An image to heal - influence of models as a cause of eating disorders

She sat there in my office, her delicate face obscured by a shield of blond hair, her timid voice just above a whisper: "I want to look like the supermodels. I'm five-foot-nine, so I have the height, but I can't lose the weight. I'd like to look like Cindy Crawford. But I can't get below 140 pounds." She reminded me of a frightened rabbit as her shaky voice grew even quieter, her eyes softened with tears: "I've tried everything, but I just can't."

Time and time again, I hear this confession in the conversations I have with young women. They want to look good in a bathing suit. They want a tight butt. They go on diets and work out every day. They're never thin enough, so they go to unnatural extremes. All they really want is to feel good about themselves in a sea of doubt and turmoil encouraged by a multi-billion-dollar-a-year beauty industry. And they think the panacea is to look like a supermodel: perfectly thin, tall, sculpted, and commanding - our cultural epitome of feminine success. I have known hundreds of women who feel justified in their starving, binging and purging, and excessive exercise - their attempts to drain themselves of fat and mold their bodies into the illusions of perfection that pour into their senses from every direction. Of course, despite the money spent, the sweaty hours on the Stairmaster, the deprivation and abuse, most of these women - like most women everywhere - will never look like supermodels. This cruel reality cuts through them like a poison arrow, causing feelings of anger and shame to flood their unforgiving hearts. Initially, many of my patients don't really have lives, their ideas, feelings, and activities all revolve around calories, fat grams, and numbers on a scale.

When Cindy Crawford snapped tartly, "Do you look at pictures of me and want to puke?" to the question of whether or not models cause eating disorders, she was not only responding to a coed's provocative question at a Princeton conference. She was broadcasting the viewpoint of the majority of American beauty-industry moguls: focus on the corporate bottom line, and to hell with the health and welfare of those who create the profits. This reckless attitude was reflected by Harper's Bazaar's Tina Gaudoin, who warned in her article, "Body of Evidence," that "models like Kate Moss, Amber Valetta, Nadja Auermann ... might not [make] you feel good about yourself ... but this is an ectomorphic body type. It's in fashion. You'll be seeing more of it." I wish every women's magazine editor, advertising executive, cosmetics czar, fitness guru, fashion designer, and modeling agency CEO could have observed my session with the tearful girl who was severely bulimic in her frenzy to get down to Crawford's well-publicized 120 pounds. "Do you look at pictures of me and want to puke?" Evidently they're not hearing - or paying attention to - a deafening "Yes!" from the seven million American girls and women who, according to Dr. Vivian Meehan, president of Anorexia Nervosa and Associated Disorders, suffer from eating disorders. (Add to this the number of male youths who struggle with society's image of the perfect stud and with eating disorders.)

Even if we're not afflicted with anorexia nervosa, bulimia, or compulsive overeating, we are not immune to the effects of the supermodels who are used as bait to lure us into feeling physically insecure. Money speaks loud and clear and, given the huge numbers of dollars we spend each year to "beautify" ourselves with exercise and diet products, cosmetics, and fashions, the voice Madison Avenue placates is screaming, "Give me more!" The job of the beauty industry is to make money for its companies and clients, ours must be to learn how to take better care of ourselves so we don't cave in to the pressures of advertising. For beauty hype is as hard to avoid in America today as landmines were in the jungles of Vietnam 30 years ago. It's up to us to step gingerly, to gravitate toward what helps us feel beautiful physically, emotionally, and spiritually, and to leave the destructive traps by the wayside.

The idea that we can - and should - accept our natural body types is a relatively new concept. For over a century, newspapers and magazines have been deluging Americans with images of ideal beauty, and only strict emulation of these ideals has been sanctioned as attractive. There was a period of time during the early, to mid-1800s when the full feminine figure was considered beautiful. However, the slimmer, more athletic-looking Gibson Girl, first created by artist Charles Dana Gibson, replaced it as the ideal in the 1890s, and thinness has remained an integral part of female attractiveness ever since. (Thinness, of course, is always relative. According to the August 1905 Ladies Home Journal, the Gibson girl had average measurements of 38-27-45 - quite chunky by today's standards.)

The Gibson Girl remained the image of American beauty until World War I, when the flapper became the vanguard of fashionableness, prompting the late Dr. Morris Fishbein, longtime editor of the Journal of the American Medical Association, to lament, "Of all the fads which have affected mankind, none seems more difficult to explain than the desire of American women for the barberpole figure." During the Great Depression of the 1930s, the flapper lost her popularity, larger, stronger, more mature ideals superseded her "boyish form" during this time of national hardship. But after World War II, at the start of the baby boom, women's magazines began promoting Christian Dior's "New Look," which demanded a hand-span waist - and the necessary corsets, girdles, waist cinches, and diets to achieve it. With Audrey Hepburn - like models as the new embodiments of haute couture, women once again felt too fat.

Women's magazines have had no mercy on teenagers who, for generations, have been encouraged to join their mothers in worrying about their weight. According to Seventeen, Carol Lynley, the first celebrity teen model, "came prepared for every photo shoot in the 1950s with a head of lettuce, a pound of seedless grapes, and three green peppers," her food for the day. In the 1960s, Mademoiselle and Seventeen became saturated with columns and features enumerating the diet strategies and exercise habits of models - a practice that continues to this day.

Starting in 1962 with "How to Look Like a Seventeen Model," young women learned that even a model as slim as Susan Van Wyck (at 32-20-33) was told to lose 10 pounds at the beginning of her career. Van Wyck told teens, "It was agony dieting ... because I love to eat. But I finally made it!" Other popular models shared their secrets with eager readers, such as this tidbit from that much adored prom-queenesque brunette Colleen Corby: "Even though I love pork chops and steak ... I've been eating lots of fish ... and seafoods [which] are low in calories." In "Do You Want to Be a Model?" modeling agency fixture Eileen Ford informed readers that an average model was five feet, seven inches, and between 100 and 115 pounds, and that one of the most indispensable items in a model's tote bag was "a waist cinch that really pulls you in around the middle" to make the "typical 20-22" waist look even smaller. Made-moiselle's "How Beautiful Can You Get?" depicted the dramatic makeover of an aspiring model: Barbara Gallant dieted down to 100 pounds, had a nose job, dyed her hair blond, had corrective braces on her teeth, and received localized dehydration treatment to smooth out her hips and thighs - "thoroughly remodeled so she could become a model!"

Perhaps the only 1960s model who reportedly didn't have to jump through diet and exercise hoops to keep her slender figure was also the skinniest: Twiggy, the icon of Mod at five feet, six inches, and 89 pounds. She admitted to eating "anything, absolute rubbish," including the ice cream and chocolate sauce piece de resistance "Bananas Twiggy" whipped up especially for her at her favorite London restaurant. Her irreverent eating habits aside, Twiggy set a standard that most models found impossible to reach. In his book Models, Michael Gross quotes Gillian Bobroff, a British model in the 1960s, as saying, "It was dreadful.... [Twiggy] started a trend, and you had to be just the same. I ... started killing myself, taking a million slimming pills. I never ate. I had bulimia. It was a nightmare, trying to keep up."

Even though the 1970s brought us larger, more healthy-looking images, models still had to diet with Herculean effort to keep their shapes. Cheryl Tiegs, the most highly paid model of that decade, wrote The Way to Natural Beauty, which became a hot seller among young women in 1980. At five feet, ten inches, and 120 pounds, Tiegs offered a variety of dieting tips, including:

Weigh in every morning. As soon as you've gained a pound, cut back on your food consumption.... I don't let another morsel pass my lips after 6:00 pm.... I always ask the waiter not to serve me potatoes, rolls, or creamed vegetables if they come with a meal. When I need to drop a pound in a big hurry, I skip dinner, breakfast, and lunch the next day and eat a small dinner the following evening.

Tiegs also gave some interesting advice on how to start a diet, which likely reflected her own ambivalence toward such a limited regimen: "Before you go on a serious diet, I recommend that you eat all the food you can manage for three solid days. The point is to overdo it, knowing that you will never overeat again."

Model/actress Brooke Shields, touted by Calvin Klein in the 1980s as being "the most beautiful girl in the world" came out with her own book, On Your Own, in 1985. A model since she was a baby, Shields, now in her early thirties, admits that she has dieted since she was eight, when she "decided to give up soda pop and pizza." In On Your Own, she confesses, "I have to diet constantly to keep my weight down" and shares her appetite-squelching bag of tricks, such as eating half a grapefruit and drinking a glass of warm lemon water one-half hour before meals. She is apparently scared to death of her sweet-tooth: "Do whatever you have to do not to indulge in ... sweets. Run in place, do sit-ups, sit on your hands - but don't eat those cookies!"

To Kim Alexis, one of the most sought-after models of the 1980s, looking back on a hugely successful modeling career revives some especially painful memories. She told People:

I remember trying every fad diet ... starving myself for four days in a row. I remember trying the Atkins diet, which was low carbohydrate, high protein. If I didn't drop 10 pounds in a week, I was on to another diet. I think I was a normal person before I started screwing around with all these diets. My metabolism got screwed up. I lost my period.... I cried for the first year of my career.

Now in her mid-thirties, Alexis admits that she's suffered "long-term health effects from the crazy diets." Today she eats healthy, low-fat meals and insists, "I'm a big, strong girl." The only apparent residue from her model dieting mentality is that she reportedly takes CitriMax, a natural appetite suppressant that she has also endorsed.

Supermodels may be enjoying a bigger piece of the beauty-industry pie in the 1990s, but the standards by which they are judged by agents and clients have also escalated. They must model fashions that, according to Vogue's May 1995 "Point of View", "demand a body at its personal peak. Hard work is one way to get there; counting calories is another.... A well-honed physique is worth any price." According to Shape magazine, "Agencies are asking their models to get strong, lean, and more defined. A little bit of extra weight ... could hurt [their] photographic images or their ability to fit into the narrow cut of couture clothes. Agencies give these women a matter of weeks to shape up, tone down, or ship out." And most models must jump to the command or risk losing financial security.

Consequently, it's hardly surprising that we sometimes stumble upon magazine articles such as Vogue's "Nobody's Perfect," which disseminate a body-image message with a twist: even supermodels feel heaped with physical flaws and are slaves to their self-perpetuated myths. To the cynical, this could be construed as a marketing ploy to promote an even stronger identification between the average woman and the supermodel. But through my work with eating-disordered women, I've learned that models aren't invincible to poor body image.

An ironic example of this is Cindy Crawford. On the one hand, she's flippant in her attitude about models, impacts on eating disorders, on the other, her colleagues apparently affect her in much the same way that she affects my bulimic patient. For in spite of being acknowledged as a world-class beauty, Crawford admitted to Vogue that she felt "self-conscious of my arms, because I look at someone like Linda [Evangelista] and she has these little bird arms and they look great in clothes." Crawford also doesn't like the area right under her butt, "where the cellulite tends to come," and thinks that her feet are too wide. Evangelista, in turn, told interviewers that she covets Christy Turlington's mouth and would like to "remove two ribs - or just shrink the size of my rib cage."

Nadja Auermann, who "eats like a horse" (according to Tina Gaudoin) and who lost half her body weight before becoming a supermodel (according to the 1994 Vogue article "Platinum Hit") reportedly still has high anxiety about her weight. Auermann attributes this to her early experiences as a model in Paris: "Everybody made me paranoid. Everybody told me, `Nadja, you can't eat so much. You have to stop.' If I gained half a gram, I was like completely freaking out"

Glamour reported that supermodel Tyra Banks once canceled a job because of a "bloated stomach" and often thinks about holding in her stomach during shoots. Top Model, a magazine devoted to the promotion of models, disclosed that Victoria Secret's Stephanie Seymour - at five feet, nine inches, with perfect supermodel measurements of 34-24-34 - "thinks she's too fat and hates her buttocks." And Christy Turlington, my 19-year-old neighbor's favorite model and the star of Calvin Klein's recent underwear ads, told Vogue she had considered cosmetic surgery at one point: "I don't like my knees.... I hate my feet, they're just big and long and skinny... I have a beer belly." She concurs with Auermann that "fashion editors can be very cruel.... They constantly watch you and say, `Oh, look at your ass.' They do that all the time." Indeed, to highlight the plight of her fellow supermodels, Carol Alt was quoted in People as saying, "Anyone who thinks that society pressures women to live up to our image should think of what we have to go through to maintain that image." It's true: supermodels are ensnared with the rest of women in the sticky web of never feeling thin enough, of lacking the inner security of body acceptance. A supermodel's toil may culminate in a fabulous career, but the cost is often a well of inner unhappiness.

But the legacy lives on. Articles and books proclaiming the strenuous diets and work-out schedules of models - 1990s' style - are ubiquitous in bookstores, on newsstands, and in grocery store checkout lines. In Glamour's "The Secret Life of Models," we learn that fewer than 5 percent of the supermodels have a stick of butter in their refrigerator. Diet & Exercise magazine tells us that Vendela, the Swedish-born supermodel, works out one-and-a-half to two hours every day with a personal trainer. Nadja Auermann's fitness regimen includes swimming, riding a stationary bicycle, aerobics, and weight training with elastic bands. Linda Evangelista admits to spending all her free time on maintenance:

"Every day is a battle....

"I'm talking about dieting. I'm talking about working out. I'm talking about health and skin quality."

Actresses also deserve some recognition for the suffering intrinsic to their profession. Like models, they're under the gun. If they're considered fat and unfit, they're considered unattractive - which spells failure in a field overflowing with one "perfect"-looking woman after another. According to an article in Longevity, Pamela Anderson Lee had a contract with "Baywatch" that strictly forbade her to gain weight. The article says that Anderson Lee "follows a mind-boggling fitness regimen. Even during non-working months, Anderson keeps to a rigorous program of 25-mile mountain bike rides or one- to two-hour athletic walks, plus 50 lap pool swims or more strenuous ocean swims."

The Redbook article "Take It Off Like a Star" described Oprah Winfrey as having "a maniac exercise routine" that includes two daily four-mile runs, plus 45 minutes on the Stairmaster and 350 sit-ups. The article reported, "In an eight-month period, [Winfrey] walked, climbed, biked, and hiked about 2,260 miles - the distance from her own Harpo Studios in Chicago to Eureka, California." Bette Midler reportedly eats nothing but vegetables after 5:00 pm. Demi Moore's workout "stresses crosstraining: road cycling, ocean and river kayaking, snowshoeing, hiking, skiing, plus daily weight lifting." Moore, like many stars, has a live-in nutritionist/cook and a personal trainer to ensure that she adheres to her strenuous workout schedule and spa cuisine. (Would we really trade places with any of them if we had to live in fear of losing our jobs if we gained five pounds?)

In the schizophrenic 1990s, women's magazines routinely show two sides of the same coin: a gooey, fat-laden chocolate cake recipe placed next to an advertisement for Slimfast; "How the Stars Fight Fat" diet tips across the page from an article on anorexia nervosa. It is not often that women's magazines present articles that are actually meaningful for today's body-image-conflicted woman.

This has also been true historically; articles geared toward helping women develop positive feelings about their bodies have been few and far between. In 1996, 17-year-old Resa Holsapple from Little Sioux, Iowa, wrote one of the first essays on body image published in a women's magazine. In "Our Muscle Mania Has Gone Too Far," Holsapple wasn't so much concerned about losing weight. She was concerned about her self-esteem, which was plummeting because she was a self-proclaimed "clumsy, uncoordinated, leaden-footed nonathlete" during the John Kennedy-inspired physical-fitness wave that swept through our nation's high schools. She wrote: "Like many of my fellow incompetents, I try to do the best I'm capable of. A few years ago that would have been enough. Now it leaves me feeling unpatriotic and disgraced.... Let P.E. classes produce fun as well as fitness."

Fourteen years later, Seventeen published a groundbreaking article, also written by a teenager, on the media's effect on body image. In "Let's Become Our Own Best Friend!" Lisanne L. Renner stated:

Physical appearance plays an important role in our emotional development. Hollywood makes us feel inadequate if our bodies aren't carbon copies of the professional beauties seen in movies or on television. We seem to be so busy wishing our figures were a perfect size five that we forget there is beauty in individuality.... Next time you look into a mirror, don't dwell on the negative. Instead, compliment yourself!

Apparently, her important advice went unheeded. Four years later, a Glamour survey revealed that, out of 33,000 female respondents, 85 percent felt dissatisfied with their bodies. This statistic has not improved over the years, most girls and women of the 1990s continue to be plagued by poor body image.

In her book Women Who Run with the Wolves, Dr. Clarissa Pinkola Estes breathes a breath of fresh air into our feminine cultural ideal as she shares the tale of La Mariposa, the Butterfly Woman. To Native Americans, Butterfly Woman comes to pollinate the souls of the earth as the female fertilizing force. She helps people transform themselves, like a caterpillar into a butterfly. She is the center of metamorphosis, bringing opposites together, strengthening the weak, making people whole by "taking a little from here and putting it there." Butterfly Woman "is big, really big.... Her hips are like two bouncing bushel baskets and the fleshy shelf at the top of her buttocks is wide enough to ride two children.... Her belly holds all the babies that will ever be born.... She is wide of thigh and broad of rump because she carries much." Butterfly Woman is full and whole with life, and she touches everyone. "It is her privilege to touch all.... This is her power."

It seems that, if women wish to be truly happy, we must let Butterfly Woman touch us as well. For how can we feel good about ourselves if we don't let her earthy, healing image sit beside the hard-body image of Cindy Crawford in our mind's eye and in the deep crevices of our hearts? To feel whole, we must mingle all our parts into an internal oneness. How can we feel whole inside if we are constantly dealing with the warring factions of sensuality versus fear and restriction? How can we give to others in relationships if we can't even feed ourselves?

All women - rich or poor, thin or fat, famous or not - can be caught up in poor body image and low self-esteem. It is important that we find ways to disentangle ourselves from that web. We must wriggle free before we can learn to really feel good about ourselves, body type and all. In doing so, we need to make friends with all our parts - our desire to be healthy and fit, our desire for friendship, our desire for the intimacy of a significant other, our desire to inhabit a peaceful mind, our desire for a successful career, our desire to look attractive, our desire to raise happy children, our desire to be creative, and so forth - so that, instead of hating the roll of fat under our buttocks or wishing our tummies were hollowed in, we can accept who we are and revel in that. Most of us would agree intellectually that diversity in bodies is as natural and acceptable as diversity in flowers or trees. We must learn to embrace this idea with our emotions and our spirits as well. For as Brooke Shields fights her war against cookies, she is really waging a war against her body. If she - if we - could only learn that eating cookies is one of our rightful choices, cookies would lose their power to punish us. Cookies would be on our side. We may choose to eat them (and there is nothing wrong with that), we may choose to wrap them up and give them to a friend, we may choose to save them for later or to throw them in the garbage. We would be like Butterfly Woman throwing feathers on ourselves, bringing opposing forces together, transforming our fear into strength, fertilizing our hearts, minds, and souls with compassion, confidence, and the power to heal.

Are we too intimidated to change? Are we too scared to look the media bullies in the eye and say, "No!"? Angela Farmer, an internationally nowned yoga instructor, was once asked by a student, "Why can't I do this pose?" Farmer replied, "You must soften your buttocks - that is, of course, unless you're afraid of losing a tight bottom" The quality of our lives would so greatly improve if we could only believe that a hard body isn't the only kind of attractive body and that having some softness and looseness may actually be beneficial to our health and beauty. (To look at Angela Farmer verifies this as fact.)

But how do we work on our self-image? How do we change our thinking and feeling habits in order to unite our various parts and neutralize the negativity that our culture blasts our way via the media@ Unfortunately, we can't wave a magic wand to make our culture more sensitive to our needs. But we can change our own attitudes: we can refuse to take the media so seriously and we can challenge the images and their devaluing messages. The only way our culture will change is if we stop believing in the social attitudes which make us feel not good enough and start believing in ourselves and our right to our individual body - even if it isn't a body type currently worshipped as fashionable.

Young women like Natalie Laughlin are leading the way. A plus-size model, she represents an alternative and has learned to feel good about herself even though she's not a size four. In a 1995 Glamour article, she states, "I don't restrict myself to certain styles and colors. The other night I wore a black velvet turtleneck bodysuit with a form-fitting sarong skirt - but I'm just as likely to wear red chiffon. Now when I work out, it's not about losing weight...it's about feeling better, feeling my own strength. I no longer base my worth on what my body looks like. I'm making peace with it"

Others are following in Laughlin's footsteps. Mandi Patterson describes herself as an overweight teen who is learning to value herself. In an essay published in Parade, she wrote: "I've been fat all my life. I've made a vow to lose weight... but I don't think I can reach my goals when I'm constantly feeling ugly and self-conscious. I'm learning to accept myself the way I am and to respect myself, even though I have a weight problem."

Nineteen-year-old Susanna isn't overweight but nonetheless has been deeply affected by media stereotypes She shared these thoughts with me in a casual interview:

I think there's a direct link between the models who are the most popular and girls feeling bad about their bodies. Almost everyone I knew in high school, except for me, had an eating disorder. I'm serious. I think the reason they felt like they had to lose weight is that the media portrays women having these perfect bodies. They aren't realistic. So girls feel they need to weigh less. This year I've gained 20 pounds and it looks different and I have to get used to that. I mean I really was like a wait, and now I'm more athletic. That's how I want to be. I don't want to be unhealthy.

In another conversation, Kate, age 12, pointing to a picture in a magazine, put it this way:

I like the sweater on this model and she's not a super-model. She doesn't starve herself, you can just tell. I'd be happy with that. That should be the kind of model that people should put in magazines, because it's just getting out of hand with people not eating. The models aren't eating, and girls look at them and think, "Look how pretty they are. Look how skinny they are. Maybe if I don't eat and I wear those clothes, I'll look just like them." Girls won't eat and then they make themselves throw up. I had a friend last year who stopped eating for a while because she thought she was too fat. But she really wasn't.

These young women are only a few examples of the many sensitive thinkers - young and old - who have begun to give media images a critical look. For an of us women - whether were students, homemakers, lawyers, heart surgeons, or super-models - are wounded warriors. We've been in the trenches fighting a war against our bodies for generations. Our healing has something to do with mending ourselves so that the wounded places can grow stronger, so that we have energy to cultivate the gardens that are ourselves.

Babies aren't born with the syndromes of compulsive over-eating, bulimia, or anorexia nervosa. Babies push away their bottles when they feel full. They bawl when they're hungry. They don't hate their bodies, in fact, they delight in their discovery of them! Just watch how babies try to suck their toes, wave their hands wildly as they giggle. They touch themselves everywhere - they love their bodies!

Likewise, most of us loved our bodies when we were small children and, if we've lost this gift, we can learn to retrieve it. It's waiting to be excavated, like a secret treasure. In our search to revalue our bodies, we must discover ways to detoxify ourselves - to find our personal antidotes to advertising's lure to be something different from what we are. We may learn to meditate, to cook and eat healthily, to exercise wisely. We may learn to request massages, to breathe deeply, to develop our values. We may write poems or paint or take singing lessons.

Whatever we do, whatever answers resonate within us as right, we may share them (especially with our children), but we must never lose sight of them. We must continually center ourselves. Being mindful of all this, we can reclaim our natural body rhythms, our natural body acceptance. If we refuse to give up, if we spread the message, we can change our culture as well.

Jill S. Zimmerman is a psychotherapist, writer, and lecturer specializing in women's issues. She has taught at the University of Chicago, Loyola University, and Northwestern University, has lectured widely on eating disorders, and is currently writing a book about body image.

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