It was early evening and I was getting ready to take a bath. The day had been exhausting, but these days, that's the way they all were. I had worked for nine hours and then exercised for two and a half. Before stepping into the bathtub, I stood before the mirror and stared at my legs in utter disgust. I felt betrayed by them. They were so big and ugly. I desperately wished I could change them. I was willing to try just about anything. I gripped the back of both legs and pulled at the skin and fat so I could see how they'd look if they were smaller.... I looked down at my sore stomach and started yelling at it for being sore.

In her 1997 book Leaving Food Behind, Sheila Mather describes candidly her recovery from bulimia, starving, and overeating. At age 18, after three years of restricting her diet, binging and purging, and exercising obsessively in pursuit of perfection, Sheila was 5'8"and an enviable 115 pounds. She also had receding gums, brittle hair, an ineffective digestive tract, a slow metabolism, constant fatigue and bruises across her abdomen (from forced vomiting). She had "hit bottom," and she knew it was time to change.

Odds are that many of the women lugging their books around your campus this semester carry the enormous burden of an eating disorder. For them, as for Sheila, there is much more to an eating disorder than eating. It's more than being caught up in food. It's about how a woman feels about herself, how she sees her body, and, most significantly, how she avoids the pain in her heart. It's a vicious cycle of thoughts, behaviors, and physiological consequences.

Worse yet, this burden can be contagious. If a woman is already vulnerable, the temptation to starve or overeat can become irresistible when others around her are doing it on a daily basis. A recent article in People magazine describes a sorority house where the pipes clogged because so many women vomited into the toilets every day. Wendy Shalit in her 1999 book A Return to Modesty refers to a woman who does not even think twice about the abnormality of eating chocolates right in the bathroom — so she can throw them up immediately. In some college communities, eating disorders are so common that they seem normal. The fact remains: they are not normal. No matter who else practices them — even supermodels! — the habits involved in an eating disorder are harmful.

Normal, healthy behavior does not cause bad breath, swollen cheeks, abdominal pain, and constant weight fluctuations. Persistent purging can cause fatigue, heart palpitations, seizures, and death. Anorexia, a glorified way of starving the body, will cause all the same problems. One of life's cruelest ironies is the anorexic who, presumably in pursuit of beauty and perfection, dies with a stomach bloated like a Third World child and brittle hair, orange at the roots due to malnutrition.

So, where do eating disorders come from?

Once the vicious cycle has begun, it's hard to pinpoint an original cause. Counselors at Remuda Ranch and Sierra Tucson (inpatient treatment centers) often find that relatives of bulimics struggle with depression, manic-depressive disorders, alcoholism, or eating disorders themselves — which suggests a possible genetic predisposition. Other psychiatrists follow the book and call it a disease.

The most recent version of the Diagnostic Statistical Manual (DMS-IV), published by the American Psychiatric Association, defines bulimia as recurrent episodes of binge eating, along with attempts to compensate for this behavior by purging, fasting, or excessive exercising, least twice a week. While this clinical definition is helpful when diagnosing the problem, it may lead some to look for a quick solution: a parent to blame it on, or a pill to take.

Others take a more head-on approach. Florence Wolfe, a Christian guidance counselor at a private Maryland high school for 17 years, has seen her share of eating disorders among students. Whether a student is toying with anorexia or immersed in bulimia, Wolfe says she has found that it all begins with a conscious choice. True, the culture screams "thin is in" at every turn, but ultimately we each have control over our own actions.

Mrs. Wolfe prefers to start with the "honesty factor": When a woman is deliberately starving herself or bingeing and purging, she has begun lying to herself and deceiving her parents, boyfriend, and anyone else who cares about her enough to object to anything that hurts her. Mrs. Wolfe encourages her students to take ownership of their own choices, and of the greed or gluttony involved in their behavior.

Taking ownership does not necessarily mean that a woman is to be condemned and punished for her choices. Often there are deep issues behind eating disorders: At the very least, her friends and parents may have pressured her to be thin. Worse, she may have been abused or traumatized, and is now living in fear and self-hatred. Still, the first step to recovery is finding a better way to deal with the pressures from others, or the abuse suffered, or the lies of the culture. Self-abuse is not the answer.

My friend Dahnna recovered from bulimia in college because she realized the deep love that God has for her — no problem can overwhelm her as long as she is aware that she is passionately loved by a personal God. She thinks of the behaviors involved in bulimia and anorexia like dandelions on a lawn: We can run the lawnmower over the "flower" (i.e., cure the symptoms), but new flowers will just pop up the next day. The only way to cure the problem permanently is to get at the root. Those who have had the most success know that the root is usually in the heart.

To cope with emotional pain, many of us eat (or to avoid eating). For some reason, this "works" at first. Even when the physical pain of starving or vomiting becomes intense, it still seems better than facing the very real and poignant emotional pain. The truth, however, is the only thing that will set a person free.

Another college friend, Carolyn, who still has intense emotional pain from her past confided that her mind "just races" at times — filled with memories of abuse, hateful thoughts about herself, loneliness, and a desire to eat until she vomits — which only leads to more self-condemnation. She is a Christian, but in the depths of her struggles, she can hardly muster up the strength to believe. She has learned that in order to prevent these horrible experiences, she needs to attend certain counseling groups regularly — to help her heal and forgive, and to remind her of the truth that she is not alone.

If you are struggling with an eating disorder, the first thing to do is tell someone else. Healing comes from a lot of talking, thinking, working, and listening — especially, listening to your heart. This will require honesty. You will need someone objective, someone outside of yourself, to help you process all your thoughts and feelings.

Granted, it seems embarrassing and scary to entrust someone else with such personal information. So choose carefully who you tell — but do tell someone. Peers may not be the best option; even family members who love you dearly may not know what to say or do to help you get at the root. In fact, those who care about you will not want to see you hurt, so they may try to help you distract yourself from the pain. A licensed therapist can be objective, and will keep everything absolutely confidential. He or she can help sort through all the confusing thoughts, and speak some trustworthy truth into the situation.

A good counselor or program will also hold you accountable — that is, they will empower you by encouraging you to make good, healthy choices about what to do with your body. They will not allow you to make any excuses that will keep you in the destructive patterns. If you sincerely don't know how to feed your body well, a nutritionist can help.

Important Points to Remember:

You are not alone. Many women in college suffer with eating disorders — bulimia and anorexia together form the third most common illness among adolescent females. Intake counselors at Remuda Ranch in Arizona report 500 calls each month — and these are only from the women who are hurting enough to ask for help! Those counselors are there to help each and every woman figure out the best way to tackle her problem — call them. Or call Focus on the Family (1-719-531-3400 ext. 2700) for the number of a trustworthy counselor in your area.

Healing will take work. Most women aren't "fixed" overnight. Sheila Mather worked through guilt, fear, shame, inferiority, anger, and grief from her past from age 25 to 30. Every day she had victory, she confronted the false messages in her mind that had played for so long and allowed her to be so hard on herself. Some days she slid back into old patterns, but once she had begun the path to recovery, she could only press forward to wholeness. Sheila wouldn't trade any of the hard work for something less than the freedom she has now:

I woke up on a beautiful summer morning and leapt out of bed. I felt a drive to live! The past was behind me. I felt no need to cling to it or change it in any way. Today was a new day with new choices.... I looked forward to new challenges. What other people thought had no bearing on my choices....I liked who I was. I wanted to be all that I was. I was eager to live life. I was ready. I knew that there would be times when I would feel overwhelmed with fear. I knew that shame would always be a part of my life. I knew that I'd experience pain and disappointment, probably many times. But joy and love were at the centre of my thoughts. I had hope. I had excitement. Negative thoughts no longer ruled, although they were still present.

You do want to be free! Human beings were not created to live in the kind of misery that bulimia and anorexia cause. You were made to be free, and God wants to set you free. You can use food as it was intended — to nourish your body. You can be free to feel — to hurt, to be confused, to be sad, to be repentant, to be angry. You can even laugh again — a light, joyful laugh from the depths of your soul. Your healing depends partly on your desire. If you truly want to be free, remind yourself of that every moment, and ask others to help you remember that.

When Paul the Apostle petitioned God to remove his "thorn in the flesh," the Lord replied, "My grace is sufficient for you, for my power is made perfect in weakness." So Paul decided, "I will boast all the more gladly about my weaknesses, so that Christ's power may rest on me. That is why, for Christ's sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong."

God specializes in taking the "weaklings" of the world and turning them into strong and beautiful souls. In his eyes brokenness is not a failure; it is the gateway to deeper spirituality. (From Judith Couchman's Designing A Woman's Life: Discovering Your Uniques Purpose and Passion.)

If you want freedom from the compulsion to eat, or if you are unsure if you have an eating disorder, call one of the numbers below. A counselor will help you discern your own situation, and advise you on what to do next.