Wednesday, June 01, 2005

Eating disorders in the Jewish community -- the stats

Thanks to Dr. Uri Cohen for emailing me the section of ATID's booklet on eating disorders which addresses the question of whether disorders are more common in the Jewish community than in the general population. I asked about this here.
Studies are limited and the evidence is inconclusive, often contradictory. Some studies suggest that Jews are at average risk for eating disorders, others that they are at higher risk; no one seems to suggest they are at a lower risk. Why does anorexia have a reputation as a 'Jewish disease,' then?
Hillary Domers, director of child and adolescent services for Jewish Family and Children's Service of Southern New Jersey (JFCS), points out that eating disorders are more prevalent among white, upper middle class females -- a group that obviously includes many Jewish girls (Wolkoff, 2000). It is not that Jews have higher rates of eating disorders than other groups, but rather that Jews often belong to the demographic group which is the most susceptible to eating disorders (Zlotnick, 1999). Abigail H. Natenshon, a psychotherapist and social worker who has written a book, When Your Child Has an Eating Disorder (Natenshon, 1999), phrases it this way: "There's this tremendous misconception that anorexia is a Jewish disease, but it's not at all true. There's a very high incidence of eating disorders in all upwardly mobile groups" (Levinson, 2003).
Amongst the Orthodox, the evidence seems to be all over the place (including some suggestions that body image is better and eating disorders less common than average) -- nothing firm there. But when eating disorders do occur, they often have more severe consequences because of a 'code of secrecy' which
leads the Orthodox to avoid treatment until the situation has become extremely severe, making recovery that much more difficult (Blustain, 1996; Haas, 1999). A study in Jerusalem reported that "religious Jewish girls with anorexia nervosa present for treatment at a lower body weight and have a higher hospitalization rate than their non-religious peers" (Benaim, Turel & Sznajderman, 1998).
If you can get your hands on the booklet, it looks very thorough and includes lots of interesting speculation about the reasons why Jews may be at average/high risk for eating disorders. I don't have room to elaborate here, but one final significant finding is that
poor body image is more common among girls in Israel than in other countries. This study analyzed data from a World Health Organization survey that compared eating behaviors among thousands of 6th to 10th graders in 28 countries. The data revealed that over 70 percent of Israeli girls want to change their body (ranking fourth among the 28 countries), and about half feel too fat (ranking 17th). In addition, one quarter of Israeli girls are dieting, peaking at one third in 10th grade. This rate of dieting ranks Israel as first -- the very worst -- among the 28 countries. It seems that there is a “diet atmosphere" in Israel, making girls feel compelled to diet. At least some of these girls are at risk for developing eating disorders (Harel & Molcho, 2000).
I've written before about a study showing that 10 per cent of Israeli girls between 14 and 17 have eating disorders. In fact, the problem of dieting and the pressure to be thin in Israeli society is so acute that it hardly needs a study to diagnose; it's obvious to anyone walking down a Tel Aviv street. My analysis here.

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