Abigail Natenshon, MA, LCSW, GCFP
Highland Park, Illinois 60035
Terri Schiavo’s Death Could Save
Eating Disordered Lives
Terri Schiavo lapsed into a coma from
complications of an eating disorder. Electrolyte imbalances from
repetitive bulimic binge/purge cycles can damage the electrical
function of the heart, in some instances causing the heart to
stop beating. Following a bulimic purge in February 1990, Terri
suffered a potassium deficiency that resulted in cardiac arrest,
depriving parts of her brain of oxygen for 14 minutes, causing
extensive brain damage.
It is disappointing that the focus of media
coverage has been on matters concerning family disputes, the
courts, and church/state politics to the exclusion of the
condition leading to her demise. Terri Schiavo was the victim of
bulimia nervosa, the most lethal of all the mental health
disorders. Of the 13 million people in the US today who
suffer with anorexia, bulimia, or compulsive over eating, six to
13 percent will die or be maimed from complications of these
disorders. Though 87 percent of victims are under the age of 20,
adults like Schiavo may carry unresolved disorders with them for
decades, into their 30’s, 40’s, and 50’s, into their marriages,
parenting, and professional lives. Some will carry the disease
to their death bed.
It is hardly surprising that in the
reporting of this case, Terri’s eating disorder remained
essentially undercover. Families
are typically either uninformed or reticent to discuss these
illnesses cloaked in shame, stigma, fear and misunderstanding. Many
parents feel inadequate and disempowered to intervene, assuming
personal guilt for causing their child’s eating disorder… and
all too many health professionals corroborate this false notion. The
fact is that parents are not to
blame for their child’s eating disorder; eating
disorders are diseases, like diabetes or cancer; their origins
lie in brain chemistries, temperament and genetic
predisposition. Though not responsible for causing their child’s
eating disorder, there is a great deal knowledgeable parents can
do to facilitate healing.
The Role of parents
Parents influence and shape their child’s
attitudes, a healthy eating lifestyle within the home, and a
supportive emotional environment conducive to treatment and
cure, even when their offspring is no longer a child. As
diagnosticians, mentors, and recovery advocates, parents need to
remain authoritative and “parental,” taking charge whenever
appropriate, and wherever possible, for the eating disordered
child who is incapable of responsible self-care. When it comes
to an eating disorder, simply loving one’s child is not enough.
Action is prerequisite to healing. Because these diseases do not
typically show up in doctor’s offices, but around kitchen tables
and in family bathrooms, parents as diagnosticians need to learn
what to watch for, how to listen actively, and how to help a
child learn to listen to her/himself. Parents are advised to
seek advice, counsel and support for themselves throughout a
recovery process that invariably becomes a shared family crisis.
Myths and misunderstandings about
eating disorders that sabotage disease detection and encourage
non-disclosure include the following erroneous notions:
- A person can identify an eating disorder just by looking,
through physical appearance alone. In fact, bulimics are
generally of normal weight, often physically fit. I know of
a perfectly healthy looking teen in recovery from bulimia
who went to sleep one night and never woke up.
- Eating disorders are incurable. In fact, eating disorders arecurable
in 80 percent of cases where they are detected early and
- Eating disorders are a form of insanity. Eating disorders
typically occur in healthy personalities, where they
coping devices for
adolescents and young adults struggling to survive the
stresses of turbulent years of change and transition.
Through the most benign intentions, people
like Schiavo initially turn to bulimia as an easy method of
weight management. Schiavo had been overweight throughout her
teen-age years. Bulimia is a repeated cycle of out of control
eating followed by some form of purging, including self-induced
vomiting, obsessive exercising, and excessive use of laxatives,
diet pills or diuretics. An eating disorder is a misuse
of food to resolve emotional problems; by taking control of
food, the victim feels in control of life itself; in an ironic
turn-about, dysfunctional behaviors become compulsions, and
tenacious habits take control of and enslave their host.
Behavioral, physical and emotional aspects of bulimia affect the
victim’s capacity to solve problems in life-spheres extending
beyond food, eating and weight management. All three
realms must be addressed simultaneously for treatment to be
Health problems that occur as a result of
bulimia may include osteoporosis, reproductive problems, kidney
and digestive problems, and heart failure. Continued nutritional
insults and abuse to the body will damage and compromise vital
organs and bodily systems eventually to the point of no return.
A 20 year old college athlete, neurologically impaired from a
bulimic coma, will spend the rest of her life in a facility for
individuals incapable of self-care. An edematous hospitalized 42
year old woman, bulimic for 26 years and in a starvation mode,
is in such a state of decline that her abdomen wall is incapable
of supporting a feeding tube.
Signs to watch for: The bulimic
- Engages in binge eating, binge exercising which she cannot
- Displays excessive, erratic, impulsive, or compulsive
behaviors in life spheres beyond food and weight management,
such as studying, shopping, promiscuity.
- Copes with emotional stress through food abuse or
- Abuses laxatives, diuretics, diet pills, Ipecac.
- Is obsessively concerned about weight.
- Engages in repeated dieting and repeated dieting failures.
- Frequents the bathroom during and after meals.
- Suffers mood disorders, depression, feels out of control.
- Has swollen glands, menstrual irregularities.
- 59% of hospitalized bulimics have experienced sexual or
disorders kill and maim. Had her
bulimia been addressed and treated
early on, Terri Schiavo most likely
would have been alive today. Her
passing has the potential to make a
real and positive difference in the
lives of millions of people who need
to know more about what eating
disorders are about, what they do,
and how they can be recognized.
So that Schiavo will not have died
in vain, there are important lessons
to learn from the errors of her
health professionals who failed to
diagnose and treat her condition,
from her parents who did not have
the knowledge or foresight to press
on in seeking help, and from the
woman who could not envision life
without her eating disorder.
for the community at large to
and state legislatures to move
forward on approving legislation
that requires insurance companies to
cover the treatment of eating
companies need to support treatment
for eating disorders in their
earliest stages to facilitate
secondary and tertiary forms of
prevention, saving lives and
millions of health dollars;
currently families supporting
children in recovery from eating
disorders find that they have to
sell businesses, homes, deplete
retirement accounts or life savings
to save the life of their loved