More threads by David Baxter PhD

David Baxter PhD

Late Founder
Shy about eating in public: A precursor to anorexia?
September 19, 2007

Whenever Leslie Lipton was handed a menu, she'd freeze.

She suddenly would feel that all eyes were upon her, noticing and judging her eating habits. This was something she couldn't quite swallow when she was a teenager.

"I'd sit there, and I'd wait, and I'd see what everyone else was ordering before I ordered," says Lipton, now 21 and a student at Barnard College in New York City.

Lunch in the high school cafeteria felt like a competition. "Everyone would be looking at everyone else's tray to see what everyone else was eating," says Lipton. "If you eat less, at least the comparisons are good."

Lipton says this reluctance to eat in public was the prologue to her anorexia, the starvation eating disorder from which she has since recovered. But, she says, many girls across the country avoid food in public even if they eat normally at home.

This self-conscious group is convinced that without the classical symptoms of an eating disorder, such as extreme weight loss, there's no problem.

But parents and friends are often left wondering at what point such behavior indicates that an eating disorder is brewing.

Lipton, who now speaks to girls across the country about eating disorders and her recovery, says the phenomenon is "rampant." The author of Unwell: A Novel, which was published last year, Lipton blames society's emphasis on thinness. "People don't seem to look at girls as needing food," she says.

A lesser-known disorder
"Anecdotally, that's a pretty common sort of scenario: not wanting to be appearing to eat or competing either implicitly or explicitly to eat less," says Doug Bunnell, a clinical psychologist and eating disorder treatment specialist in Connecticut and a former president of the National Eating Disorders Association.

Not eating in public is one of several behaviors known in the eating disorder community as EDNOS, or eating disorders not otherwise specified. Purging occasionally, chewing a large amount of food but spitting it out, and obsessively dieting also fall into this category.

"That is where people fall in the cracks," says Lynn Grefe, chief executive of the National Eating Disorder Association, which will hold its annual conference in San Diego next month to help families, treatment providers and educators. "They're not getting treatment, and they think, 'I don't really have a problem, do I?'"

Bernardo Carducci, director of Indiana University Southeast's Shyness Research Institute, calls it the Scarlett O'Hara syndrome. In a famous scene in Gone With the Wind, Scarlett's maid tells her not to eat at a barbecue if she wants to uphold her reputation.

"She's pulling her in that corset, and then she's saying, 'We want you to eat a little bit now so you won't eat when you go to the party,'" says Carducci, adding that the message reinforces stereotypes about feminine appearance and social behavior.

He says that when adolescents think like that, they're vulnerable to eating disorders. "They control their eating as a way to sort of control all this change that's occurring in their life, but they also use this as a way to control what other people think about them," he says.

James Mitchell, president of the Neuropsychiatric Research Institute in Fargo, N.D., focuses on eating disorders in his research. He says the large number of girls who don't eat in public is under the radar because weight concerns are so prevalent in this country.

While this behavior is a phase for some, the consequences could be serious for others, experts say, including malnutrition and the progression to a full-blown eating disorder. Bunnell says those are real risks for young women when body image and weight have become the dominant measure of self worth.

Grefe has even talked to grown women who gave up eating in public for life after being teased in elementary school.

"They're not seeing it as a joyful time to interact with family and friends and breaking bread," she says. "They're seeing it as a test or it says something about them."

Early treatment recommended
Lipton urges girls to seek treatment early.

"I don't think there's really that much of a difference between convincing yourself it's OK to be anorexic and convincing yourself it's OK not to eat in public," says Lipton. "Even if you're not classically anorexic and 50 pounds, that doesn't mean that you don't have a problem. That doesn't mean that there isn't help out there to be had."

Experts give this advice to girls struggling with this issue:

  • Learn about eating disorders. Treatment and information resources are available at the National Eating Disorders Association or by calling its hotline at 800-931-2237.
  • Befriend girls who have healthful eating habits and are comfortable with eating in public.
  • Volunteer or get a job that involves serving others. Such activities build confidence and forge connections with people who evaluate each other based on willingness to help, not weight.
  • Talk to a trusted adult or a guidance counselor. Cognitive therapy or other forms of professional counseling can provide an awareness of negative thought processes.
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