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Eating Disorders, A Hidden Problem for Orthodox Jews

One in 19 Orthodox Jewish teenage girls in Brooklyn have an eating disorder, according to a study by eating disorder expert Dr. Ira Sacker. “It could no longer be swept under the rug” said Adrienne Ressler, a training director at a center which treats Orthodox Jewish eating disorder patients.

When Faryn Hart settled into her seat at the weekly Shabbat table set for 20 at her home in Johannesburg, South Africa, she also settled into the role her grandmother expected her to play.

Yes, she would study medicine. Yes, she would marry an engineer. Yes, she got an A on her exam. And yes, she’d take another helping of whatever was coming from the kitchen.

Even as the ballerina and popular Hebrew day school student effortlessly spit out the right answers, her mind was awash in torment. As the food was passed around—fried sole, fish cakes, salad oozing with mayonnaise—her instincts to binge and purge became uncontrollable.

“I was not present,” Hart, now 24, recalled. “I was in the conversation but completely thinking about the food. It wasn’t about the ritual, it was about the ego. Perhaps it was a way to deal with the discomfort of a family that put so much pressure on me.”

The eating disorder Hart struggled with throughout high school and at the University of Florida reflects an alarming trend that’s long been a hidden problem for Orthodox Jewish women.

Though statistics are few, eating disorder expert Dr. Ira Sacker found in a 1996 study that one in 19 Orthodox Jewish teenage girls in Brooklyn had an eating disorder—about 50 percent higher than the general population.

The Philadelphia-based Renfrew Center, which treats patients with eating disorders at nine U.S. locations, reported this year that 13 percent of its Florida and Philadelphia patients identify as Jewish—up from 5 percent just three years ago.

Renfrew recently launched a first-of-its-kind treatment track geared specifically for Orthodox Jewish patients.

“It could no longer be swept under the rug,” said Adrienne Ressler, Renfrew’s national training director. “But we were not as aware of all that was involved in the treatment of this population.”

There were no such programs when Hart sought treatment two years ago, so she constructed her own program when she took a job as a manager at the eco-friendly Hostel in the Forest sustainable farm and retreat center in Brunswick, Ga.

“It’s not this evil thing anymore,” Hart shared of her relationship with food. When she toils in the garden’s acre of produce, she often thinks, “this is what a zucchini looks like—it’s beautiful. It’s magical.”

The Orthodox Union sought Renfrew’s help last year, just a few months after the organization released “Hungry to be Heard,” a documentary that profiles observant Jews who struggle with eating disorders, and a community reluctant to acknowledge them. The two organizations have since hosted conferences and workshops in New York and Bethesda, Md.

“It took a lot of courage for the Orthodox Union to approach us,” Ressler said. “They wanted to help families get past the shame of admitting they have a problem—(one) that may reduce the chance of making a good marriage contract.”

The challenge of treating Orthodox Jewish patients is twofold: dealing with the logistics of kosher food requirements, and addressing the subtleties and complexities of the tight-knit culture that surface during recovery.

When Rocky Horwitz, 19, was admitted to Renfrew’s facility in Coconut Creek, Fla., two years ago, the center wasn’t equipped for kosher dietary laws. The staff ordered in from a kosher restaurant, but being served eggplant Parmesan—while the rest of the patients ate bean fajitas—added stress to an already fraught situation.

“I was freaking out that I was having more calories (than the other patients),” Horwitz recalled. “My plate looked different from everyone else’s. My portion looked bigger.”

Julie Dorfman, nutritional director for Renfrew’s Philadelphia center, recalled tensions when Orthodox patients were served a cheese sandwich while others were served pizza.

“Some foods are categorized as `scary,”’ Dorfman said. “The fat in a cheese sandwich is contained, not as visual. But the grease on the pizza is visible and there’s the temptation to blot it with a napkin.”

Since then, the Renfrew kitchens in Florida and Philadelphia have been retooled to serve kosher dairy and kosher vegetarian fare.

Dietitians and therapists were also taught how to discern problems related to religious rituals from those related to an eating disorder.

“The control of food that’s necessary in Judaism is very different than control of food around someone who has an eating disorder,” said David Hahn, a psychiatrist at Renfrew’s Philadelphia center. “It may look the same, but it’s not.”

At the same time, though, treatment staff have learned to be wary of patients who actually use their kosher observance as a stumbling block to recovery.

Becca Shrier, 27, a graduate of Renfrew’s Florida program before the Orthodox track was implemented, often relied on her kosher practice—fasting from breads or pasta during Passover, for example—to secretly limit her caloric intake.

“I used my religion as an excuse to engage in my eating disorder over and over again,” she recounted.

The problem is as much cultural as kosher, experts have learned. They discovered that a skinny bride in her early 20s is often idealized as the ultimate prize, as well as her quick evolution into a mother of a large brood.

“I speak to boys who tell me they want someone who’s a size zero or size two,” said Frank Buchweitz, director of community services and special projects at the Orthodox Union.

Such issues are now incorporated into Renfrew’s group therapy sessions and Jewish-themed classes, starting with the text of a traditional prayer sung by husbands on Shabbat.

“There’s many things your wife is supposed to be—gracious, kind and wise,” Hahn said. “Thin is not one of them.”

Religion News Service
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#1 Comment By Just saying it as it is On July 29, 2010 @ 8:00 pm

Unfortunately this issue will continue to be swept under the rug in Crown Heights as most people will only care as to whether or not the girl plans to wear a sheitel and be model thin all the time..oh yeah and says yechi. Any other issues such as this one will be deemed “goyish”

#2 Comment By ch On July 29, 2010 @ 9:46 pm

very sad but true

#3 Comment By chani On July 29, 2010 @ 10:07 pm

to number 1. its not just about being goyish
we came to a point where alot of people have a need to live up to the johnson’s

#4 Comment By Guy On July 29, 2010 @ 10:38 pm

A different question:
Why is it normal for a girl to ask that the guy should be taller and in no way he can be shorter, but if the guy wants a girl to look normal/thin then it’s goyish, not important, etc.

#5 Comment By WAKE UP!! On July 30, 2010 @ 12:57 am

Finally, a wake up call! Women often feel this pressing need to be a size 0 or 2, thanks to the outside media influences, and to boot, our inner pressure. Its not realisitic expectation that a mother of, lets say 3, weigh the same as a newly married woman. We pressure our own kind, without words, and try to out-do eachother on everything! Cars, money, house, weight. We must ease the pressure and learn to make do with what we have.

Kuddos to Dr. Sacker who realized there is a need for this. We must appreciate our bodies. Hashem made us who we are.

#6 Comment By Sara H On July 30, 2010 @ 2:36 am

As a mother of a daughter in recovery I can say it is a difficult scary process and we thank Hashem every day for her recovery and continued good health. If a boy is looking at the outside of a girl for the ideal mate, he is not the boy for our daughter

#7 Comment By ZELDA On July 30, 2010 @ 3:13 am

Also Beware that Naturally Skinny girls are getting HARASSED by ‘WELL MEANING’ women, and that is actually very psychologically damaging to them.

Just as Bigger girls should like the way they are, so should all types!

Think a little before bothering people.

#8 Comment By agree with #7 On July 30, 2010 @ 3:39 am

To Zelda you are so right!

#9 Comment By Chanie On July 30, 2010 @ 4:03 am

FINALLY! Thank g-d my friends are all healthy and baruch Hashem happy with their self image.
If the individuals going through the treatment would accpet that their friends and family only mean to help, the healing process may be easier and quicker.
A cousin of mine cut off her friend who tried to help her. The family turned their backs on her friend as well. I think that therapy needs to be enforced as well to let the individual speak their mind and let the therapist help them understand people want to HELP.

#10 Comment By why is it more by us? On July 30, 2010 @ 4:54 am

I think its because frum girls are so separated from guys so they have a lower self esteem. They think that all guys only care about their waist size (which is not true). In other circles girls that are not skinny but have other likeable things about them will still get feedback from guys (which is what they really care about) so they’re not as worried.

#11 Comment By Road to Recovery On July 30, 2010 @ 3:45 am

This is a very important topic and needs to be addressed. I have been dealing with anorexia nervosa for 10 years. I am BH at a healthy weight now, but it took years to get to this point. It was very challenging, especially because I’m an orthodox Jew. I had to be hospitalized because I was malnourished. My doctor started me on a strict meal plan and TPN ( Total Parenteral Nutrition) I was very sick, my kidneys and liver were failing and my body was so depleted. I had to consume a ridiculous amount of calories to get well. It was exhausting having to explain the kashrus laws over and over again. At times they thought I was using kahrus as an excuse, to get out of eating whatever was on my meal plan and it was very frustrating. Obviously not everyone understands the extent of our dietary restrictions and we (my parents and I) were very patient with them. Eating disorders are a reality, a very serious one. They are not “goyish” although some feel that they are. The pressure to be thin is everywhere, it cannot be avoided. Those that have been diagnosed with an eating disorder and their families should know that they are not alone and that there is help out there.

#12 Comment By Kristina On July 30, 2010 @ 4:07 pm

Amazing article! Rocky—I had no idea they actually implemented all that at the frew! Thats great! And congrats on all your hard work!

#13 Comment By Worried single girl On July 30, 2010 @ 7:29 pm

I am a 17 year old frum girl who will be looking for a shidduch in a few years. I was not brought up with yiddishkeit, so the whole shidduchim system is something I have had to learn about. Two years ago I developed an eating disorder and gained 40 lbs. In addition to the dealing with my own feelings about this and trying to resist the urge to go to the other extreme and starve the weight off, I often hear about guys coming up with a list of attributes they want in a girl, primarily that she be thin and pretty. While no one should marry someone they aren’t attracted to, I worry that no one will be interested in me because I’m a size 16. Like most girls I am learning and working on my middos, but I wonder if anyone will notice as long as I’m not a size 0.

P.S. I don’t care if my husband is tall or what he weighs. If he is my bashert he will be exactly the way Hashem made him to be, and as far as I’m concerned that’s perfect.

#14 Comment By The Emporer-s New Clothes On July 30, 2010 @ 5:44 pm

Sorry for stating the obvious, but the main reason it is hidden is for fear that it will negatively impact someone’s shidduch prospects.
Having been there as a mother, I dont look at it as “negatively impacting”, I look at it as a weeding out process for us.
Lucky is the person who will marry my child, who is mature and good and wise and strong and real and happy, and who had courageously fought this problem, and is in recovery, boruch hashem.

#15 Comment By been there On July 30, 2010 @ 4:23 pm

I was b’h lucky to see the warning signs and got help for my child before it was too late. Thank you, staff at Dr. Rosen’s office for connecting us with Dr. Sacker. he saved my child’s life!!

#16 Comment By Judy On August 1, 2010 @ 2:36 am

I’m a shlucha and mother of four children. Eating disorders was always ‘out there’ but never in ‘our’ community. When my daughter started ‘acting out’ I called Mrs. Bronya Shaffer and that was the first time I ever heard about eating disorders in our midst. Then began a painstaking journey to find her the help she needs, first facing the terrible ‘stigma’ in our community. She helped my family through this, and even found a place in Eretz Yisroel that caters specifically to frum girls. This is a terrible disease and it takes years to beat it. The most important thing is to have good doctors and good therapists, and together with that a good mashpia to help you along every step of the way. I was lucky to have you, Mrs. Shaffer (I hope you read this!).

#17 Comment By anonymous On August 1, 2010 @ 6:10 am

This is a great article, but I can’t help feeling that it has not captured the depth and horror of what it is like to have an eating disorder. I think non-sufferers might read, “I was freaking out…” and think they understand because they can relate to freaking out when they got a bad haircut, missed the bus, fell asleep while studying for finals, or realized they wore a stained shirt to work/school. When it says freaking out, it’s talking about an intense feeling that most people probably don’t ever feel over something like this, its so intense it could be hard to breathe…its fear, uncontrollable fear, but of something that shouldn’t be fearful, so the person is probably ashamed and embarrassed of this feeling. This feeling in someone with an eating disorder can be caused by seeing food, knowing they are going to be made to eat food, or in this article’s example, having to drink, let’s say, 3/4 cup of cholov yisroel milk while everyone else gets 3/4 cup non-kosher milk which might have 10 calories less. But I guess the point of this article was to portray how hard it is to have an eating disorder in a non-jewish treatment center, which is an important issue and VERY HARD to deal with.

#18 Comment By Observer On August 1, 2010 @ 4:27 am

#4 Thin and normal are NOT the same at all. Any guy who does not understand this is not, in my opinion a good marriage candidate, unless he grows up really, really fast. Why should any sensible girl take that chance? Even one who actually IS very skinny without obsessing over her weight should watch out for such a guy.

#19 Comment By v-nishmartem me-od es nafshosaichem! On August 1, 2010 @ 8:02 am

being super skinny is not always pretty! some peoples bones are shaped differently and no matter how they starve themselves, they wont get to model skinny! just being healthy is beautiful. if a person needs to lose weight, just eat healthy! and excersize. those who are skinny should also eat healthy and excersize!

#20 Comment By S.F. On July 30, 2010 @ 10:25 pm

If there is anyone who knows anyone struggling with an eating disorder now please tell them to visit this website: http://www.roaed.com. This is a wonderful organization that I volunteer for that helps people with eating disorders and their families. They set the one who is sick up with a mentor(usually someone who has recovered themselves) who talks to them and supports them and encourages them through treatment as someone who went through it themselves. They have mentors available for siblings and parents as well. The organization also has support groups for the person suffering and separate ones for their family and they are tailored for specific eating disorders as well. They also can hook you up with a therapist if you do not have one yet. The support groups and mentor program are both completely free. For a therapist they evaluate you based on tax returns etc and try to help out in any way they can. In addition, they have various workshops that are extremely helpful as well. It is not a Jewish organization but they have experience helping frum people.

#21 Comment By Magen avrohom mentoring On August 1, 2010 @ 6:50 pm

Magen Avrohom – education, guidance and support for families dealing with eating disorders in the observant Jewish community. (718)222-4321 or (877) HELP- EAT.

#22 Comment By a women On August 2, 2010 @ 2:02 am

not just girls all kind of women. my friend is 70 years old and still has eating disorders.

#23 Comment By Where did the statistic come from? On August 2, 2010 @ 8:47 pm

To put a statistic “One in 19 Orthodox Jewish teenage girls in Brooklyn have an eating disorder, according to a study by eating disorder expert Dr. Ira Sacker.” without a citation of the study is terrible journalism.

#24 Comment By ChayaCH On October 20, 2010 @ 2:33 am

All i can say is that the girls should be practicing sports or going to the gym to be healthy, but they don’t need to be size 0 and look anorexic!!