Do families with an eating-disordered member have more physical and psychiatric disease? Studies produce different – and conflicting – answers. There does appear to be a higher incidence of weight problems, especially among families with a bulimic child. And the rate of depression is higher, again particularly among bulimics, than in the population as a whole.

What about personality? Is there a “typical” eating disorder family? Are there certain traits that would lead a bystander to say, “If the Joneses aren’t careful, they’re going to turn their daughter into an anorexic one day”?

No, although a lot of studies claim to identify such traits. One researcher, Dr. Joel Yager of UCLA Medical School, took a close look at these studies. He found they contained more different “family portraits” than you’d find on the walls of a photographer’s waiting room.

One such study declared that an anorexic family was characterized by a fussy, nervous mother and a father who alternated between being quick-tempered and laid-back. No, said another, an anorexic’s mother is robust and nagging, her father passive. Wrong, said a third; fathers are domineering and aggressive. Close, another chimed in; fathers are domineering but ïîï aggressive. Or sometimes domineering or sometimes not. Depending on your source, mothers are either attached or ambivalent toward their daughters; they are too strict or too lenient. Fathers are lenient, kind, and affectionate. No, they are cool, antagonistic, and hostile.

Remember the blind men and the elephant?

As Dr. Yager concluded, “If common personality patterns are to be found in these families, they will have to be at more subtle levels.”

Does this mean that therapists must start from scratch every time a family walks into their office? Is there any pattern among eating-disordered families that provides some basis for therapy?

Yes – sort of. Recent research has found a number of different patterns among anorexic families, but certain anorexic families do fit to some extent the “model” of functioning I’ll describe in a minute. While these traits are by no means universal, they may provide a good place to begin working with an anorexic family.

Perhaps the most important trait is the lack of joint parental authority. The parents disagree about basic issues in child rearing. As a result, the child gets mixed signals; she doesn’t know what’s expected of her.

Another common theme is that the mother tends to be the center of the family. Fathers tend to be absent because of work, death, or divorce. The children understandably develop closer relationships with the mothers.

The stereotype of an anorexic family is that the members all think and act as one unit—they are, to use the technical term, highly cohesive. Conversely, bulimic families are often thought to be highly disorganized. The reality is much more complex. Some anorexic families are so chaotic they can’t plan a trip to the mall without arguing, while some bulimic families stick together like Velcro. Interestingly, as the patient gets older and is ready to leave home, some families grow more cohesive. It’s as if they realize that the illness has served as a stabilizing force, and they are reluctant to face the changes that will befall once the patient leaves.

Families can sometimes delude themselves that the eating disorder is the only problem they must confront. One father said, “If only Gwen weren’t starving herself, we’d be the all-American family.” Such families are sometimes in for a rude shock: When the eating disorder abates, they must confront the presence of other issues in their lives.

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Since 1992, Linda Matulin has lost 400 pounds, a full two-thirds of her body weight. The 44-year-old Tucson resident attributes her success to discipline, determination, and one well-timed television show.

At her heaviest, Linda carried more than 600 pounds on her 5-foot-6-inch frame. “I don’t remember a time in my life when I wasn’t overweight,” she says. “But I really started to gain when I got a job working third shift. I don’t know why, but I ate all the time.”

Linda went on and off diets, never making much progress in her battle of the bulge. “Maybe that’s because I never tried really hard,” she says. “It may be difficult to believe, but I never saw myself as fat, even at 600 pounds. I lived a full life, doing everything I wanted—socializing with friends, going to concerts, traveling.”

Her mindset abrupdy changed on the day that she happened to catch a television interview with country singer Lorrie Morgan. “The interview had nothing to do with weight loss or fitness. Lorrie was talking about herself and her life—how she took control and made changes,” Linda recalls. “For me, something clicked. I became absolutely convinced that this time, I could really lose the weight.”

Despite her excitement, Linda said nothing to her family. “I knew that they meant well, but I didn’t want their advice,” she says. “The people closest to you tend to put a lot of pressure on you when you’re dieting.” She’d been through all that many times before, when she had tried different diets—and failed.

On her own, Linda began making dramatic lifestyle changes that supported her weight-loss goals. Most important, she stopped eating on autopilot, instead letting her body tell her when it needed food and how much. “It had always been telling me these things,” she says. “I just never took the time to listen.”

Having grown accustomed to eating as much as she wanted, whenever she wanted, Linda found the going to be tough at first. She had days when she devoured almost anything in sight. “But the more I focused on my body’s hunger signals, the less food—especially fatty food—appealed to me,” she says. And that’s when she started to lose weight.

Linda also looked for ways to be more active during the day. | She started with some gentle movements in her backyard swim- ST ming pool. After she dropped some pounds, she graduated to working out on a treadmill. “I’d do what I felt like doing on a par- § ticular day,” she says. “I didn’t have a set exercise plan, but I tried to move around a lot.”

Even as she lost weight, Linda continued to conceal her § trimmer physique under her newly baggy clothes. “I remained reluctant to tell my family what I was up to because I didn’t want them offering me advice,” she explains. When she finally broke down and bought some smaller-size attire, she wowed even those closest to her. “They were surprised, to say the least,” she says. “But they were really happy for me, too.”

Today, Linda is literally a shadow of her former self. In the years since she first began her weight-loss program, she has dropped to 200 pounds. She hopes to get down to 175 pounds, a goal that is certainly within her reach.

“Sometimes, I get a little frustrated because I’m not there yet,” she says. “But then I remind myself that I didn’t lose 400 pounds overnight. I’ll achieve my goal in good time.”

WINNING ACTION

Remember that you can do it. Linda’s story is an important inspiration for all of us. No matter how many pounds you want to lose, even if it’s 400, you can succeed. It may take some time—but remember, if Linda could do it, so can you.

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