Among Jewish women, eating disorders go underreported

COCONUT CREEK, Fla. | Hilary Waller remembers begging her mother to let her fast on Yom Kippur. At 10 years old, she was a bit too young, but embracing the rigid discipline seemed desperately important.

“It felt like I was practicing not eating. It was something that was reassuring and gave me strength and a sense of pride,” said Ms. Waller, now a 28-year-old teacher at a religious school in Blue Bell, Pa.

It was the same rush she got years later in college each time she saw the scale tip downward. Ms. Waller, who suffered from anorexia, starved herself until she stopped menstruating, lost some of her hair and was exercising several times a day.

Health experts say eating disorders are a serious, underreported disease among Orthodox Jewish women and to a lesser extent others in the Jewish community, as many families are reluctant to acknowledge the illness at all and often seek help only when a girl is on the verge of hospitalization.

Several studies indicate a rise in the problem, and those who treat eating disorders say they are seeing more Jewish patients. A new documentary, books and facilities have cropped up to help.

Ms. Waller’s family, which belongs to the Conservative branch of Judaism, fasted only on Yom Kippur, but she began fasting other holidays. “And not for religious reasons,” said Ms. Waller, who checked into residential treatment after college - more than a decade after she began struggling with her eating problems.

As eating disorders have become less taboo in mainstream U.S. culture, they’re still widely ignored in Orthodox Jewish communities, as families worry the stigma of mental illness could ruin arranged marriages for the patient and even her siblings. Strict food rituals of fasting and remaining kosher can also exacerbate the problem.

Israel has one of the highest rates of anorexia, bulimia and binge eating in the world, said Yael Latzer of the University of Haifa. No organization tracks the numbers of eating disorders among Jewish women, which experts say is partly because of a cultural reluctance to divulge the illness, but studies in different countries and Ms. Latzer’s research indicate a high rate in Israel.

When Catherine Steiner-Adair arrived in Israel more than a decade ago amid pleas from Jewish activists alarmed by a spike in eating disorders, she recalls patients were so afraid to get help that they sent a proxy.

“A nurse would come up to me on the street and say, ‘Please help me. I’m here on behalf of a 19-year-old girl who’s lost 30 pounds, but she can’t ask for help because she comes from a very religious family, and they think it’s good [for her to be underweight] because it’s better for marriage-making,’ ” said Ms. Steiner-Adair, a clinical instructor in Harvard Medical School’s psychiatry department. “I was overwhelmed by the needs and the requests.”

Experts say the Orthodox community is sending mixed messages to young women. Parents, matchmakers and potential mates want a svelte bride, but may shun a woman who divulged she has an eating disorder because of the stigma of mental illness.

In 1996, Dr. Ira Sacker, who practices in New York and has written several books including “Regaining Your Self,” studied selected Orthodox and Syrian Jewish communities in Brooklyn and found that 1 out of 19 girls was diagnosed with an eating disorder - a rate about 50 percent higher than the general U.S. population.

“It is of prime importance within the Jewish Orthodox community the bride appear to be as flawless as possible,” said Rabbi Saul Zucker of the Orthodox Union, which represents Orthodox synagogues in North America.

A mental illness, such as an eating disorder, “would be a terrible, terrible blemish and people will go to unbelievable lengths to hide it,” he said.

But recent efforts are aiming to stop the trend. The Orthodox Union, which has been an advocate for treating drug abuse and other taboos in the Jewish community, recently released a documentary “Hungry to be Heard” about the illness and started two support groups in New York City.

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