The media's pressures
Let's say you have this biological predisposition. Then you add to that our cultural imperative for youthful beauty and all the fawning over the perfect postbaby bodies of celeb moms like Jennifer Lopez and Naomi Watts.
"As we see more and more cases of eating disorders in adult women, we're getting a better sense of what's going on," says Cumella. "And I think it hinges on this time and place in our culture, which is obsessed with weight and youth and body perfection to a degree that we've never seen before."
Holly Grishkat, Ph.D., the site director for outpatient programs at the Renfrew Center, a foundation for researching and treating eating disorders based in Philadelphia, calls it "the Desperate Housewives effect." "What we're seeing now on TV shows where many of the actors are in their forties but look like they're in their twenties is the not-at-all-subtle message that not only can suburban mothers and housewives be thin and beautiful and youthful at any age -- they should be," she says.
A recovering anorexic, Katie Harrison says her biggest struggle is having to tune out this media obsession. "There's a lot of pressure out there to lose weight and go on diets," says the Arroyo Grande, California, mom of two girls. "When I see pictures of celeb moms, I know all of it is airbrushed, but still part of me wants to follow those diets and exercise regimens. But I can't go there because I know I'd take it to extremes."
Like mother, like daughter?
Now that she's maintained a healthy weight of 130 pounds for the past three years, Sortzi is fighting back against these pressures -- for her daughter's sake. "Society says that women are supposed to look the same pre- and postbaby, but we, the women whom society is supposedly constricting, accept it," she says. "We say, 'Look, this is the standard.' And we try like hell to meet it. We don't fight it. We fight to reach it. Sure, society throws us a lot of nonsense, but we have to realize that we perpetuate the nonsense -- and that we can stop it, too."
Harrison says she's very aware that her two daughters, ages 1 and 2, are at higher risk for developing an eating disorder. "I have to stay strong, for myself and for my family," she says. "I sometimes feel like skipping a meal. It's irrational, but I feel if I eat breakfast, for example, I won't be able to fit into my jeans. So it's a struggle, but in the end, I eat the meal because I want my girls to know that it's healthy for them to eat breakfast."
Delmers, who is still in therapy, is also trying hard to be a good role model to her daughters by avoiding standing in front of the mirror and making comments about her body. But she does worry that her girls are picking up on her struggle, especially at mealtimes, when she finds it difficult to eat more than a salad while the rest of her family has a normal dinner.
"It's better to get the issue out in the open," says Cabrera. "You can tell your child, 'Mommy has a hard time with food, just like you have a hard time doing your math homework.' Communicating and sharing your feelings is much better for the whole family than keeping your struggle a secret."
That's why it's so important for moms to get help. We want our kids to feel good about their bodies, weight, and shape, and we need to be their role models for a healthy lifestyle, says Cabrera. But it's even more critical for the mom herself. Without treatment, she can't fully be in the moment and enjoy her kids because she is too busy living inside her head, trapped in her fear, shame, and guilt.
In the end, after flirting with the urge to contain my pain by containing what I ate, I couldn't do it. I couldn't embrace anorexia as I had before, basically because when Henry died, I learned, in the most brutal way, that some things in life are beyond control.
I have two children now, both daughters. Lydia is 4, almost exactly a year younger than Henry would be; Genevieve is 3. Because I have struggled with anorexia, they will be more likely than other kids to feel its tug. But thanks to the struggle I had when their older brother died, they'll also get that you can fight it. Just like their mom.
Megan Othersen Gorman writes about health for Prevention and other magazines.