Barbie dolls.

Runway models.

Television and movie stars.

Magazine ads.

It might be easier to be rich than to have the kind of body touted by the media as the prototype for how today's women should look. It seems no matter where you look, there is always someone smaller than you. Thinner maybe, but not necessarily healthier or better.

Barbie wouldn't be able to walk normally with the body proportions she has.

These views handed down by society are causing young women in America to take these unrealistic body shapes to heart. The most common age for the onset of anorexia, an eating disorder, is between 11 and 18. Today, more than 80 percent of college-age women diet to fit current fashions. One in every 100 women suffers from anorexia.

Marilyn Monroe wore a size 12 dress. She was five feet, five inches tall.

The good news is that more than 30 percent of all anorexia patients recover with treatment. "Overcoming an eating disorder means a long-term change in not only what you eat, but how you think," says Patty Kane, R.N., UI Behavorial Health Eating Disorders Program. "You can't go back to an 'illness' way of thinking. An eating disorder has very little to do with food. It's about perfectionism, it's about self-esteem. It is a coping mechanism. Young girls--and boys--need to learn to openly communicate so they don't act their feelings out with food."

Here is a story by a young woman brave enough to share her battle against anorexia and how she beat it. It might help your daughter or niece or granddaughter look at body image a different way.

By Rachel Ballweg

I wanted to be a runner. Runners were thin and I attributed this to dieting, not training. So I began restricting my diet: No butter, red meat, pork, dessert, candy, or snacking. If I ate any of the forbidden items I obsessed about it and felt guilty for days.

As a high school freshman, I wanted to run with the fastest girls so I trained hard, really hard and ate less. Lunch was lettuce sandwiches, carrots, and an apple. By my senior year, I was number three on the team and lunch was a bagel and an orange.

I maintained a rigid schedule--running cross country and track, having a seat on student council, volunteering, and maintaining a 3.9 GPA throughout high school--while starving myself (1,000 calories per day), trying to attain the impossible perfection I thought couldn't be far away if I only slimmed down a little bit more.

Several teammates were concerned, but I shrugged them off saying family members were tall and slender; I was a health nut, I didn't like fatty foods; I was a vegetarian; I didn't like sweets; I wasn't hungry; I wasn't starving.

A psychiatrist didn't help at all. I went in, sat on the couch and told her what she wanted to hear: I would eat more, run less, stop restricting myself, and quit obsessing about being thin. I was very good at knowing exactly what to tell others.

I dropped 10 pounds my freshman year--from 125 to 115 pounds. I was five feet, eight inches tall and wore a size five. I hated my body so I starved myself and ran like a mad woman.

In quiet moments, I was sad and worried about what might be going on inside me.

I was already taking birth control to regain my menstrual cycle; my weight was 15 percent below what was recommended for my height; I was always cold; I had chest pains and an irregular heartbeat; my hair was limp and broke off; my skin was colorless.

It wasn't until I came to the University of Iowa and joined the varsity women's cross country team that I began to see what I was doing to myself. A teammate had an eating problem. Every time I saw her, I felt sick to my stomach. She had sunken cheeks, eyes so big they swallowed her face. She was an excellent student and a college-level varsity athlete. Many people wondered at her determination, but I understood. She used the same excuses I did.

For one sick instant, I wondered if I would be happier if I were that thin. That is when I started to realize I was slowly killing myself.

At the urging of my coach, I saw the team nutritionist who recommended a psychiatrist who felt no pity for me and made me take a brutally honest look at who I was and why I was starving myself. She didn't accept any of my excuses. She helped me realize that there are other things to think about besides food and body image. About this time I decided to quit the cross country team. The pressure I felt to be thin and competition at the college level were too much when I needed to focus on getting well.

After two months of therapy, my weight had dropped again. I'm not sure how far because I refused to step on a scale, but my size five pants were falling off. My psychiatrist required weekly weigh-ins.

I wasn't putting into practice any of the things my nutritionist and counselor suggested. They told me that if I wanted to have children someday I needed to eat. They warned me of osteoporosis at age 30. Then my psychiatrist scared me to death. She told me I needed to start eating more or I would be checked into the hospital and hooked up to an IV. That would put me on the same level as my Iowa teammate. I had looked at her with such horror and never realized that I was in the same position.

My psychiatrist asked how my family would feel if they had to visit me in the hospital because I refused to eat. It was enough to make me think hard the next time I went through the food service lines.

Of course, I didn't get better the next day. But it was a step in the right direction. It's taken me three years to get where I am now. At five foot, eight and three-fourth inches (I even grew as I got healthier) and 145 pounds, I look and feel healthier, have better eating and exercise habits, and I don't obsess about food as much as I used to. On rare occasions, I think about controlling my food intake. My eating disorder will haunt me for the rest of my life. If I'm not careful, it could creep back.

(Rachel graduated in May 2001 with a BS degree in journalism with an emphasis in health, leisure and sports studies.)

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I remember seeing my mother and my friends' mothers struggle with their negative body images.

It affected me so much that, in fifth grade when our class was instructed to create a booklet describing ourselves, I recorded that my worst fear was getting fat.

Fifth grade.

I was 10 years old.

My classmates were afraid of spiders, the dark, scary movies.

I was afraid of getting fat.

If you have a health-related question, or to make an appointment, call UI Health Access - 800- 777-8442 or 384-8442.

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• American Academy of Family Physicians Eating Disorders: Facts for teens
• Facts About Eating Disorders and the Search for Solutions

Listed above are several Web sites that offer additional information on this topic. University of Iowa Health Care does not sponsor or endorse these sites, or guarantee the accuracy of the information contained on these sites. These links are here for general information only, and should not be used for personal diagnosis or treatment. If you have any questions, please contact UI Health Access.

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