance. A comprehensive clinical interview is necessary, and, even then, a diagnosis may be difficult if the patient is not forthcoming. Second, not all anorexics have the look of a "walking skeleton," as the diagnosis requires (amongst other criteria) that a patient weigh less than 85% than expected--how this translates into "looks" varies by individual. Finally, hospitalization can and does occur at various points along the continuum of eating-disordered symptoms and is not simply a stop-gap, life-saving measure once a patient appears to be "a walking skeleton."

I write with concern that your readers may, based on the above misinformation, understand anorexia to be less serious (or more black-and-white) than it is. Nicole Ritchie is, even by her own account, "too thin," but to label her as anorexic (or not) is questionable journalism, given the complexity of the diagnosis. Moreover, information about an eating disorder (a mental health disorder) diagnosis and treatment should come from a mental health professional, not a nutritionist or fitness expert.

I urge you to promote responsible journalism, particularly with regard to a disease as grave as anorexia, as many young women are turning to celebrity magazines for information about this condition.

Licensed Psychologist (specializing in eating- and body-image concerns)


PalmTreeChick said...

Way to go Stacey! I am wondering if peoples' perception of what anorexia "looks" like is changing with the ever-so-shrinking stars. Obviously the diagnosis remains, but over the past few years celebs have been getting thinner and thinner, so now when we see a thin person who may have once "looked" as though she was anorexic may not be considered (by appearance only) anorexic anymore because they're counterparts are even thinner (more anorexic looking)than they are.

I guess what I'm what I'm trying to say is, is our vision of what an anorexic looks like changing? Meaning, does one have to look even more emaciated for us to think there is a real problem?

FatMom said...

As a former anorexic (and now overeater...it's all eating disorders), I agree with you 100%, Dr. Stacey. Excellent letter.

Michelle said...

Bravo, Stacey! Thanks so much for taking the time and making the effort to write and send that letter.

It's perfect.

With respect and gratitude,

Kelly said...

I would think by the time someone looks like a walking skeleton and must be admitted to a hospital, the anorexia has progressed to a seriously dangerous point. Wouldn't it be better to encourage the anorexic person to get help BEFORE irreparable damage is done to his/her heart or other organs and he/she is just barely hanging onto life? In other words, lets help the Nicole Richies of the world before they have to actually be admitted to the hospital because they can't function outside of one anymore.

littlem said...

PTC said:
"am wondering if peoples' perception of what anorexia "looks" like is changing with the ever-so-shrinking stars."

PTC, I'm sure it is. Check out the articles on Salon, Big Fat Deal, and Feministe following up on what Dr. S. wrote about that Holly Millea "Details" article and how size 4 women like Kristin Davis are "plate-scrapers" now. Like the culture is saying, "those women are fat, and we find them attractive, but they'd better watch it, and anyone larger than them is truly disgusting."

Way to go, Dr. S. What grinds my tailfeathers is that that twinkleheaded "nutrition expert"'s opinion means that people who starve themselves, but are still "fat", aren't believed when they crank up the courage to tell their doctors they have anorexic tendencies -- and then they're not helped.

ps22 said...

Great letter Dr. S and, as always, many props for putting action behind your beliefs/words. I think all the commenters thus far have hit the nail on the head. Littlem - definitely share your frustration and worry that people who ask for help may not get it. Always an issue with anorexia....people get praise from others as they lose weight.."have you lost weight?"....."you look great"...yada...yada. Then all of sudden, that same person looks "too thin" and everyone gets worried and in an uproar as if they never saw it coming.

Beth said...

Stacey, I hope your letter is effective, and should be printed in those magazines before any "fitness expert." If girls are, in fact, ignorant enough to use magazines as a diagnostic health resource, they don't need advice from people unfamiliar with the psychological causes and factors involved with eating issues. Ultimately, its only the individual, along with close friends and family, who knows if one is suffering from a disorder.

Stacey, I wish you had also asked the magazine to leave Nicole the heck alone! Whether she is healthy or sick, it is worse for us to speculate, and imagine how she feels! What about girls like Mary Kate who kept denying, entered rehab, quit college, and continues to hide her disease beneath layers of "glamorous" bag lady clothing. Why do the magazines leave her alone? At least Nicole is proud to show off her body, as she should be.
Once again, that was an amazingly accurate letter, and you should send it to all those trendy mags who claim to uncover or discuss eating disorders serously. Readers could learn a lot more from that than any pseudo-doctors they quote!

drstaceyny said...

ptc--excellent point. I think so. . .



kelly--absolutely. Thanks for your other comments, too. I usually don't go back and reply to "older" comments (sometimes I can't even "find" them!), but I have read them and am happy you're writing in! : )

lm--another good point.

ps--shocking, huh? Thanks for your support. ; )

beth--I agree, they should leave Nicole alone (they should also stop photo-shopping her--as a dear friend pointed out--to look more sickly than she does).

To all, think they'll write me back? ; )

littlem said...

Dr. S asked:
"To all, think they'll write me back? ; )"

Well, we all know that I'm a little confrontational, but I wouldn't wait to find out.

I'd call the editor right up that I wanted to talk to and say "Did you get my response? Did you read my response? And what do you think about the response?"

If nothing else, it throws up the teensy red flag that someone important -- that would be you, Dr. S -- is really paying attention.